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Treatment of plantar myoapon├ęvrosite by high-energy extracorporeal shock wave

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Summary "electrohydraulic High-Energy Shock-wave chronic plantar fasciitis for Treatement" by John A.Ogden. The Journal of Bone ant Joint Surgery, Volume 86-A. Number 10, october 2004.

The effectiveness of the treatment of chronic plantar fasciitis (plantar myoaponevrosite) by extracorporeal shock wave (ODCE) was evaluated in 289 patients between 1996 and 2003, compared to placebo.

Patients treated with extracorporeal shockwave are patients who have not been sufficiently improved by at least six months of adequate medical treatment, including at least physiotherapy, insoles and local or systemic anti-inflammatory treatments.

All patients received after anesthetic block 1500 shock waves at an intensity of 18 kV at a frequency of 2 Hz, giving a total of 324.25 Joules energy, applied to the maximum area of ??pain in a radius of 1 cm. For the placebo group, a fluid-filled bag is placed in the probe of the device to absorb the shock waves.

Patients were followed for 12 months. They completed a self-assessment questionnaire: rest pain, pain during daily activities, level of recreational activity and ability to work and were regularly assessed by an examiner, different therapist, who did not know whether the patient had received treatment or placebo.

The results of the study showed 76.8% good and excellent results at 12 months of treatment, with a significant difference compared to placebo. The average age of patients was 48.6 years, 2 women for every man.

In summary, the treatment of plantar fasciitis is primarily medical, it is satisfactory in 90% of cases. The first-line treatment consists of wearing insoles made by a podiatrist and taking anti-inflammatory drugs; second line, it makes sense to offer local and only for the third infiltration ODCE, one or two sessions with a specialized therapist. A heel spur present in 50-60% of heel pain persists after treatment and does not influence the result.

Doctor Yves GUGLIELMETTI. - 11 juin 2010.

Conflicts of interest: the author or authors have no conflicts of interest concerning the data published in this article.

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