Extracorporeal Shockwave Therapy (ESWT)

We provide extracorporeal shockwave therapy in Seattle, Washington, for foot and ankle injuries and conditions.  We use it for many ligament and tendon problems such as plantar fasciitis, tendinitis (including Achilles, peroneal, posterior and anterior tibial, flexor and extensor), ankle sprains, Lisfranc’s injuries, sinus tarsi syndrome, partial tears and partial ruptures, capsulitis, plantar plate injuries.

What Is ESWT?

Extracorporeal Shock Wave Therapy (ESWT) is a noninvasive procedure that uses sound waves to stimulate healing in some physical disorders, including plantar fasciitis. “Extracorporeal” means “outside of the body” and refers to the way the therapy is applied. Because there is no incision, ESWT offers two main advantages over traditional surgical methods: fewer potential complications and a faster return to normal activity.  ESWT has been used extensively for years to treat plantar fasciitis and other disorders. Our office utilizes this Extracorporeal Shockwave Therapy (EPAT) technique for acute and chronic foot and ankle injuries and musculoskeletal conditions.

EPAT (Extracorporeal Pulse Activation Technology) is a pulse-activation technology that has been approved by the FDA. This proprietary technology is based on a unique set of pressure waves that stimulates metabolism, enhances blood circulation and accelerates the healing process. Damaged tissue gradually regenerates and eventually heals. This non-invasive office based procedure represents a breakthrough treatment option for a broad range of musculoskeletal conditions.

What Disorders Can Be Treated?

  • Plantar Fasciitis
  • Capsulitis
  • Sports Injuries
  • Tendonitis
  • Neuromas
  • Achilles Tendonitis

What is Plantar Fasciitis?

Plantar fasciitis is the most common form of heel pain. This painful condition results from inflammation of the plantar fascia—the connective tissue that stretches from the heel bone, across the arch, and to the base of the toes. Plantar fasciitis is sometimes also called heel spur syndrome when a spur (bony protrusion) is present.

Who Is a Candidate for ESWT?

Some patients should not be treated with ESWT. The procedure is not appropriate for patients who are pregnant, have cancer or a bleeding disorder, or take medications that may prolong bleeding or interfere with clotting. Dr. Hoy will determine if the procedure is appropriate for you based on your medical history.  Alternative treatments include use of anti-inflammatory medications, steroid injections, ice packs, stretching exercises, orthotic devices (shoe inserts), and physical therapy.

Is It Safe? Any Side Effects?

Yes, EPAT is safe. The FDA cleared technology was developed in Europe and is currently used around the globe. A wealth of medical experience, state-of-the-art engineering and optimal quality have been built into each EPAT device and extensive clinical studies and tests have confirmed its safety and efficiency. If performed by a qualified caregiver, EPAT treatment has virtually no risk or side effects. You will receive post-treatment instructions from your physician to continue recovery.

Why Consider Non-Invasive EPAT?

Epat has a proven success rate that is equal to or greater than that of traditional treatment methods (including surgery) and without the risks, complications and lengthy recovery time. EPAT is performed in the office and does not require anesthesia, requires only a minimal amount of time and patients can be weight-bearing immediately and return to normal activity within a few days of the procedure.

Benefits include:

  • Faster healing
  • No anesthesia
  • No risk of infection
  • No scarring
  • No downtime
  • Over 80% patient satisfaction

What Are the Expected Results?

The beneficial effects of EPAT are often experienced after only 3 treatments. Some patients report immediate pain relief after the treatment, although it can take up to four weeks for pain relief to begin. The procedure eliminates pain and restores mobility, thus improving your quality of life. Over 80% of patients treated report to be pain-free and/or have significant pain reduction. Treatments are scheduled with one treatment per week and a total of three to five treatments per patient to achieve maximum effectiveness.  While most patients need only three treatments, a fourth or fifth treatment will be provided as is deemed medically necessary by the physician.

What To Expect with ESWT

A new patient visit is required to identify the condition and discuss all treatment options. If shockwave therapy is indicated we will discuss the procedure, medical eligibility, activity during treatment, and expectations. A series of three separate weekly sessions will then be scheduled thereafter, followed by re-evaluation in 6 weeks for possible two more weekly sessions.

In preparation for ESWT, Dr. Hoy will instruct the patient to stop any anti-inflammatory steroid therapy 6 weeks before the procedure. It is important to avoid these medications because they are known to weaken tissue or prolong bleeding under the surface of the skin.

ESWT is performed in the office.  During the procedure sound waves penetrate the affected area and stimulate the healing response. More than one session is needed to adequately treat the inflammation and reduce the patient’s symptoms.

After the Procedure

You will receive post-treatment instructions from your physician to continue recovery.  Dr. Hoy may advise you to do the following:
• Rest and elevate the foot
• Resume gentle stretching exercises
• Avoid heavy lifting or excessive activity until the surgeon approves resuming this activity.
• You may walk on the foot.
• Avoid going barefoot during the healing process.
• Wear supportive shoes.
• In some cases, orthotic devices (shoe inserts) will be prescribed.

Although patients sometimes feel they can return to normal activities right away, the surgeon will determine when that is appropriate for your situation. It is important to use caution and follow the doctor’s instructions to avoid injuring the treated foot. Because ESWT temporarily reduces or eliminates the sensation of pain, patients sometimes become too active too soon.

ESWT is very safe and effective, but every surgical procedure carries the possibility of complications. In addition to mild pain and tingling or numbness, bruising and swelling sometimes develop after ESWT.  There have also been reports of rupture of the plantar fascia and damage to the blood vessels or nerves.

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