BMJ  2003;327:75 (12 July), doi:10.1136/bmj.327.7406.75

Paper

Extracorporeal shock wave therapy for plantar fasciitis: randomised controlled multicentre trial

¹ Orthopädische Klinik, Universität Regensburg, 93077 Bad Abbach, Germany, ² Orthopädische Klinik Kassel, 43131 Kassel, Germany, ³ Orthopädische Klinik, Johannes Gutenberg Universität Mainz, 55131 Mainz, Germany, ⁴ Klinik für Orthopädie, Martin Luther Universität Halle, 06097 Halle, Germany, ⁵ Rehbergklinik St Andreasberg, 37444 St Andreasberg, Germany, ⁶ Orthopädische Klinik, Christian-Albrechts-Universität Kiel, 24105 Kiel, Germany, ⁷ Orthopädische Klinik, Ludwig Maximilians Universität München, 81377 München, Germany, ⁸ Medizinische Biometrie und Epidemiologie, Philipps-Universität Marburg, 35033 Marburg, Germany, ⁹ Koordinierungszentrum Klinische Studien, Philipps-Universität Marburg, ¹⁰ Medizinische Biometrie und Epidemiologie, Philipps-Universität Marburg

Objective To determine the effectiveness of extracorporeal shock wave therapy compared with placebo in the treatment of chronic plantar fasciitis.

Design Randomised, blinded, multicentre trial with parallel group design.

Setting Nine hospitals and one outpatient clinic in Germany.

Participants 272 patients with chronic plantar fasciitis recalcitrant to conservative therapy for at least six months: 135 patients were allocated extracorporeal shock wave therapy and 137 were allocated placebo.

Main outcome measures Primary end point was the success rate 12 weeks after intervention based on the Roles and Maudsley score. Secondary end points encompassed subjective pain ratings and walking ability up to a year after the last intervention.

Results The primary end point could be assessed in 94% (n=256) of patients. The success rate 12 weeks after intervention was 34% (n=43) in the extracorporeal shock wave therapy group and 30% (n=39) in the placebo group (95% confidence interval - 8.0% to 15.1%). No difference was found in the secondary end points. Few side effects were reported.

Conclusions Extracorporeal shock wave therapy is ineffective in the treatment of chronic plantar fasciitis.

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bmj.com, 11 Jul 2003 [Full text]

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Correction on previous comment

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Poor studies may yield poor results

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bmj.com, 20 Aug 2003 [Full text]

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