A systematic review of shockwave therapies in soft tissue conditions: focusing on the evidence.

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Abstract

[Indexed for MEDLINE] 18. Ann Med. 2025 Dec;57(1):2543056. doi: 10.1080/07853890.2025.2543056. Epub 2025 Aug 10. The efficacy of ultrasound for plantar fasciitis, a systematic review and meta-analysis. Li X(1), Yang J(1), Li S(1), Yang L(1), Meng D(1). Author information: (1)Rehabilitation Center, the First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu, China. BACKGROUND: Ultrasound (US) has been widely used in the treatment of plantar fasciitis (PF); however, its therapeutic effect remains unclear. OBJECTIVE: This meta-analysis aimed to investigate the effects of ultrasound (US) on pain intensity and foot function in patients with PF. METHODS: PubMed, Web of Science, Cochrane Library, and other databases were systematically searched from inception to July 2024. Meta-analysis was performed using RevMan 5.3. RESULTS: Thirteen trials were performed. There was no difference in pain relief between US alone and no treatment, as was US plus conventional physical exercises (CPE) compared with CPE alone. In the comparison between the US plus CPE group and the other interventions plus CPE group, there was a statistically significant difference in pain intensity (MD = 0.78, 95%CI= 0.12 to 1.44, p = 0.02), except in the case where extracorporeal shock wave therapy (ESWT) acted as an "other intervention" (MD = 0.75, 95%CI= -0.28 to 1.78, p = 0.15). The foot function measured in the Foot Function Index (FFI) showed a statistically significant difference between the two groups (MD =9.20, 95%CI = 0.77 to 17.63, p = 0.03), while the American Orthopaedic Foot showed no statistically significant difference. CONCLUSION: Whether applied alone or in combination with CPE, US cannot reduce pain intensity in patients with PF. However, US in combination with CPE may improve foot function. Plain Language Summary: The included studies reported the effects of US on pain intensity and foot function in patients with PF.This meta-analysis showed that US, either alone or in combination with CPE, could not reduce pain intensity in patients with PF.The role of US in the improvement of PF function should be paid more attention. DOI: 10.1080/07853890.2025.2543056 PMCID: PMC12340940