Comparison of the effectiveness of extracorporeal shock wave therapy and local ozone injection in the treatment of patients with plantar fasciitis

AIM: Plantar fasciitis (PF) is a common cause of heel pain that affects daily activities and quality of life. Although often treated with conservative methods, symptoms can become chronic in some patients, requiring advanced treatments. This study aims to compare the effectiveness of Extracorporeal Shock Wave Therapy (ESWT) and local ozone injection in treating chronic PF and evaluate their effects on pain, quality of life, and functionality. MATERIALS AND METHODS: Sixty patients who were admitted to the Physical Medicine and Rehabilitation and Algology outpatient clinics of Sakarya University Training and Research Hospital with chronic (more than 3 months) heel pain and who were diagnosed with plantar fasciitis by history and physical examination and who received routine ESWT or local ozone injection treatment were evaluated. The patients were followed up with NRS, SF-12 and Foot Function Index (FFI) before, 1 month and 3 months of treatment with exercise and ESWT or exercise and local ozone injection. RESULTS: Both ESWT and ozone injection reduced pain and improved function. Significant decreases in NRS scores were observed in both groups, with faster improvement in the ESWT group. Both groups showed significant post-treatment improvements in FFI scores. The ESWT group showed greater improvement in FFI-A and FFI-Total scores at the 2nd evaluation period, consistent with reduced NRS pain scores. PCS and MCS scores improved similarly in both groups at all time points. CONCLUSİON: ESWT and ozone injection are effective for treating chronic PF, providing pain relief and functional improvement. ESWT offers faster pain reduction, while functionality outcomes are comparable. These results highlight the importance of personalized treatment approaches.