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To the Editor: I have several concerns about the study of Dr Buchbinder and colleagues.¹ First, the study enrolled patients who had only 6 weeks of symptoms, without a minimum baseline pain level requirement. By contrast, my study of the higher-energy device approved by the US Food and Drug Administration required symptoms of at least 6 months' duration with a minimum pain scale score criterion (G.H.T., unpublished data, 2002). The reason is that most cases of plantar fasciitis are self-limited and resolve within 6 to 8 months.

Second, the control group of this study was treated with low-energy EWST while the active group was treated with a higher dose. If both the placebo and active groups are exposed to the same treatment, the ability to differentiate and validate the results between the 2 groups becomes impaired.

Third, the study of Buchbinder et al used low-energy ESWT administered at 3 different . . . [Full Text of this Article]

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