Extracorporeal Shockwave Therapy Versus Ultrasound Therapy for Plantar Fasciitis: Systematic Review and Meta-Analysis

ObjectiveTo compare the outcomes of Extracorporeal Shockwave Therapy (ESWT) versus Ultrasound Therapy (UST) in plantar fasciitis. MethodsA systematic review and meta-analysis were performed. An electronic search identifying studies comparing ESWT and UST for plantar fasciitis was conducted. Primary outcomes were morning and activity pain, functional impairment and the American Orthopaedic Foot and Ankle Society (AOFAS) scale score. Secondary outcomes included fascial thickness, primary efficacy success rate, activity limitations, pain intensity and satisfaction. ResultsSeven studies enrolling 369 patients were identified. No significant difference was found between ESWT and UST for functional impairment (Mean Difference [MD]= -2.90, P= 0.22), AOFAS scale score (MD= 35, P= 0.20) and pain in the first steps in the morning (MD= -4.72, P= 0.39). However, there was a significant improvement in pain during activity for the ESWT group (MD= -1.36, P= 0.005). For secondary outcomes, ESWT had improved results in terms of primary efficacy success rate, activity limitations and patient satisfaction. Reduction of planter fascia thickness showed no significant difference. Pain intensity after treatment had varied results amongst included studies. ConclusionESWT is superior to UST for plantar fasciitis as it improves pain activity and intensity, primary efficacy success rate and activity limitations.