Low-dose radiotherapy produced durable benefit in refractory plantar fasciitis

Low-dose radiotherapy produced sustained pain, function and quality-of-life improvement after conservative treatment and shock-wave therapy had failed.

KEY POINTS

  • This prospective observational study included 68 patients with magnetic resonance imaging-confirmed chronic plantar fasciitis persisting after conservative management and extracorporeal shock-wave therapy.
  • Patients received 3 Gy in six 0.5 Gy fractions, delivered twice weekly over three weeks.
  • At six months, 95.6% met the study definition of global clinical response, integrating pain, function and health-related quality of life.
  • A good response was maintained in 85.1% at 6, 12 and 24 months, while 35.8% achieved an excellent long-term pain response.
  • Clinical improvement correlated poorly with structural magnetic resonance imaging changes, and no acute or late radiation-related adverse events were identified.

CLINICAL TAKEAWAY

Low-dose radiotherapy may be a reasonable salvage option for carefully selected patients with persistent, disabling symptoms after established conservative therapies. The uncontrolled design, response definitions and very small number of non-responders prevent conclusions about comparative efficacy or rare long-term radiation risks.

SOURCE

Clinical and Translational Radiation Oncology