Extracorporeal Shockwave Therapy versus Low-Level Laser Therapy in the Treatment of Plantar Fasciitis: A Randomized Controlled Trial.

BACKGROUND

Plantar fasciitis is predominantly treated conservatively through modalities such as extracorporeal shockwave therapy (ESWT) and low-level laser therapy (LLLT), yet the short-term effect of these modalities on pain and function is still ambiguous. We compared the short-term effectiveness of ESWT and LLLT on pain and function in patients with plantar fasciitis.

METHODS

Participants (n = 47) were randomly assigned to the ESWT group (n = 27) or the LLLT group (n = 20). Participants received ESWT (once a week) and LLLT (three times a week) for 3 weeks. The Foot Function Index, including the pain, disability, and activity limitation subscales, was administered at baseline and after treatment. A reduction of 1 point in total scores was considered a minimum clinically important difference. Repeated-measures analysis of variance was used to analyze the changes in outcomes and compare groups.

RESULTS

There were significant main effects of time, and significant interaction effects between group and time on pain (P < .001), disability (P < .001), and activity limitation (P < .05). The main effect of group was not significant for all of the subscales (P = .811, P = .481, P = .865, respectively). The LLLT group showed significant declines in pain (P < .001), disability (P < .001), and activity limitation (P < .001), and there was no change in the ESWT group over time (P = .319, P = .711, P > .99, respectively). Consistently, 95% of participants in the LLLT group had a clinically important difference in the pain subscale versus 48% of the ESWT group.

CONCLUSIONS

Compared with ESWT, LLLT was found to be superior as an effective approach in the short-term management of plantar fasciitis.