Extracorporeal Shock Wave Therapy (ESWT) is a procedure used to treat chronic heel pain (plantar fasciitis/heel spur syndrome/insertional Achilles tendonitis). "Extracorporeal" means "outside of the body," and refers to this non-invasive surgical procedure in which strong sound waves are directed at the area of heel pain. The device used is similar to that currently used in non-surgical treatment of kidney stones.
Heel pain can usually be successfully treated with conservative measures such as use of anti-inflammatory medications and ice packs, stretching exercises, orthotic devices, and physical therapy. If the condition does not clear up after six months of these treatments, ESWT may be considered.
- What Happens During ESWT?
Your doctor will ask you to quit taking anti-inflammatory medication approximately five days prior to the procedure. The treatment takes about 30 minutes and is performed under local anesthesia and/or "twilight" anesthesia with oral medications. These will be called in to your pharmacy and 2 pills should be taken 1 hour prior to coming to the office. Bring the rest with you. Someone must drive you to the office and bring you home. The procedure includes strong sound waves penetrate the heel area and stimulate a healing response by the body. It is an outpatient procedure and does not require an overnight stay in the hospital.
- What Happens After Treatment?
There may be some mild pain or numbness and tingling after the treatment. Patients should be able to return to work or school the following day with modified or light duties. Activities to be avoided for the 4 to 6 weeks after the procedure include heavy lifting of objects, running, aerobic classes, or sporting activities.
It is very important to understand that anti-inflammatories like Advil, Aleve or prescription meds should be avoided for at least 8 weeks after the treatment. Ice should also be avoided. If you have pain, Tylenol is your best choice. If your pain is not controlled with Tylenol, your physician can give you a mild narcotic.
It is important to continue stretching for 3 months at least twice a day after the procedure. Night splints should also be worn for at least 3 months. If you do not already have a night splint, you physician will dispense one after the procedure. Orthotic usage is also important. You should wear your orthotics at least 80% of the time for 3 months after the procedure. If you do not have orthotics, a pair of sturdy arch supports will be dispensed by your physician after the procedure. These should be worn in sneaker-type shoes at least 80% of the time for 3 months.
As with any surgical procedure, complications may arise. There have been reports of bruising of the skin, swelling, pain, numbness or tingling, and rupture of the plantar fascia/Achilles tendon. Misdirected treatment may result in blood vessel or nerve damage.
ESWT is 80-85% successful in alleviating chronic heel pain. If pain is still present 3 months after the procedure, an open or endoscopic release of the fascia may be necessary.
Contact our office for any questions you have regarding this procedure!