High Energy Shockwave Treatments
(Extracorporeal Shock Wave Therapy i.e., ESW Treatment)
What is ESW treatment?
This new procedure is used to treat chronic heel pain (plantar/fasciitis/heelspur syndrome). It uses strong sound waves that are directed at the area of heel pain. The device used is similar to that currently used in non-surgical treatment of kidney stones. This is a non-invasive procedure that is performed in the office. Before starting the treatment, Dr. Bembynista uses a local anesthetic to numb the affected area. It takes approximately 20 minutes to perform the procedure. Afterwards, Dr. Bembynista reviews post procedure instructions with the patient.
Who is a candidate for ESW treatments?
Patients with heel pain are usually treated with more conservative therapies (link to heel pain treatment). These include oral medication, changing shoe types, steroid injection, and orthotics. If pain continues after these treatments, then this procedure can be used. Conservative treatment should be tried for 3 months first.
Who should not have ESW?
ESW is not appropriate for patients who have a bleeding disorder or who are taking medications that may prolong bleeding or interfere with blood clotting. It should not be used during pregnancy or for children. In addition, its safety and effectiveness have not been established for those with nerve damage, osteoporosis, rheumatoid arthritis, tarsal tunnel syndrome, diabetic neuropathy, severe peripheral vascular disease, metabolic disorders, and infections.
Are there complications?
As with any surgical procedure, complications may arise. There have been reports of bruising of the skin, swelling, pain, numbness, or tingling, and rupture of the plantar fascia. Misdirected treatment may result in blood vessel or nerve damage.
How successful is ESW treatment?
In recent studies patients with chronic heel pain/plantar fascitis have been getting 60 to 70% success in just one treatment.
What happens after treatment?
Patients are generally given a mild pain medication for any discomfort and are seen within the first few weeks back in the office. There may be some mild pain or numbness and tingling after the treatment. Patients should be able to return to work or school the following day with modified or light duties. Activities to be avoided for the 4 to 6 weeks after the procedure include heavy lifting of objects, running, aerobic classes, and sporting activities.
Patients should call our office to make an appointment to see Dr. Bembynista. If you have been treated for chronic heel pain, please bring any history of treatments and x-rays, if available.
Does insurance cover this procedure?
This varies significantly from one insurance to another. After evaluation by Dr. Bembynista, and if treatment is recommended, we will assist you to determine if benefits are available by your insurance.