Letters Section Editor: Stephen J. Lurie,
MD, PhD, Senior Editor.
To the Editor: Dr Buchbinder and colleagues1 report that low-energy extracorporeal shock wave
therapy (ESWT) for plantar fasciitis offered no measurable benefit. Plantar
fasciitis is characterized by poor healing and the formation of scar tissue
after an acute or overuse injury. The scar tissue has extremely poor blood
supply that inhibits the entry of tissue healing cells (fibroblasts and osteoblasts)
into the pathologic site. The delivery of shock waves to this scar tissue
is thought to cause microscopic injury with associated deposit of endothelial
cells, resulting in re-engineering of the scar tissues.
Wheelock AJ. Shock Wave Therapy for Treatment of Plantar Fasciitis. JAMA. 2003;289(2):172-173. doi:10.1001/jama.289.2.172-a