by dr.g

Do you suffer from pain in the heel or bottom of the foot that hurts with your first steps out of bed and then improves a bit as you walk around. Have you noticed the pain is now there more of the day when you walk and run? Is the pain getting to the point where you can not wear certain shoes or can not run anymore. If so then you probably have plantar fascitis that is becoming chronic. If you have been through orthotics, stretching, massage and or injections then you might want to try Extracorporeal Shockwave Treatment (ESWT).

Medical X-rays

Medical X-rays (Photo credit: Wikipedia)


What is Extracorporeal Shockwave Treatment?

Extracorporeal Shockwave Treatment is a non-invasive (no incisions) treatment that involves the delivery of high energy sound waves, or acoustical energy, to affected areas of the body to trigger the body’s own natural repair mechanisms and stimulate healing. Shockwave Treatment (‘extracorporeal’ meaning ‘outside the body’) is a safe and effective treatment option. The recovery period is shorter than traditional invasive surgery and the procedure eliminates many of the risks associated with traditional surgery. Extracorporeal Shockwave Treatment (ESWT) has been used effectively for many years around the world. It was first approved in the United States by the FDA in October 2000 for the treatment of Plantar Fascitis, a type of heel pain. The FDA subsequently approved ESWT for Lateral Epicondylitis, commonly referred to as Tennis Elbow, in March 2003.

What Is ESWT Used For?

ESWT has been used effectively worldwide to treat “insertional tendinopathies,” such as:
• Heel Pain (Plantar Fasciitis)
• Tennis Elbow (Lateral Epicondylitis)
• Shoulder Calcifications (Calcific Tendonitis)
• Achilles Tendonitis
• Knees (Patellar Tendonitis)
Millions of people suffer from pain caused by inflammation of tendons and other soft tissues attached to bones, commonly referred to as “insertional tendinopathies.”

How Does Extracorporeal Shockwave Treatment Work?

The widely accepted theory is that Extracorporeal Shockwave Treatment (ESWT) causes micro-trauma and controlled injury at the affected area, thereby leading to the formation of blood vessels (revascularization) which triggers the body’s natural healing process and repair mechanisms. The sound waves are also thought to release adhesions and scarring to help increase mobility an doptimize healing. Studies have shown a 60-80% success rate in significantly reducing or eliminating pain.

What Happens Before, During and After ESWT Treatment? 


BEFORE: Patients will be evaluated to determine if their condition might respond to ESWT and what other treatments may help them restore function and reduce pain. 


DURING: Treatment typically lasts 10-15 minutes and is performed in the office. The treatment begins by placing the Myact head over the sensitive area and applying shocks until the patient gets a slightly painful sensation (“patients report saying yeah that is the area or feeling tingling over the area and surrounding areas)  Once the most sensitive area is determined approximately 1000-1500 compressions are delivered to the area to help stimulate blood flow and improve healing. The goal is to deliver the highest tolerable intensity of compressions during treatment.  Treatment is always delivered to patient tolerance. 


AFTER: Patients may experience discomfort in the treated area after the treatment but many feel decreased pain or increased range of motion immediately following treatment.   Some bruising, swelling, and temporary numbness is normal and expected. In the immediate days following treatment, many doctors will recommend RICE – Rest, Ice, Compression, Elevation. In some instances they will recommend heat. Movement and stretching will also be recommended. Weekly follow-up visits with your doctor allow the physiotherapy needed for optional healing. 


For three to four weeks following treatment, patients are advised to not participate in stressful activities or to limit those (e.g. jogging, heavy housework, yard work, participating in sports) involving the affected area. Patients can then typically resume normal activity. Heel pain patients are typically instructed to avoid flat shoes such as sandals and slippers; continued use of orthotics may be encouraged. Healing is generally complete at about twelve weeks, although patients may continue to experience additional reduction in pain thereafter

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