The analysis of factors determining the effectiveness of extracorporeal shock wave therapy in patients with calcaneal spur.

Abstract

Background: Extracorporeal shock wave therapy (ESWT) may improve pain and function in patients with calcaneal spur; however, outcomes may vary according to patient characteristics.

Purpose: This study aimed to identify clinical, functional, radiological, and physical activity-related predictors of treatment response in individuals with calcaneal spur who received ESWT and to assess the extent of improvement after treatment.

Study design: Retrospective observational study using a single-assessment retrospective pretest-posttest design.

Methods: A total of 120 patients who underwent ESWT for heel pain/plantar fasciitis associated with calcaneal spur and who had complete study data were included. Participants completed a single post-treatment telephone interview, reporting their current status and retrospectively recalling their pre-treatment status. Assessments included Numerical Rating Scale scores for first-step pain and total heel pain, Roles and Maudsley Scale scores, Foot Function Index scores, International Physical Activity Questionnaire-Short Form scores, analgesic consumption, calcaneal spur size, and radiological stage.

Results: Significant improvements were observed in pain and foot-related functional measures following ESWT. The percentage of patients utilizing analgesics decreased from 64.2% to 31.7%. IPAQ-SF (International Physical Activity Questionnaire-Short Form)/MET (Metabolic Equivalent of Task)-based scores for walking, moderate-intensity activity, vigorous activity, and total physical activity increased significantly after ESWT.

Conclusions: ESWT may reduce pain and analgesic use while improving function and physical activity in patients with calcaneal spur. Patient-related, radiological, functional, and physical activity-related factors were associated with the degree of treatment benefit.