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Is oral hydrocortisone a contraindication to ESWT for plantar fasiopathy?

We have a patient who takes 10mg x 2 a day and 5 mg x 1 a day of hydrocortisone following removal of a brain tumour over 10 years ago. Is there a risk that the plantar fascia may rupture with ESWT?

Anne-Marie Hutchison

1 year ago

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Anne-Marie. It has been reported in the literature that Shockwaves have a proinflammatory effect. Therefore when used concomitantly with anti-inflammatories these may restrain or abolish its therapeutic effect. Like Cliff and Tim I do not think that is a contraindication in these cases, but it is surely a precaution which warns to the risk of bias in the results and thus question its usefulness.

Prof Tim Watson
Prof Tim Watson

Anne-Marie. Agree with Cliff in that the current opinions would say that oral hydrocortisone does not constitute a contraindication when it comes to radial shockwave nor indeed low dose focussed. My understanding is that it is still an issue to consider with high dose focussed, but I doubt that is what you are planning to use?? Tim

Cliff Eaton
Cliff Eaton

Dear Anne-Marie If you refer to the ISMST website also DIGEST (German speaking) you will find the recent concensus statement on both indications and contraindications for Shockwave You will see that for low energy Radial Pressure Wave ( RSWT) or low energy Focused Shockwave (FSWT) any type of hydrocortisone is NOT contraindicated I hope that helps Cliff

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