Prospective comparative study between extracorporeal shock wave therapy and ultrasound-guided ozone (O2-O3) injection in patients with plantar fasciitis.

Abstract

The aim of this study was to compare the effectiveness of extracorporeal shock wave therapy (ESWT) and local ozone (O₂O₃) injection in patients with plantar fasciitis. This prospective study included 47 patients who were scheduled for ESWT or local ozone (O₂O₃) injection with the diagnosis of plantar fasciitis. ESWT group (n = 23) received 2000 radial shock waves (session of 2.8 Bars with a frequency of 12 Hz). Local ozone (O₂O₃) injection group (n = 24) underwent an ultrasound-guided injection of 5 cc ozone (O₂O₃) gas with a 10 μg/mL. ESWT and local ozone (O₂O₃) injection were applied once a week for three sessions. The outcome measures were assessed prior to treatment, after the last intervention, and 3rd month follow-up; morning and overall pain via Visual Analog Scale (VAS), foot functions via Foot Function Index (FFI), and plantar fascia thickness via ultrasound. In both ESWT and ozone groups, there were statistically significant improvements in morning VAS, overall VAS, FFI, and plantar fascia thickness scores post-treatment and at 3rd month follow-up compared to pre-treatment (p ˂ 0.017). There was no significant difference between ESWT and ozone groups on changes of morning VAS, overall VAS, FFI, and plantar fascia thickness scores at post-treatment and at 3rd month follow-up compared to pre-treatment (p > 0.05). In the present study, it was observed that both ultrasound-guided local ozone (O₂O₃) injections and ESWT were effective in reducing pain, improving functionality, and reducing plantar fascia thickness in patients with plantar fasciitis but they were not superior to each other.