Efficacy of extracorporeal shock wave treatment in calcaneal enthesophytosis

Objective-To evaluate the efficacy of extracorporeal shock wave treatment ( ESWT) in calcaneal enthesophytosis. Methods-60 patients (43 women, 17 men) were examined who had talalgia assoc iated with heel spur. A single blind randomised study was performed in whic h 30 patients underwent a regular treatment (group 1) and 30 a simulated on e (shocks of 0 mJ/mm(2) energy were applied) (group 2). Variations in sympt oms were evaluated by visual analogue scale (VAS). Variations in the dimens ion of enthesophytosis were evaluated by x ray examination. Variations in t he grade of enthesitis were evaluated by sonography. Results-A significant decrease of VAS was seen in group 1. Examination by x ray showed morphological modifications (reduction of the larger diameter > 1 mm) of the enthesophytosis in nine (30%) patients. Sonography did not sho w significant changes in the grade of enthesitis just after the end of the treatment, but a significant reduction was seen after one month. In the con trol group no significant decrease of VAS was seen. No modification was obs erved by x ray examination or sonography. Conclusion-ESWT is safe and improves the symptoms of most patients with a p ainful heel, it can also structurally modify enthesophytosis, and reduce in flammatory oedema.