# A Narrative Review of Shockwave Therapy in Plantar Fasciitis

## TL;DR

This review summarizes evidence on shockwave therapy for plantar fasciitis, comparing it to other treatments and highlighting current research gaps.

## Contribution

The paper provides the first comprehensive synthesis of ESWT research across assessment methods, treatment protocols, and comparative interventions.

## Key findings

- 36 assessment tools were identified, with pain and function measures being most common.
- Typical ESWT protocols use 2000 impulses per session and 0.2 mJ/mm2 energy flux density.
- ESWT was frequently compared to corticosteroids, PRP, and laser therapy, but evidence limitations prevent clear clinical recommendations.

## Abstract

This narrative review synthesizes evidence from 108 studies to provide the first comprehensive overview of extracorporeal shockwave therapy (ESWT) for plantar fasciitis across three key domains. First, assessment methodologies were evaluated, identifying 36 distinct tools classified into six categories, including pain (with the Visual Analog Scale being the most frequently used), function (most commonly the Foot Function Index), plantar fascia thickness, and other measures. Second, treatment protocols were analyzed, revealing commonly applied parameters of 2000 impulses per session and an energy flux density of 0.2 mJ/mm2 or 3.0 bar. Third, the comparative status of ESWT relative to other interventions was examined. Across 18 alternative treatments, corticosteroid injections, platelet-rich plasma (PRP), dextrose prolotherapy, laser therapy, and ultrasound were the most frequently compared modalities. ESWT and comparator interventions demonstrated differential advantages across specific outcomes; however, these findings cannot be directly translated into clinical recommendations, due to the limitations of the available evidence. By consolidating fragmented data, the present review clarifies the current research landscape and provides a foundational reference to support outcome evaluation and individualized treatment selection.