Extracorporeal Shock Wave Therapy

Plantar fasciitis is inflammation of the plantar fascia. This is a thick fibrous band of tissue at the bottom of your foot that lies between your toes and your heel. Repeated small injuries to the plantar fascia are believed to be the cause of the inflammation.

What is ESWT?

ESWT is a procedure where shock waves are passed through the skin to the injured part of the foot, using a special device. Extracorporeal means outside of the body. The shockwaves are mechanical and not electric. They are audible, low-energy sound waves, which deliver impulses of energy, targeted to specific damaged tissues within the abnormal tendon and/or plantar fascia. This increases the blood flow in injured area, stimulating cell regeneration and healing, and decreasing local factors which can cause pain. This speeds up your body’s healing process. You will usually require a course of three to six treatments, one to two weeks apart.

Why should I have ESWT?

ESWT is offered to patients who have not responded well enough to other treatments, such as physiotherapy, orthotics (insoles or leg braces), rest, steroid injection, ice therapy and pain relief. It is a minimally invasive treatment that is carried out on an outpatient basis, which means that you can go home the same day. ESWT can offer relief from pain and other symptoms.

Before shockwave therapy is considered you will have a full clinical assessment. This will include a film of you walking to assess your gait and joint alignment, and may include a referral for an MRI or Ultrsound scan.

What are the risks/side effects?

You will experience some pain/discomfort during the treatment, but you should be able to cope with this. Following the treatment, you may initially experience more pain, redness, bruising, swelling and numbness to the area. These side effects should resolve within a week, before your next treatment. There is a small risk of tendon rupture or ligament rupture and damage to the soft tissue.

You will be asked to complete a questionnaire before your treatment starts, after three months and again one year after your treatment.

You must not have ESWT for plantar fasciitis if you are pregnant, have a blood clotting disorder, are taking certain medication, or have certain other medical conditions.

These will be discussed with you by your specialised Podiatrist when the treatment is offered. Your Podiatrist will discuss the benefits and risks of the procedure with you in more detail – please let them know if you have any questions or would like any further information.

Are there any alternatives?

If ESWT does not help your pain, then sometimes an operation may be available, depending on your condition. You can discuss this with our Consultant Podiatric Surgeon Ms Diane Nicholl Msc FCPodS.

How can I prepare for ESWT?

• You will need to be available for the full course of treatment.
• You should not take any non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, for two weeks before your first procedure, and throughout your treatment.
• If you are unsure if any of your medicines contain NSAIDs then please check with your doctor, Podiatrist or pharmacist. Wear comfortable clothing as you will be lying on your front for the treatment.