Home Exercise With or Without High-Intensity Laser or Radial Shockwave Therapy for Plantar Fasciitis: A Randomized Controlled Trial

Abstract

Background:

To investigate the efficacy of extracorporeal shock wave therapy (ESWT), high-intensity laser therapy (HILT), and exercise therapy in patients diagnosed with plantar fasciitis.

Methods:

A total of 84 patients diagnosed with plantar fasciitis were randomized into 3 groups: ESWT combined with a home exercise program (n = 28), HILT combined with a home exercise program (n = 30), and a home exercise program alone (control) (n = 26). The ESWT group underwent a total of 3 ESWT sessions, performed once a week, whereas the HILT group underwent a total of 15 HILT sessions over 3 weeks. All 3 groups were evaluated at the beginning of the treatment, at the end of the treatment (week 3), and at the 12th week for pain levels (measured using the visual analog scale [VAS]), plantar fascia thickness, and the Foot Function Index (FFI). Because of the nature of the interventions, participant masking was not possible; however, assessor masking was strictly adhered to.

Results:

Eighty-four patients completed the study. Significant reductions in plantar fascia thickness, VAS scores, and FFI values were observed in all 3 groups (P < .05). However, baseline-adjusted analyses detected no meaningful between-group differences at 12 weeks (P > .05; small effect sizes).

Conclusion:

Our study demonstrated that ESWT, HILT, and exercise therapy each effectively reduced pain levels and improved functional capacity in the treatment of plantar fasciitis. Adding ESWT or HILT to a structured home exercise program did not provide an incremental clinical benefit during the follow-up period. The findings support exercise therapy as a practical first-line option.