Comparison of Effectiveness of Radiation Therapy, Local Steroid Injection, and Extracorporeal Shock Wave Therapy in Patients with Plantar Fasciitis: A Multicenter Study

Abstract

OBJECTIVE The aim of this study is, therefore, to compare three different treatment modalities for symptomatic plantar fasciitis (PF), namely, effective in pain control. METHODS This study involved 205 patients with a diagnosis of painful PFs, treated during the years 2013 through 2017 at three institutions. Of these, 67 patients received a total dose of 6.0 Gy radiotherapy (RT in 3-weekly fractions of 1 Gy (RT arm); 65 patients received local steroid injection (SI) of 40 mg (1 ml) of methylprednisolone; and 0.5 ml of 1% lidocaine in the painful heel spur, using palpation (palpation guided) (PG SI arm) and 73 received extracorporeal shock wave therapy (ESWT) in five sessions with weekly intervals (ESWT arm). Patients recorded visual analog scale (VAS) score, a modified Pannewitz score and a 5-level function score. Patients with available ≥12 months of data were included in the present study. RESULTS Follow-up data were available for patients with a median of 15.5 (range, 6.5-37.4) months. There was a significant improvement in VAS scores and 5-level function scores in the RT arm at 3 and 6 month period arm (p