Extracorporeal shock wave therapy, or ESWT, has emerged as a possible treatment option for patients with chronic plantar fasciitis. ESWT delivers focused shock waves to the body. There is both a high-energy and low-energy form of ESWT, and both forms of shock wave therapy can be used in the treatment of plantar fasciitis.
Low-energy shock wave treatments are given as a series of three or more treatments. The low-energy shock waves are not painful, or mildly painful. On the other hand, the high-energy shock wave treatments are given at one session. High-energy shock wave treatments are quite painful, and some type of anesthesia is needed. Either a regional block or general anesthesia can be administered for the high-energy treatments.
Shock wave therapy is thought to work by inducing microtrauma to the tissue that is affected by plantar fasciitis. This microtrauma initiates a healing response by the body. This healing response causes blood vessel formation and increased delivery of nutrients to the affected area. The microtrauma is thought to stimulate a repair process and relieve the symptoms of plantar fasciitis.
The FDA approved the use of shock waves for the treatment of plantar fasciitis in 2000. Since that time, numerous studies have investigated the use of shock wave treatments for plantar fasciitis, and found good results in patients treated with three sessions of ESWT.
The most attractive aspect of shock wave treatment for plantar fasciitis is that surgical treatment of chronic plantar fasciitis is not terribly effective. Because of this, orthopedic surgeons are seeking a more effective treatment for these patients who do not seem to improve with more standard treatments. The standard treatment for plantar fasciitis that does not improve with conservative measures is surgery.
For patients who have chronic plantar fasciitis, and who have failed a minimum six month trial of standard treatments, shock wave therapy is a safe treatment alternative to surgery. Many patients wish to avoid surgery if at all possible. Furthermore, one of the most concerning aspects of surgical treatment of plantar fasciitis is that there are potentially serious complications.
Ask your doctor if extracorporeal shockwave therapy is right for you.
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