Houston Methodist. Leading Medicine

Foot FAQ

Question:

I'm thinking about trying shock wave therapy for my very painful plantar fasciitis. My doctor is in complete agreement with ths plan. I've had the plantar fasciitis for two years now. Nothing has touched it -- not drugs, injections, night splints, or stretching exercises. Are there any bad side effects from this new treatment?

Answer:

Extracorporeal shock wave therapy (ESWT) is a newer form of nonsurgical treatment for chronic plantar fasciitis. It uses a machine to generate shock wave pulses to the sore area. Patients generally receive the treatment once each week for up to three weeks. It is not known exactly why it works for plantar fasciitis. It's possible that the shock waves disrupt the plantar fascial tissue enough to start a healing response. The resulting release of local growth factors and stem cells causes an increase in blood flow to the area. Recent studies indicate that this form of treatment can help ease pain, while improving range of motion and function. There's even a more specific type of ESWT being tested for this condition. It's called radial extracorporeal shock wave therapy (rESWT). rESWT applies vibrational energy at a specific point of tenderness. The force of the vibration spreads out over a larger area. The pattern of vibrational energy released looks like the shape of a megaphone. Treatment is directed at the painful region rather then at a painful point. The shock waves are applied to the bottom of the foot using a special hand piece that directs the energy at the point of maximum tenderness. FDA approval studies have found the treatment to be both safe and effective. Some patients report feeling increased pain during the procedure. A local injection of a numbing agent can be used to help reduce or eliminate this sensation. However, a few studies have had results that suggest the local numbing agent might reduce the benefit of the shock wave therapy. Most patients offered this pretreatment pain reliever do not accept it. Ludger Gerdermeyer, MD, PhD, et al. Radial Extracorporeal Shock Wave Therapy Is Safe and Effective in the Treatment of Chronic Recalcitrant Plantar Fasciitis. In American Journal of Sports Medicine. November 2008. Vol. 36. No. 11. Pp. 2100-2109.

*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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