Extracorporeal Shock Wave Therapy and Ultrasound Waves Effectively Reduce Symptoms of Chronic Calcaneal Spur Pawel Lizis 1* , Wojciech Kobza 2 , Grzegorz Manko 3 , Barbara Para 4 , Jaroslaw Jaszczur-Nowicki 5 and Jacek Perlinski 6 1 Department of Education and Health Protection, Holycross College, Kielce, Poland 2 Physiotherapy Laboratory, Zywiec, Poland 3 Department of Ergonomics and Physiology of Physical Effort, Jagiellonian University, Cracow, Poland 4 Global Care Clinical Trials, Ltd., Bannockburn, Illinois, USA 5 Department of Tourism, Recreation and Ecology, Faculty of Environmental Sciences, University of Warmia and Mazury, Olsztyn, Poland 6 Department of Health Sciences, University of Humanities and Economy, Elblag, Poland * Corresponding author: Pawel Lizis, Department of Education and Health Protection, Holycross College, Kielce, Poland, Tel: +48 663 793 834; E-mail: pawel_lizis@poczta.onet.pl Rec date: Mar 04, 2017; Acc date: Mar 07, 2017; Pub date: Mar 14, 2017 Copyright: © 2017 Lizis P, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Letter to Editor Calcaneal spur occurs when calcium deposits build up on the underside of the heel bone, the process that usually continues for many months. Chronic calcaneal spur is a vested disease commonly appearing in adults and it leads to the inlammatory of the plantar fasciitis, disability and as a result to the limitation of social and professional activities. Among main causes of the plantar fasciitis, there are: an inlammation of the Achilles tendon bursitis, fatigue fractures of the calcaneal tuberosity, obesity, running and jumping, work in a standing position, liting heavy objects, lat feet, rheumatic changes. he treatment of calcaneal spur is primarily conservative, it includes kinesiotherapy, orthoses, corticosteroid therapy, and electrotherapy, but their eicacy remains controversial. Surgery is also a line of treatment, however diferent (more invasive) from a conservative treatment in people sufering from calcaneal spur. Despite on this, in this publication we don’t compare which treatment line is more efective for the symptoms of calcaneal spur, because the goal of this study was to compare the eicacy of the extracorporeal shock wave therapy and ultrasound waves in reducing the painful symptoms in people with calcaneal spur. Numerous studies show, that electrotherapy, such as ultrasound waves and extracorporeal shock wave therapy are used on pain in patients sufering from calcaneal spur. Boerner et al., compared the analgesic eicacy of the 0.8 W/cm 2 and 1.2 W/cm 2 doses during 10 ultrasound wave treatments performed 5 times a week. he results showed that a less dose decreased the pain in the patients with calcaneal spur [1]. Lizis and Husar also conirmed the analgesic eicacy of the 0.8 W/cm 2 dose ater 10 ultrasound wave treatments performed 5 times a week, because a very signiicant decrease of pain remained for 6 weeks ater the treatment [2]. Zanon et al. evaluated the analgesic eicacy of the 2 W/cm 2 dose for 15 treatments performed three times a week. It turned out that the ultrasound wave topical application of high power did not decrease the pain in chronic plantar fasciitis inlammation associated with calcaneal spur [3]. he cited authors studies’ results showed that the patients had better reactions to less doses of ultrasound wave, because of the patients’ efective decrease of pain and their faster taking normal daily activities. he researchers also explored the analgesic eicacy of shock wave therapy in calcaneal spur associated with plantar fasciitis. Gerdesmeyer et al., treated chronic (as it lasted longer than 3 months) plantar fasciitis with shock wave therapy. he patients altogether got 6000 impulses of shock waves, energy lux density 0.16 ml/mm 2 during 3 treatments, once a week. he ater treatments’ results showed that as pain as plantar fasciitis subsided [4]. Yalcin et al. studied the shock waves’ inluence on pain and the calcaneal spur size which was evaluated on the basis of X-ray made before and ater the treatment. For this purpose the patients altogether got 10000 impulses of shock waves, energy lux density from 0.05 to 0.4 mJ/mm 2 during 5 treatments, once a week. Ater the treatment it turned out that there were no radiology changes in the calcaneal bone, the spur did not get smaller, but the pain signiicantly decreased [5]. he researchers also studied the shock waves’ inluence on the changes in thickness and soreness of plantar fasciitis during the inlammation associated with calcaneal spur. For this purpose Hammer et al. used altogether 9000 impulses of shock waves, energy lux density 0.2 mJ/mm 2 at 3 sessions of shock wave therapy, once a week for three weeks. With the help of ultrasonograph they measured the plantar fasciitis’ thickness of 2 cm distal to the tuberosity of the calcaneus before the therapy, 6, 12 and 24 weeks ater the therapy, and compared them with the plantar fasciitis of a healthy foot. It turned out that 6 weeks ater the shock wave therapy the plantar fasciitis thickness of the ill foot and its pain signiicantly decreased, that caused the locomotion improvement [6]. In their next research Lizis and Hudakova compared the shock waves’ and the ultrasound waves’ inluences on the improvement of the feet health status of the patients with calcaneal spur, whose heel spur pain lasted longer than 6 months. he patients treated with shock waves got the altogether dose of 7000 impulses of shock waves, energy lux density 0.4 ml/mm 2 during 5 treatments performed once a week for 5 weeks. he patients treated with ultrasound waves got the dose of 0.8 W/cm 2 during 10 treatments performed three times a week. In both groups the authors noted the signiicant improvement in the feet health status. However, the patients treated with ESWT had signiicantly greater pain decrease and life quality improvement, and those beneits were still present 3 months ater the treatment [7]. he shock waves’ and the ultrasound waves’ analgesic efectiveness in patients with calcaneal spur were also compared. Krukowska et al. treated the patients with 2000 impulses of shock waves during 2 weeks in 4 sessions, once every 3 days. he patients treated with ultrasound waves got the dose of 1.5 W/cm 2 during 10 sessions performed 5 times Clinical Research on Foot & Ankle Lizis et al., Clin Res Foot Ankle 2017, 5:2 DOI: 10.4172/2329-910X.1000229 Letter to Editor OMICS International Clin Res Foot Ankle, an open access journal ISSN:2329-910X Volume 5 • Issue 2 • 1000229