Symptom duration of plantar fasciitis and the effectiveness of Orthotripsy®

Background: The use of surgically noninvasive application of Orthotripsy((R)) (extracorporeal shock waves) for various musculoskeletal disorders is being increasingly utilized. Because most patients have had prolonged symptoms refractory to nonoperative treatments, this study evaluated the effectiveness of electrohydraulic Orthotripsy for chronic proximal plantar fasciitis compared to the duration of symptoms prior to treatment. Methods: Following evaluation for study inclusion (unresponsive symptoms for more than 6 months), qualified patients received Orthotripsy or placebo. The study patients were randomized per described protocol. Additional groups of nonrandomized patients also were studied. Results: In both the randomized and nonrandomized patient groups, those who received Orthotripsy were slightly more likely to have a positive result (complete symptom relief or satisfactory improvement) if symptoms had been present and unresponsive to other nonoperative therapeutic attempts for less than 2 years. The same trend was evident in patients undergoing a second Orthotripsy application. In the placebo group, there was no correlation between symptom duration and outcome. However, when placebo patients crossed over to the treatment arm of the study, the same response was evident: patients with symptoms for less than 2 years were slighty more likely to have a positive therapeutic response. Interestingly, the two patients with the longest duration of symptoms (15 and 18 years) both had complete symptom relief. Conclusions: The longevity of symptoms of chronic proximal plantar fasciopathy had a minimal impact on the likelihood of a positive response to Orthotripsy.