(adapted
from information provided by United Shockwave Therapies)
What is ESWT?
Extracorporeal shockwave treatment, also known as ESWT, is a non-invasive,
non-surgical option for treating chronic Plantar Fasciitis (commonly referred
to as “heel spurs”), Plantar Fasciosis and Achilles Tendonosis.
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. Today, ESWT is available as an alternative,
non-invasive treatment option.
What is plantar
fasciitis?
Plantar fasciitis is an inflammation of the plantar fascia. The plantar fascia
is a thick ligamentous/fibrous band on the bottom of the foot that is attached
to the heel, and runs forward to insert into the ball of the foot. Plantar
fasciitis is a painful inflammation of this band, which usually occurs at its
attachment to the heel; however, the inflammation and pain of plantar fasciitis
can occur anywhere on the plantar fascia.
What is plantar fasciosis/Achilles Tendonosis?
With time the plantar fasciitis becomes a Plantar Fasciosis and Achilles
tendonitis becomes Achilles Tendonosis. Plantar fasciosis/Achilles Tendonosis
is a chronic scar tissue with little to no vascularity (blood supply), which
causes pain.
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.
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. If you have not
been treated with these therapies, Rochester Podiatry can recommend the
treatment(s) most suited to your condition.
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 at Rochester Podiatry Associates 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 our 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. A lot of our patients also bring a pair of headphones, this helps them
relax during the procedure. It is always a good idea to bring identification
(driver’s license, ID card) and insurance information. Your injured foot
will be numbed during the procedure. Therefore, it is imperative that you bring
someone to drive you home following the procedure. We do 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?
Despite its widespread effectiveness, some insurance companies do not offer
coverage for ESWT at this time. For information regarding your specific
coverage, please contact our office for assistance.
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 us at (585)424-2420.
How much will I owe?
The out-of-pocket expense for ESWT depends on each patient’s insurance
coverage. Please contact our office for further explanation of your financial
responsibilities.
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