Shocking shockwave defeat

Every clinic in the world that invested in shockwave ultrasound hardware:

“It’s great, it works!” Ka-ching!

This good quality new study of shockwave therapy for plantar fasciitis:

“NOPE.” Sad trombone…

A few years ago, I wrote this about shockwave therapy for plantar fasciitis: “Starting in 2016, new evidence convinced me to cautiously endorse it, when I had previously been entirely pessimistic about it. This is quite unusual.”

That was a strange optimism … and perhaps doomed. Unfortunately, this new test by Heide et al. strongly fits the classic pattern of “better studies undermine weaker early ones.” It almost always goes like this.

Obviously one study of one kind of shockwave therapy for one condition can’t be the nail in the coffin for all of ESWT. But… this was a good test of the most widely used type of shockwave therapy for its most popular target. If that doesn’t work, it really doesn’t bode well for the rest. (And I know the body of evidence for “the rest,” and it’s pretty underwhelming.) This might be one of those things that hangs on because there are legit strong responders … that we cannot reliably identify, but hey, roll the dice, you might get lucky!

I’ll finish with an interesting anti-monial from a reader about abusing horses with shockwave therapy:

Horse had deep digital flexor tendon tear just above anular ligament in rear off leg. Vet had whizz bang shock wave therapy machine at $180.00 for about 10 min.

6 treatments a week apart, absolutely no difference except horse hated him by 3 visit and required sedation for treatment. I would not recommend…

My plantar fasciitis book will tell you about many, many other things that also don’t work very well for arch and heel pain! If that sounds like a ridiculous thing to spend twenty bucks on, you should try spending hundreds on radial shockwave therapy… 😏