NEW RELIEF FROM HEEL PAIN

October 28, 2003

By Todd C. Skiles, DPM, FACFAS

Heel pain can develop from a variety of foot problems; but is most commonly caused by a condition called Plantar Fasciitis.

What is Plantar Fasciitis?

Plantar fasciitis (often 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.

A ligament (the plantar fascia) stretching along the bottom of your foot is responsible for maintaining the arch of your foot. When the plantar fascia pulls away from the bone, your heel becomes painful. Your body may react by forming new bone, a heel spur. Most people think heel spurs are the cause of the pain - but the pain is actually caused by the inflammation or irritation of the plantar fascial ligament.

Plantar fasciitis can be caused by a number of factors and is a common sports injury among runners, walkers, and other athletes. Overweight people and those whose jobs require a lot of standing and walking are also at higher risk. Other factors leading to plantar fasciitis include flat or high arch feet, worn-out or improper shoes, jogging, on sand and increasing age.

Common treatments for heel pain

Conservative treatments for heel pain include rest, physical therapy, heel cushions, anti-inflammatory medications, steroid injections, taping, orthotics, shoe modifications, night splints and casting. Fortunately, conservative treatments have an approximately 90% success rate. In years past, surgery for chronic plantar fasciitis was required when conservative treatments had failed; but today, a new treatment is available called Extracorporeal Shockwave Therapy (ESWT).

What is ESWT?

Extracorporeal shockwave treatment 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 device, and focused onto the targeted tissue. The shockwaves are delivered outside the body to trigger an individual's own repair mechanisms. Shockwave therapy was originally developed to break up kidney stones in the body. The FDA approved this therapy in the early 1980s; and today it is the standard treatment of choice for kidney stones. An important benefit of this therapy is that it's delivered outside the body, so many of the risks associated with surgery are eliminated. Doctors around the world, especially in Europe, have successfully used this technology since the early 1990s.

What are the benefits and risks of ESWT?

Based on worldwide medical experience, ESWT is a safe and effective alternative to traditional treatment methods. Shockwave therapy relieves pain, provides a short recovery period and eliminates the need to be off your feet for any period of time following the procedure. This therapy may eliminate the need for surgery altogether, which is often expensive and has risks. There are very few side effects or risks involved in shockwave therapy. The most common patient complaint is some pain or discomfort during and after treatment. Other side effects might include minor skin bruising and/or reddening, as well as swelling for a brief period of time.


Should you receive ESWT for plantar fasciitis?

Before undergoing ESWT treatment, you must have symptoms of chronic plantar fasciitis for at least 6 months. You must also have tried, and not found relief, from more conservative treatments.

Who should not receive ESWT for plantar fasciitis?

ESWT is not appropriate if you are suffering from acute plantar fasciitis. ESWT is also not recommended under certain conditions, i.e. you have a pacemaker, are taking medications that may prolong or interfere with blood clotting, or you are pregnant. Children also should not receive this treatment. Your health history needs to be reviewed with your doctor to see if this treatment is right for you.

If you or someone you know suffers from chronic heel pain, see your doctor for help and stop living with the pain.