Plantar fasciitis, commonly referred to as a "heel spur", is a common cause of heel pain and affects about 2.5 million people each year in the U.S.

The muscle that stretches along the bottom of the foot (the plantar fascia) is responsible for maintaining the arch of the foot.  When the plantar fascia pulls away from the bone, the heel becomes painful.  The body may react to this condition by filling the space with new bone - a heel spur.  Heel spurs are not actually the cause of the foot pain, but the inflammation or irritation of the plantar fascia and/or muscle is the cause.

Plantar fasciitis is caused by a number of factors and is a common sports injury among runners, walkers, and athletes.  Overweight individuals and those whose jobs require a lot of standing or walking are also at higher risk.  Other risk factors of plantar fasciitis include flat or high-arched feet, neurological pathology, worn out or improper shoes, and increasing age.

How does Extracorporeal Shock Wave Therapy Work?

Shock wave therapy was originally developed to break up kidney stones in the body.  The therapy was approved by the FDA in the early 1980s, and today shock waves are the first choice of treatment for urinary stones.

Extracorporeal shockwave treatment, also known as ESWT, is a non-invasive, non-surgical treatment option for the intense, persistent heel pain associated with chronic plantar fasciitis.  “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 an individual’s own repair mechanisms.  An important benefit of this therapy is that it is delivered outside the body, eliminating many of the risks associated with surgery. 

Who Should Receive EWST?

Prior to undergoing ESWT treatment, the patient must have been diagnosed with chronic plantar fasciitis for at least six months. Only after the patient’s symptoms fail to respond to three conservative treatments should ESWT be administered. Conservative treatments include rest, physical therapy, heel cushions, non-steroidal anti-inflammatory drugs (ibuprofen, acetaminophen, etc), cortisone injections, taping, orthotics, shoe modifications, night splinting and casting. In years past, surgical intervention for chronic plantar fasciitis was required when these other treatments had failed. Today, ESWT is available as an alternative, non-invasive treatment option.

What happens during treatment?

The entire treatment takes approximately 15-30 minutes.  Before therapy begins, patients are asked to identify the area of the foot with the most pain, which the physician will note.  An ultrasound image of the foot will also probably be taken.  An ankle block utilizing local anesthetics may be administered to numb the afflicted area if high energy shockwave is used, and no anesthesia is required for low energy shockwave therapy.  Both low and high energy shockwave treatments offer similar therapeutic results.  During this outpatient procedure, the injured heel receives several thousand shockwaves. 

After treatment, patients are discharged directly home from the office.