Stretching may be more effective than shockwave therapy for acute plantar fasciitis

Plantar fasciitis -- an inflammation of the band of fibrous tissue that connects the heel bone to the base of the toes -- can be extremely painful and sometimes difficult to treat. But a new study finds that specific stretches done several times a day may provided fairly quick relief for people with severe pain.

Researchers worked with 102 men and women who had acute plantar fasciitis, which refers to having pain for less than six weeks. The study participants were divided into two groups: 54 people were randomly assigned to an eight-week stretching program, while 48 received radial shockwave therapy. Shockwave therapy, found in some studies to be a useful treatment for plantar fasciitis, works by creating microtraumas to the damaged tissue, triggering the body’s healing response.

The stretches (shown on the American Orthopaedic Foot and Ankle Society website), which include manually stretching the foot, were done three times a day. Participants were checked on by phone to make sure they were doing the exercises. Those in the shockwave group had three therapy sessions.

Follow-ups were done on all test subjects at two months, four months and 15 months after the start of the study. Although both groups said that generally pain was reduced, the stretching group found relief sooner. At the two and four-month follow-ups, 65% of people in the stretching group said they were satisfied with the treatment or were satisfied but with minor reservations, versus 29% of those in the shockwave therapy group. At 15 months, no substantial differences were seen.

“The earlier you understand how stretching fits in, and the earlier you learn how frequently to perform the simple plantar stretch, the less likely you will require a more invasive treatment method,” said study co-author and orthopedic surgeon John Furia in a news release. “Shockwave therapy has been shown to be a very effective treatment for patients with chronic plantar fasciitis, however acute cases are probably best treated with more simple measures.”

The study appears in the Nov. 3 issue of the Journal of Bone & Joint Surgery.