Extracorporeal Shock Wave Therapy, also known as ESWT, is a non surgical alternative treatment option for intense persistent heel pain, often associated with chronic plantar fasciitis. Its sound wave technology is similar to that of a Lithotripsy, which is used to break up kidney stones. In the early 1990’s it was discovered that these high intensity acoustic sound waves had a benefit and on wound and fracture healing. ESWT has been used on a regular basis in Europe for the treatment of painful tennis elbow, plantar fasciitis, and to treat fractured bones that did not heal normally.
Mechanism of Action
Sound waves utilizing a high intensity sonic pulse generated from a computerized device with a movable are that allows the physician to position a water filled soft rubber bladder that targets the precise point of pain. Although it is not fully understood how why the treatment works, it is believed that microtrauma will ultimately repair damaged tissue and increase the blood supply to the area.
Candidates for ESWT
If you have been diagnosed with chronic plantar fasciitis for a duration of at least six months, and if your symptoms have failed to respond to a conservative treatments which may include rest, physical therapy, non-steroidal anti-inflammatory medications, cortisone injections, strappings, custom orthotics, shoe modifications, or use of night splints.
After exact positioning of the foot, a computer is then set to deliver 1000-4000 high energy sonic pulses. It is recommended that the procedure be performed under IV sedation with local anesthesia.
Immediatley following the procedure patients are advised to rest for the remainder of the day. Most patients are able to return to normal activities about 24 hours after the procedure. No immobilization or bandaging is required. The most common side effects are temporary bruising and soreness. Any swelling will usually clear within a few days. Significant pain relief has been noted in 80% of patients within two weeks of the procedure. Full clinical benefits of ESWT are appreciated 2-3 months following the procedure.