EFFICACY OF EXTRACORPOREAL SHOCK WAVE THERAPY IN THE TREATMENT OF A PATIENT WITH A CALCANEAL SPUR: A CASE REPORT Rathish Manickam *, Dirk Laubscher, Mohamed AG Elbaz .   Department of Physiotherapy & Department of Orthopaedics, Medeor 24x7 Hospital, Abu Dhabi, UAE. Address   for   Correspondence:   Mr.      Rathish   Manickam,    Department   of   Physiotherapy,   Medeor   24x7   Hospital,   A   Unit   of   VPS   Health   Care,   Abu   Dhabi   -   United Arab Emirates. Tel: +971 26900 .   E-Mail:  rathish605@gmail.com ABSTRACT Plantar   fasciitis   is   one   of   the   most   common   causes   of   pain   in   the   inferior   heel.   During   the   chronic   stage   of   this   condition,   a   calcaneal   heel   spur   might develop   which   leaves   the   patient   in   agonizing   pain   whenever   the   heel   undergoes   any   weight   bearing   activity   like   standing   and   walking,   adversely   affecting the   patient’s   activities   of   daily   living.   Thus   the   purpose   of   the   study   was   to   find   the   efficacy   of   ExtraCorporeal   Shock   Wave   Therapy   in   the   treatment   of calcaneal spur. Our   patient   was   treated   in   the   outpatient   department   of   physiotherapy   in   which   6   sessions   of   Extracorporeal   Shock   Wave   Therapy   were   administered. Plantar   fascia   stretching   exercises   and   deep   friction   manipulation   was   also   given   to   the   fascia   during   the   treatment.   Outcome   measures   used   were   the Numeric   Pain   Rating   Scale   (NPRS)   and   Foot   &   Ankle   Ability   Measure   (FAAM).   During   a   one   month   follow   up   period,   there   were   no   reoccurrence   of   heel pain.   The   patient   also   used   viscoelastic   insoles   which   provided   a   cushioning   effect   and   comfort   during   walking   and   other   daily   activities.   Thus   it   was concluded that ExtraCorporeal Shock Wave Therapy is effective in the treatment of calcaneal spur and improving patients functional activities KEY WORDS: Plantar fasciitis, Calcaneal spur, Pain,  ExtraCorporeal Shock Wave Therapy, Numeric Pain Rating Scale (NPRS). References 1 . Rompe   JD,   Hopf   C,   Nafe   B,Burger   R.   Low-energy   extracorporeal   shocks   wave   therapy   for   painful   heel:a   prospective   controlled   single-blind   study.   Arch Orthop Trauma Surg. 1996;115:75–9. 2 . Bordelon RL. Subcalcaneal pain.A method of evaluation and plan for treatment. Clin Orthop Relat Res.1983;177:49–53. 3 . Ang   Tee   Lim,   Choon   How   How,   Benedict   Tan.   Management   of   plantar   fasciitis   in   the   outpatient   se tting.   Singapore   Medical   Journal.   2016;57(4):168- 171. 4 . Maier   M,   Steinborn   M,   Schmitz   C,   Stabler   A,   Kottler   S,   Pfahler   M.   et   al.   Extracorporeal   shock   wave   application   for   chronic   plantar   fasciitis   associated with heel spur: prediction of outcome by magnetic resonance imaging. J Rheumatol 2000;27:2455–62. 5 . Davis, P.F., Severud, E., and Baxter, D.E.: Painful heel syndrome: results of nonoperative treatment. Foot Ankle lnt. 1994;15:531-535. 6 . Levitz, S.J., and Dykyj, D.: Improvements in the design of viscoelastic heel orthoses – a clinical study. J. Am. Podiatr. Med. Assoc.1990; 80:653-656. 7 . Martin,    R;    Irrgang,    J;    Burdett,    R;    Conti,    S;    VanSwearingen,    J:    Evidence    of    Validity    for    the    Foot    and    Ankle    Ability    Measure.    Foot    and    Ankle International.2005;11: 968-983. 8 . McCaffery, M.,Beebe, A., et al. Pain:Clinical manual for nursing practice, Mosby St. Louis, MO. .1989 9. Digiovanni BF, Nawoczenski DA, Malay DP, et al. Plantar fascia-specific stretching exercise improves outcomes in patients with chronic plantar fasciitis. A prospective clinical trial with two-year follow-up. J Bone Joint Surg Am. 2006; 88:1775-81.