WHAT IS ESWT?
Extracorporeal Shockwave Therapy, also known as ESWT, is a non-surgical treatment option for the intense, persistent heel pain associated with chronic plantar fasciitis. "Extracorporeal" means "outside the body." Shock waves, also known as pressure or sound waves, are generated by a special ESWT device, and focused onto the targeted tissue. The shock waves are delivered to stimulate and reactivate the body's repair mechanisms to advance normal tissue healing.
WHAT IS PLANTAR FASCIITIS?
The plantar fascia is a band of connective tissue beneath the skin at the bottom of the foot. It begins at your toes and continues to the heel and wraps around the heel bone and forms the Achilles tendon. The plantar fascia plays a large role in maintaining the normal mechanics of the foot. Plantar fasciitis is a common condition caused by overuse or injury to this area. Symptoms include sharp heel pain, burning in the sole of the foot, recurring foot pain that is especially present in the morning or after sitting, or heel pain after beginning a new exercise routine.
WHAT CAUSES PLANTAR FASCIITIS?
There are a number of predisposing factors including the way you walk, obesity, poorly fitting shoes, minor trauma, occupational risks and a change in your exercise program. Although everyone is at risk, plantar fasciitis is most commonly found in athletes, runners, overweight individuals, or those required to stand on hard surfaces for prolonged periods. ESWT is an appropriate treatment option for approximately 5 to 10 percent of people suffering from plantar fasciitis - most others are treatable with therapies that are more conservative.
AM I A CANDIDATE-FOR ESWT?
You and your doctor will decide if ESWT treatment is right for you after looking at all the options. You could be a candidate if you have been diagnosed with chronic plahtar fasciitis for at least six months and if your symptoms have failed to respond to three conservative treatments which may include rest, physical therapy, heel cushions, non-steroidal medications (motrin or other anti -inflammatories), cortisone injections, taping, orthotics, shoe modifications, night splinting and casting. In the past, surgical intervention for chronic plantar fasciitis was required when these other treatments had failed, but today, ESWT is available as an alternative, noninvasive treatment option.
ARE THERE ANY SIDE EFFECTS TO ESWT?
Compared to invasive or endoscopic surgery, ESWT has fewer side effects and a much shorter recovery time. The most common side effects include temporary pain (bruising and soreness), swelling and petechiae (broken blood vessels that are generally of no concern). These possible occurrences, however, usually clear within a few days. Moreover, the risks associated with surgical incisions and general anesthesia are eliminated.
WHO SHOULD NOT RECEIVE ESWT?
ESWT is not recommended if you have a pacemaker, if you are taking medications that may prolong or interfere with blood clotting (coumadin) or if you are pregnant. Your doctor can discuss other possible concerns with you. ESWT is not appropriate for individuals suffering from acute plantar fasciitis. Your health history should be reviewed with your doctor to see if this treatment is appropriate for you.
WHAT HAPPENS DURING TREATMENT?
On the day of the procedure, you will arrive at the treatment location at the designated time prior to the scheduled appointment where you will meet your physician and technician. After registering, you will recline in a comfortable chair or bed, with your affected foot resting on a large, fluid-filled cushion. Either an ankle block utilizing local anesthetics is administered to create a "numb" feeling throughout the foot or, if your physician chooses, IV sedation may be used to administer a light "sleep" until the procedure is complete. After localizing the inflamed area, the affected heel receives oevoral thousand shock waves during the approximately 20 minute outpatient procedure.
WHAT HAPPENS AFTER THE TREATMENT?
You will be discharged dihact!y from the treatment center and your physician will provide post-treatment instructions and exercises necessary for your recovery. We advise you to have someone accompany you to the treatment facility. The recovery time is very short, and after a recuperative peiiod, usually 24 to 48 hours, you should be able to return to normal daily activities. You may begin to feel relief immediately or it could take from three to six months to improve.