Extracorporeal Shockwave Therapy vs Ultrasound Therapy for Plantar Fasciitis

Knowing the most effective treatment options for your patients is crucial for their speedy recovery. In this post, we will discuss a recent meta-analysis on shockwave therapy and ultrasound therapy for treating plantar fasciitis.

What is Ultrasound Therapy?

Ultrasound therapy is a non-invasive therapy used for the treatment of various conditions that cause chronic pain. It uses ultrasound waves to create a “deep heating” effect within the body’s tissue. This heating effect can increase tissue elasticity, increase circulation to tissue, decrease pain, and help to speed up the body’s natural healing process. The ultrasound waves are steady periodic oscillations with narrow bandwidth. 

What is Shockwave Therapy?

Shockwave therapy is also a non-invasive therapy used for the treatment of various chronic pain conditions; however, shockwave therapy works a bit differently. 

Shockwave therapy works by distributing high-energy shockwaves from a shockwave therapy device, to a patient’s tissue through their skin. This energy in the form of shockwaves, has been found to increase circulation, stimulate healing, and activate resident stem cells.

Shockwave therapy creates an acoustic pressurized wave of energy that works to stimulate tissue rather than adding heat to tissue like ultrasound therapy. It releases a single, mostly positive pressure pulse followed by a comparatively small tensile wave. This makes it a “true” shockwave and is what sparks the healing process.

The Research


Researchers compiled data from 7 different studies with a total of 369 patients comparing shockwave therapy and ultrasound therapy for the treatment of plantar fasciitis. They analyzed the following outcomes to determine the difference in treatment effectiveness for plantar fasciitis:

  • Primary:
    • Morning and activity pain
    • Functional impairment and the American Orthopaedic Foot and Ankle Society Scale Score
  • Secondary:
    • Fascial thickness
    • Primary efficacy success rate
    • Activity limitations
    • Pain intensity and satisfaction


After reviewing the data, the researchers found that there was no significant difference in functional impairment, the AOFAS score, or morning pain between patients receiving shockwave therapy or ultrasound therapy for plantar fasciitis. However, they did find that there was a significant improvement in pain during activity for patients who received shockwave therapy vs those who received ultrasound therapy. 

In addition, shockwave therapy had improved results in terms of primary efficacy success rate, activity limitations and patient satisfaction. 


With those results in mind, the researchers concluded that shockwave therapy is superior to ultrasound therapy for plantar fasciitis as shockwave therapy was found to improve pain with activity, primary efficacy success rate, and activity limitations.

Your Next Steps

To read the original publication of the referenced meta-analysis click here.
To read more about shockwave therapy click here

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