Radial vs Focused Shockwave Therapy for Plantar Fasciitis

A Randomised Controlled Trial Comparing Radial Versus Focused Extracorporeal Shockwave Therapy for Chronic Plantar Fasciitis

The goal of this clinical trial is to learn whether focused extracorporeal shockwave therapy (ESWT) provides better outcomes than radial ESWT for adults with plantar fasciitis. It will also learn about the safety and tolerability of both treatments.

The main questions it aims to answer are:

1. Does focused ESWT lead to greater improvement in heel pain than radial ESWT?
2. Does focused ESWT improve foot function more than radial ESWT?
3. Do participants experience less discomfort during focused ESWT compared with radial ESWT?
4. What medical problems or side effects occur with either treatment?

Researchers will compare focused ESWT to radial ESWT to see whether one treatment offers better clinical outcomes or is better tolerated.

Participants will:

1. Receive three shockwave treatment sessions (radial or focused), one week apart
2. Attend clinic follow-up assessments at 6 weeks, 12 weeks, 6 months, and 12 months
3. Complete questionnaires about heel pain and foot function Keep a diary of symptoms, daily pain levels, activity limitations, and any use of pain medication

Study Overview

• Status: Not yet recruiting
• Conditions: Plantar Fasciitis, Chronic
• Intervention / Treatment: Device: Focused Shockwave therapy; Device: Radial shockwave therapy

• Study Type: Interventional
• Enrollment (Estimated): 150
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: DR Mukhey; Phone Number: 020 8510 5555; Email: dev.mukhey@nhs.net

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• aged 18 years or older; 2. chronic plantar heel pain for at least 3 months; 3. clinical presentation consistent with plantar fasciitis / plantar fasciopathy; 4. baseline average heel pain of at least 4/10 in at least one heel proposed for study treatment; 5. imaging findings supportive of plantar fasciitis / plantar fasciopathy on either:

  • ultrasound scan (USS); or
  • magnetic resonance imaging (MRI); 6. able to understand the study and provide written informed consent; 7. sufficient spoken and written English to understand the study information and complete the planned questionnaires and telephone follow-up assessments

Exclusion Criteria:

• Participants will be excluded for any of the following:

  1. previous ESWT to the affected study foot;
  2. corticosteroid injection to the affected region within the preceding 3 months;
  3. previous plantar fascia surgery;
  4. an alternative diagnosis considered to be the principal cause of the heel pain;
  5. current or suspected calcaneal or other relevant stress fracture;
  6. relevant inflammatory arthropathy;
  7. pregnancy;
  8. recognised contraindication to ESWT;
  9. inability to provide informed consent;
  10. insufficient spoken or written English to understand the study information or complete the planned study procedures where appropriately translated materials and interpreter-supported longitudinal follow-up are unavailable;
  11. any other clinical factor considered by the investigator to make participation inappropriate or unsafe

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Random allocation to focused ESWT	Device: Focused Shockwave therapy; Patients will be randomly allocated to focused shockwave therapy. The settings with regards to the waves will be pre-determined and will be the normal setting usually used by the department They will have one session every week for 3 weeks We will chase them up with outcome at 6 weeks, 12 weeks, 6 months and 12months.
Active Comparator: Random allocation to radial ESWT	Device: Radial shockwave therapy; Patients will be randomly allocated to radial shockwave therapy The setting for the shockwave will be pre-determined as advised by the literature and manufacturers of the device They will have one session every week for 3 weeks We will chase them up with outcome at 6 weeks, 12 weeks, 6 months and 12months.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Average Heel pain at 12 weeks using a numerical rating scale ranging from 0 - 10	To compare the clinical effectiveness of radial versus focused Extracorporeal shockwave therapy (ESWT) for chronic plantar heel pain by assessing the difference between treatment groups in average heel pain at 12 weeks, adjusted for baseline pain. The numerical rating scale ranges from 0 - 10 with 10 being a worse outcome	12 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
To compare the effect of radial and focused shockwave therapy on foot related function using the modified Foot Function Index (FFI) questionnaire	The modified foot function index is a 23 item questionnaire with a 0 - 10 numerical scale response. Higher scoring tends to indicate worse outcome. This questionnaire will be done at baseline, 6 weeks, 12 weeks, 6 months and 12 months	12 months
Comparing first step heel pain after radial vs focused shockwave therpay using a numerical rating scale from 0 - 10	This will be recorded at baseline, 6 weeks, 12 weeks, 6 months and 12 months. A higher score indicates a worse outcome	12 months
To compare procedural treatment discomfort after radial vs focused shockwave therapy using a numerical rating scale (ranging 0-10)	This will be recorded after each treatment session. There are 3 treatment session in total happening in 3 consecutive weeks, once a week A higher score indicates a worse outcome	3 weeks
Patient-reported global improvement following radial vs focused shockwave therapy using a Likert scale	This will be recorded at 6 weeks, 12 weeks, 6 months and 12 months. The likert scale is as follows: Compared with before shockwave treatment, how is your heel pain now? Much worse Worse no change Better Much better	12 months
To compare patient satisfaction after undergoing radial vs shockwave therapy using a likert scale	Patient satisfaction will be recorded at 12 weeks, 6 months and 12months using a Likert scale in the following format How satisfied are you in the outcome of your treatment? Very dissatisfied Dissatisfied Neutral satisfied Very satisfied	12 months
To compare willingness to undergo the same treatment after undergoing radial vs shockwave therapy using a qualitative question	This will be recorded at baseline 12 weeks, 6 months and 12 months using the following template; If you were int he same situation again, would you choose to have this treatment Yes No Unsure	12 months
Comparing treatment related adverse events after radial vs focused shockwave therapy using a qualitative question	This will be recorded at 6 weeks, 12 weeks, 6 months and 12 months. The question template is as follows; Adverse event since the previous study contact None Bruising New neurological symptoms Pain flare lasting >48hours Skin irritation Others (please elaborate)	12 months

Collaborators and Investigators

• Sponsor: Homerton University Hospital NHS Foundation Trust

Study record dates

Study Major Dates

• Study Start (Estimated): September 1, 2026
• Primary Completion (Estimated): September 1, 2027
• Study Completion (Estimated): September 1, 2027

Study Registration Dates

• First Submitted: September 9, 2026
• First Submitted That Met QC Criteria: September 14, 2026
• First Posted (Actual): September 18, 2026

Study Record Updates

• Last Update Posted (Actual): September 18, 2026
• Last Update Submitted That Met QC Criteria: September 14, 2026
• Last Verified: September 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Musculoskeletal Diseases; Foot Diseases; Fasciitis; Fasciitis, Plantar
• Other Study ID Numbers: IRAS project number: 375776

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No