Anne Moseley talked to Professor Rachelle Buchbinder (Monash University, Australia) whose trial evaluating extracorporeal shock wave therapy for plantar fasciitis is one of the most significant trials in physiotherapy.
Anne: Explain what you did in the study
Rachelle: The aim of our study was to determine whether extracorporeal shock wave therapy is effective for people with heel pain due to plantar fasciitis. We randomised 166 participants to receive either this therapy given weekly for three weeks or an identical placebo. Neither the investigators nor the participants knew which treatment was received. We measured pain and function including walking ability at baseline, at 6 and 12 weeks.
Anne: What was the main finding?
Rachelle: We found that both treatment groups improved over time but there was no statistical or clinically important difference in the degree of improvement between groups for any of the measured outcomes.
Anne: Why do you think the study is important?
Rachelle: The study is important because we found that this treatment has no intrinsic therapeutic value in the treatment of this common condition and it has led to a change in practice.
Anne: What led you to do the study?
Rachelle: Extracorporeal shock wave therapy was becoming an increasingly used treatment for plantar fasciitis as well as other regional conditions such as lateral epicondylitis (tennis elbow). However there was limited evidence from high quality trials to support its use.
Anne: What studies are you conducting now?
Rachelle: We performed a similar trial of extracorporeal shock wave therapy for lateral epicondylitis which was also unable to demonstrate any benefit of the therapy over an identical sham. We are continuing to perform trials to assess the efficacy and safety of various interventions for regional conditions including shoulder, elbow and foot pain as well as osteoarthritis. Currently we are performing a three-arm placebo-controlled trial to determine the efficacy and safety of platelet-rich plasma injection and glucocorticoid injection for lateral epicondylitis.