Radial Extracorporeal Shock Wave Treatment for Chronic Plantar Fasciopathy

Inclusion Criteria: * Adults over the age of 18 years * Diagnosis of painful heel syndrome by clinical examination, with the following positive clinical signs: (i) pain in the morning or after sitting a long time; (ii) local pain where the fascia attaches to the heel; and (iii) increasing pain with extended walking or standing for more than 15 minutes * History of six months of unsuccessful conservative treatment * Therapy free period of at least four weeks before referral * Signed informed consent Exclusion Criteria: * Bilateral plantar fasciitis * Dysfunction of foot or ankle (for example, instability) * Arthrosis or arthritis of the foot * Infections or tumors of the lower extremity * Neurological abnormalities, nerve entrapment (for example, tarsal tunnel syndrome) * Vascular abnormality (for example, severe varicosities, chronic ischemia) * Operative treatments of the heel spur * Hemorrhagic disorders and anticoagulant therapy * Pregnancy * Diabetes