OBJECTIVES: Chronic plantar fasciitis (CPF), the most common cause of plantar heel pain, lacks an optimal treatment standard. The electromagnetic Epos® Ultra (EPOS) and the electrohydraulic OssaTron® (OSSA) are the only two FDA approved extracorporeal shock wave therapy (ESWT) devices for CPF. This assessment will examine the net health outcomes obtained when using either of these devices in the treatment of CPF in patients who failed to achieve satisfactory improvement with initial conservative treatment. METHODS: Medline® MeSH heading searches of published peer-reviewed clinical literature identified all relevant studies that analyzed ESWT for the treatment of CPF dating to 1996. Additionally, conferences of professional organizations were searched for appropriate posters and abstracts. Outcomes measures focused on the ability of the comparators to reduce pain and the occurrence of adverse events. RESULTS: Treatment with EPOS demonstrated pain relief as evidenced by visual analog scale (VAS) score improvement from baseline and compared to control. When compared to control group, VAS score improvement at 3 months post treatment with ESWT was significantly greater (p=0.0149). When compared to baseline VAS scores, the improvement seen at 3, 6, and 12 months post treatment was also significantly greater (p<0.05). Adverse events in patients using EPOS were limited to pain at the time of application, which resolved after the treatment was completed. Treatment with OSSA resulted in greater pain relief than placebo, revealing an improved VAS score of approximately 1.0 to 2.5 points. Minor adverse events appearing in the area where the shock wave was applied were resolved within six weeks. Studies also revealed that ESWT as a whole improved patients' mobility scores by 38-51% (p=0.001) compared to baseline. CONCLUSIONS: The results of this assessment demonstrate that both EPOS and OSSA are safe and effective treatments for CPF patients who did not achieve adequate results with conservative treatment.