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(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
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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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