Extracorporeal Shockwave Therapy (ESWT)


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.

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.

What To Expect with ESWT

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.  The treatment may take up to 30 minutes per foot. 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

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.