Comparative Effectiveness of Radial Extracorporeal Shock Wave Therapy Versus Physiotherapy for Chronic Plantar Fasciitis

Background: Plantar fasciitis (PF) is a common and potentially debilitating cause of chronic plantar heel pain involving the plantar fascia and its surrounding structures. Radial extracorporeal shock wave therapy (rESWT) is widely accepted as a non-invasive treatment modality. Aim of Study: To determine the effectiveness of rESWT compared with physiotherapy in controlling pain intensity and functional stability in people with chronic PF. Methods: Patients who suffered from unilateral chronic PF and met the inclusion criteria were recruited to participate in this prospective randomized controlled trial (November 2022–November 2025). Patients were randomly assigned to two groups: group A (GA) received rESWT, and group B (GB) received physiotherapy. Pain intensity was the primary outcome measured by the visual analogue scale (VAS), and the American Orthopedic Foot and Ankle Society (AOFAS) score was the secondary functional outcome. Data were collected based on the AOFAS clinical classification system and VAS. These data were then statistically analyzed using SPSS version 27.0 (IBM Inc., Chicago, IL, USA). Results: In total, 296 patients who fulfilled the inclusion criteria remained for the final assessment; allocated equally, with 148 patients in each group. Their mean age was 46.3 years, with female predominance (77%). Both treatment groups showed significant within-group improvements in VAS and AOFAS scores from baseline to post-treatment (p<0.0001). The mean VAS decreased from 8.6 to 3.6 in GA and from 9.1 to 4.1 in GB, showing an equal average decrease of 5.0 points in both groups. AOFAS scores also improved considerably within-group in both groups, improving from 42.2 to 85.6 in GA and from 42.9 to 84.8 in GB. On the other hand, there was no significant difference in the between-group change in VAS (p = 0.637) and AOFAS scores (p = 0.663). Conclusion: Both rESWT and PT showed considerable improvements in pain and foot function among patients with chronic PF. Neither one had a better outcome than the other.