Does the presence of calcaneal spurs with associated oedema in plantar fasciitis affect the outcome of shockwave therapy?

BACKGROUND

Extra-corporeal shockwave therapy (ESWT) is commonly used for plantar fasciitis (PF). Calcaneal spurs have up to 80% prevalence in PF. The objective was to assess whether calcaneal spurs with associated oedema affect the outcomes of ESWT.

METHODS

Single-centre study of 30 patients over 3-years. Patients with confirmed diagnoses of PF on MRI scan who underwent ESWT were included. Patient reported outcomes scores (EQ5D / MOxFQ) were recorded pre-treatment and at 1-year post-ESWT.

RESULTS

Significant improvement (p < 0.001) in MOxFQ score and subjective improvement with ESWT in all patients. No difference in improvement of MOxFQ / EQ5D in patients with calcaneal spurs compared to without (p > 0.05). No correlation between presence of calcaneal spur oedema or spur size, and outcome scores (p > 0.05).

CONCLUSIONS

In this cohort, neither spur presence nor peri-spur oedema was associated with a significantly different response to ESWT. The majority of patients reported symptomatic improvement following ESWT (63.3%) and the.mean MOxFQ Index improvement across the cohort exceeded the published minimum clinically important difference.

LEVEL OF EVIDENCE: Level III, retrospective cohort study.