Evaluation of the efficiency of ESWT and custom insoles produced with podometric measurement in the treatment of painful heel spurs

Objective: The aim of the study; to determine the effectiveness customized insoles produced by podpmetric analysis and ESWT in patients with painfull heel spur and to determine the superiority of the treatments to each other. Materials and Methods: A total of 70 patients (59 women and 11 men) who had heel pain for at least 3 weeks and were diagnosed with heel spurs were included in the study. The patients were randomized into 3 groups. 16 patiensts were included customized insoles group, 27 patients were included in ESWT group and 27 patients were included ESWT and personalized insoles group. Frozen bottle rolling exercises, streching the soles of the feet and strenghtenin exercises were given the all groups as a home program. Evaluations were made at before treatment and at 12 weeks after treatment. In all groups, pain severity (in resting, with pression and with streching) were measured by VAS (Visual Analog Scale), assessment of pain and limitations of activities by RMS (Roles ans Maudsley Score), pain, functions and foot alignment by AOFAS ( American Orthopaedic Foot and Ankle Society) and foot functions by FFI (Foot Function Index). Results: There was a significant improvement in pain and foot functions in all of the ESWT, insoles and ESWT+insoles applied groups. When the efficacy of these treatments were compared, the combined use of ESWT and insoles was found to be more effective than the use of sole insoles. The combined use of ESWT and insole was not superior to ESWT alone. ESWT was found to be superior in some pain and functional assessments when compared to the use of insoles. Conclusion: In patients with painful heel spurs, personalized insoles with podometric measurement and ESWT applications are effective treatments on pain and foot functions when used alone and together. While the combined use of the two treatment options was more effective than the use of sole insoles, it was not found to be more effective than the use of ESWT as a single treatment. ESWT seems to be more effective than insoles on pain and foot functions. Keywords: Heel spur, calcaneal spur, epin calcanei, extracorporeal shock wave therapy, ESWT, custom insoles, podometric measurement insoles