German IQWIG published the final report of assessment of extracorporeal shock wave therapy for treatment of heel pain

In 2015, the Federal Joint Committee commissioned the Institute for Quality and Efficiency in Health Care (IQWIG) to evaluate extracorporeal shock wave therapy for treatment of heel pain in comparison with placebo, ultrasound, stretching exercises, iontophoresis and glucocorticoid injections.

On 26th of May IQWIG published the final report of assessment where analysis of available evidence was performed. IQWIG included 29 studies of comparing extracorporeal shock wave therapy with a non-active treatment, with different active therapies, or with another variant of extracorporeal shock wave treatment into evaluation.

Results of evaluation suggested that there is evidence of a benefit of shock wave therapy in comparison with placebo in relation to the pain and for the physical functional status.

Comparison of shock wave treatment with active treatment demonstrated benefit of treatment and simultaneous presence of complications. Additionally, optimal dose remains unclear for achievement of the positive effect and avoiding disadvantages of the treatment in the same time.

Shock wave therapy was also found superior to ultrasound and iontophoresis.

For two other methods of treatment: surgery and ultrasound in combination with stretching exercises, there was no evidence of increase or decrease of the benefit of extracorporeal shock wave therapy.

The extracorporeal shock wave therapy compared to stretching exercises alone and glucocorticoid injections had worse outcomes.

However, a publication bias cannot be excluded as in both cases there are unpublished studies.

See full report in German here.

See press release in German here.

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