What is the role of external shockwave therapy (ESWT) in the treatment of metatarsal stress fractures?

Updated: Jan 16, 2019
  • Author: Valerie E Cothran, MD; Chief Editor: Craig C Young, MD  more...
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Answer

Albisetti et al reported their experience with diagnosing and treating stress fractures at the base of the second and third metatarsals in young ballet dancers from 2005-2007. [24] Of 150 trainee ballet dancers, 19 had stress fractures of the metatarsal bone bases. All of the dancers were recommended to rest, but external shockwave therapy (ESWT) was also used in 18 and electromagnetic fields (EMF) and low-intensity ultrasonography was used in 1, with good results in each case. [24]

Albisetti advised the best approach to metatarsal stress fractures is early diagnosis with clinical examination and radiologic studies such as x-ray and MRI. The investigators also noted ESWT led to good results, with a relatively short time of rest from the patients' activities and a return to dancing without pain. [24] However, further study is warranted given the small study size and that all but one of the young dancers received ESWT.


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