Shock Wave Treatment for Heel Pain

What is ESWT?
Extracorporeal shockwave treatment, also known as ESWT, is a non-invasive, non-surgical option for treating chronic plantar fasciitis (sometimes referred to as “heel spurs”). “Extracorporeal” means “outside the body”. Shockwaves, also known as pressure or sound waves, are generated from a special ESWT device and focused onto the targeted tissue. The shockwaves are delivered outside the body to trigger your body’s own repair mechanisms. Shockwaves stimulate and reactivate healing to advance normal tissue healing. In years past, surgical intervention for chronic plantar fasciitis was required when these other treatments had failed. Now, ESWT is available in Austin as an alternative, non-invasive treatment option.

What is plantar fasciitis?
The plantar fascia is a band of connective tissue on the surface of the heel that plays a large role in maintaining the normal mechanics of the foot. Plantar fasciitis, also commonly referred to as heel spurs, is a common clinical condition caused by overuse or injury of the area. Symptoms include 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, poor fitting shoes, minor trauma, occupational risks and change in your exercise program. Although everyone is at risk, plantar fasciitis is most commonly found in athletes, runners, overweight individuals, or those who are required to stand on hard surfaces for prolonged periods of time.

What devices are used?
There are currently two devices approved by the FDA for the treatment of chronic plantar fasciitis, the OssaTron ® by HealthTronics, Inc., approved in October 2000, and the Epos Ultra ® by Dornier, Inc., approved in January 2002. Both systems result in equally successful patient outcomes and are high-energy devices that utilize a single treatment protocol.

Am I a candidate for ESWT?
If you have been diagnosed with and treated for chronic plantar fasciitis for at least six months and have failed to respond to three conservative treatments, you may be a candidate for ESWT. Conservative treatments include rest, physical therapy, heel cushions, NSAIDs, cortisone injections, taping, orthotics, shoe modifications, night splinting and casting. Dr. Prant has found that ESWT provides relief for about two thirds of the people who have not had relief with other treatments. Only about 5% have immediate relief however. Please ask Dr. Prant for more information.

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 should I expect on treatment day?
On the day of the treatment, expect to arrive at the treatment facility approximately 20-30 minutes prior to the scheduled appointment time. Our technician will meet you with some paperwork and your physician will be there to answer any last minute questions you may have. After the brief registration process, you will recline in a comfortable chair or bed with your injured foot resting on a large, fluid-filled cushion.

After the administration of the ankle block and the localization of the inflamed area with the ultrasound, shockwaves will be delivered to the injured heel. The outpatient procedure lasts approximately 20 minutes per injured foot.

Following the procedure, you will be discharged home from the treatment facility and will be provided with instructions and exercises that are important and necessary to your recovery.

What do I need to bring with me on treatment day?
Be comfortable! Most patients wear comfortable clothes and shoes, such as gym shoes. It is a good idea to bring identification (driver’s license, ID card) and insurance information.

Your foot will be numbed during the procedure. Therefore, it is imperative that you bring someone to drive you home following the procedure. United Shockwave does not recommend that any patient drive themselves home after receiving ESWT.

What are the side effects of ESWT?
Compared to surgery, ESWT has fewer side effects and a much shorter recovery time. The most common adverse reactions include temporary pain associated with bruising and soreness, and swelling. These possible occurrences usually resolve within a few days. Again, most risks associated with surgery and general anesthesia have been eliminated.

Does ESWT hurt?
The most common patient complaint during therapy is mild pain or discomfort during and immediately following the procedure. Typically, an ankle block utilizing local anesthetics is administered to numb the afflicted area prior to receiving any shockwaves.

What can I expect after the treatment?
After the treatment, it is normal to experience mild pain and/or discomfort when the ankle block has subsided. You may even experience heel pain similar to what you were feeling before the procedure. This pain is manageable in most situations with over the counter medications. These symptoms do not mean that the treatment was not effective. It is important to note that this is normal and to be expected following the procedure. Based on many of the clinical trials, the true and lasting effects of ESWT should be evaluated no sooner than 12 weeks following treatment. The healing process continues for weeks and months following ESWT.

Stretching exercises should be continued following the treatment per your physician’s orders. You may also want to abstain from stressful activity such as running, sports, or heavy housework for a few weeks. After approximately four weeks, you should be able to resume normal activities.

Will my insurance cover ESWT?
We are contracted with insurance companies nationwide in order to provide our services to patients. Despite its widespread effectiveness, some insurance companies do not offer coverage for ESWT at this time. For information regarding your specific coverage, please contact Candace in our office from 8 AM to 1 PM.

What can I do to convince my insurance to pay?
There are some insurance companies that are still debating coverage of ESWT. As the patient and the customer of the insurance company, your voice is important. It is imperative that you express your opinion to your insurance company. For assistance in this matter, please feel free to contact Candaice as noted above.

How much will I owe?
The out-of-pocket expense for ESWT depends on each patient’s insurance coverage. Candaice will review this in detail before anything is scheduled.

Does Medicare cover this procedure?
Medicare and Medicaid do not cover this procedure.