The Center for Podiatric Care and Sports Medicine

Which Is the Best Treatment for Plantar Fasciitis: Laser, Ultrasound, or Shockwave Therapy?

Posted by on Friday, May 18th, 2018

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The lifetime incidence for developing chronic heel pain (plantar fasciitis) is roughly 10 percent in America. If you’re one of the many people suffering from sharp, shooting pains first thing in the morning and terrible aches following periods of standing or inactivity in New York City, stop by The Center for Podiatric Care and Sports Medicine for the best treatment for plantar fasciitis. We offer multiple modes of advanced treatment you won’t find elsewhere, including laser, ultrasound, and shockwave therapy. You may be wondering: Which of these high-tech solutions is most effective? A study recently published in the Journal of Foot & Ankle Surgery sheds some light on the subject.

best treatment for plantar fasciitis
Extracorporeal Shockwave Therapy is one of the best treatments for plantar fasciitis. [Image Source: Unsplash user Cristian Newman ]

Determining the Best Treatment for Plantar Fasciitis

The most recent study, conducted by researchers from the Department of Physical Medicine and Rehabilitation at Celal Bayar University Medical School in Turkey, looked at three modern modes of plantar fasciitis treatment:

  • Low-Level Laser Therapy (LLLT)
  • Therapeutic Ultrasound (US) therapy
  • Extracorporeal Shockwave Therapy (ESWT)s

Results for 60 patients with chronic, diagnosed plantar fasciitis were examined through the use of Magnetic Resonance Imaging (MRI) one month before and one month after treatment, as well as the Visual Analog Scale, Heel Tenderness Index, American Orthopaedic Foot & Ankle Society Ankle-Hindfoot Scale, and Roles-Maudsley score. Results were considered generally “effective” if the patient saw greater than 60% improvement in baseline measurements after treatment.

Generally speaking, the results were favorable for all patients who sought advanced treatments for plantar fasciitis. For instance, all groups saw significant improvements in VAS, AOFAS scale, and HTI scores. Furthermore, significant decreases in the thickness of the plantar fascia were observed on MRI.

But just how did the three treatments stack up, statistically speaking? The treatment success rates were:

  •   70.6% in the LLLT group
  • 65% in the ESWT group
  • 23.5% in the Ultrasound group

Researchers concluded the minimal differences in LLLT and ESWT made them both excellent treatments for chronic plantar fasciitis, whereas ultrasound was a less effective treatment.

Why Bother With Therapeutic Ultrasound?

You may wonder why therapeutic ultrasound equipment and training are investigated if LLLT and ESWT are so much more effective. Podiatrists use therapeutic ultrasound for a number of applications, particularly the treatment of damaged tendons and ligaments. Achilles tendinopathy or tendonitis, in particular, responds really well to ultrasound. During the procedure, sound waves vibrate through the tissues to increase local blood-flow, relax tissues, and break down scar tissue. Compared to the other two, ultrasound uses gentler technology to prompt natural healing, so treatment is less painful. This might matter if you are an older patient or if your tolerance for discomfort is particularly low.

Pros & Cons of ESWT  for Plantar Fasciitis

ESWT delivers focused shockwaves to a precise location in the body to alert the body of a new injury it must work more aggressively to heal. We’ve seen some of the most dramatic results using ESWT. Between 80-90% of patients will remarkably improve using ESWT alone. Often, we combine ESWT with biopuncture or platelet-rich plasma injection therapy to assist in providing the necessary healing factors to treat a stubborn injury.

Low-energy ESWT costs between $900 and $1,500 for three treatments, with no anesthesia or facility fees. You don’t have to worry about the loss of income from time off work or restrictions in your mobility. When you compare this to the average $5,000 foot surgery, the benefits are pretty obvious!

Pros & Cons of LLLT for Plantar Fasciitis

Lasers work a little differently, by relaxing inflamed muscles and relieving trigger point pain. One school of thought (backed by research) contends that LLLT yields faster results. Patients report significant improvements in pain in just three weeks, compared to the three months it takes for ESWT patients to feel truly healed. Though you’ll need to come in for 15 sessions (compared to ESWT’s three), the full course of treatment costs patients the same amount.

Advanced Plantar Fasciitis Treatment in NYC

For the most severe or long-lasting cases, we may go in laparoscopically to perform ultrasonic debridement that clears out damaged tissue fibers that are impairing your healing. When structural anomalies exist, we can fit you with a pair of custom orthotics.

If you want the full range of professional treatment, contact a board-certified foot and ankle specialist like Dr. Josef J. Geldwert and his staff at The Center for Podiatric Care and Sports Medicine in NYC.

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If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.