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

Abstract

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.