OBJECTIVE: To assess the efficacy of ESWT and provide clinicians with an evidence base for their clinical decision making. DATA SOURCES: PubMed, Medline, Embase, the Cochrane Central Register of Controlled Trials, and Evidence Based Medicine Reviews. STUDY SELECTION: All randomized or quasi-randomized controlled trials of ESWT for chronic recalcitrant plantar fasciitis were searched. Searching identified 108 potentially relevant articles, of which 7 studies with 550 participants met inclusion criteria. DATA EXTRACTION: The number of patients, population, BMI, duration of symptoms, adverse effects, blinding method, and the details of shock wave therapy were extracted. DATA SYNTHESIS: For intervention success rate, ESWT of low-intensity was more effective than control treatment of low-intensity. For pain relief, the pooled data showed a significant difference between the ESWT and control groups. For function, only low-intensity ESWT was significantly superior over the control treatment. CONCLUSIONS: The efficacy of low-intensity ESWT is worthy of recognition. The short-term pain relief and functional outcomes of this treatment are satisfactory. However, owing to the lack of a long-term follow-up, its long-term efficacy remains unknown.

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