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Efficacy of extracorporeal shock wave treatment in calcaneal enthesophytosis
  1. R Cosentino,
  2. P Falsetti,
  3. S Manca,
  4. R De Stefano,
  5. E Frati,
  6. B Frediani,
  7. F Baldi,
  8. E Selvi,
  9. R Marcolongo
  1. Institute of Rheumatology, University of Siena, Italy
  1. Dr R Cosentino, Institute of Rheumatology, Policlinico Le Scotte, Viale bracci, 53100 Siena, Italyr.cosentino{at}katamail.com

Abstract

OBJECTIVE To evaluate the efficacy of extracorporeal shock wave treatment (ESWT) in calcaneal enthesophytosis.

METHODS 60 patients (43 women, 17 men) were examined who had talalgia associated with heel spur. A single blind randomised study was performed in which 30 patients underwent a regular treatment (group 1) and 30 a simulated one (shocks of 0 mJ/mm2 energy were applied) (group 2). Variations in symptoms were evaluated by visual analogue scale (VAS). Variations in the dimension of enthesophytosis were evaluated byx ray examination. Variations in the grade of enthesitis were evaluated by sonography.

RESULTS A significant decrease of VAS was seen in group 1. Examination byx ray showed morphological modifications (reduction of the larger diameter >1 mm) of the enthesophytosis in nine (30%) patients. Sonography did not show significant changes in the grade of enthesitis just after the end of the treatment, but a significant reduction was seen after one month. In the control group no significant decrease of VAS was seen. No modification was observed byx ray examination or sonography.

CONCLUSION ESWT is safe and improves the symptoms of most patients with a painful heel, it can also structurally modify enthesophytosis, and reduce inflammatory oedema.

  • shock wave treatment
  • heel spur
  • Achilles tendon
  • plantar fascia

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