Study Summary

Fifteen randomized controlled trials including 1123 patients with plantar fasciitis were included in this systematic review and meta-analysis comparing extracorporeal shock wave therapy (ESWT) vs other conservative treatments including platelet-rich plasma (PRP), corticosteroid injections (CSI), custom orthotics, dextrose prolotherapy, minimal-dose ESWT, and placebo. Pooled outcomes of interest included visual analogue scale (VAS) pain score, Foot Function Index (FFI), plantar fascia thickness (PFT), and heterogeneity across treatment modalities. ESWT demonstrated a significantly greater improvement in pain compared with placebo and improved FFI compared with CSI. PRP demonstrated superior improvement in pain and FFI compared with ESWT. These findings suggest ESWT is an effective noninvasive treatment for plantar fasciitis, although PRP may offer greater improvement in pain and function.