Why Our Long Island Podiatrists Recommend Shockwave Therapy for Foot and Heel Pain

Extracorporeal shockwave therapy (ESWT) is a non-invasive treatment option that Massapequa Podiatry Associates offers to help remedy conditions such as Achilles tendinitis, neuromas, and sprains. Our podiatrists also rely on shockwave therapy for plantar fasciitis. Here’s why we might recommend it in your case. 

How Shockwave Therapy Works

ESWT is a form of regenerative medicine, meaning that it assists your body in healing itself without the use of pharmaceuticals. Shockwave therapy has been available for more than 20 years and studied to be effective in helping numerous foot conditions.

The targeted shockwaves used in an ESWT session: 

  • Break down calcifications
  • Create new blood vessels in the affected area
  • Increase blood flow to the injury
  • Bring more oxygen to the site 
  • Decrease inflammation 
  • Enhance and speed up the body’s natural ability to heal itself 
  • Temporarily block some neurotransmitters in the brain that allow the patient to feel intense, persistent pain

How Plantar Fasciitis Occurs Runner holding foot in pain due to plantar fasciitis indicating need for shockwave therapy

Plantar fasciitis is the most common condition that causes heel pain. It results from the ligament (fibrous tissue) that runs along the bottom of the foot (fascia) and supports the arch of the foot, becoming stiff and inflamed. Typical symptoms of plantar fasciitis are stiffness and heel and arch pain early in the morning, gradually improving throughout the day. The condition may also be accompanied by inflammation or tightness in the Achilles tendon. Some of our patients state that the discomfort subsides with regular movement, but the condition still lingers

Several factors contribute to someone developing plantar fasciitis including, but not limited to:

  • Unsupportive footwear
  • Standing on hard services a lot
  • High-impact activities such as walking, running, and jogging
  • High foot arches
  • Obesity

Are You a Good Candidate for ESWT?

The Long Island heel pain specialists at Massapequa Podiatry Associates are most likely to recommend ESWT to: 

  • Athletes and other active individuals who need to minimize downtime.
  • Patients who tried more traditional methods without success.
  • Individuals who could be at risk from complications associated with surgery.

However, shockwave therapy isn’t for everyone. We generally don’t advise it for people:

  • With blood clotting disorders.
  • Who have certain heart or seizure conditions.
  • With infections in the area that need treatment.
  • Who are pregnant. 

Pros and Cons of Shockwave Therapy

As with any form of treatment, it’s important to assess the benefits of ESWT and compare them to the drawbacks. 

Pros of ESWT

  • ESWT is approved by the Food and Drug Administration (FDA) and is considered to be a safe application.
  • Sessions are short and completed in our clinic. There’s no need to go to a hospital for treatment.
  • Pain relief is almost immediate.
  • The risk of complications is very low.
  • ESWT is non-invasive and less painful than surgery. 
  • Recovery time is minimal. 
  • Shockwave therapy can be combined with other treatments to maximize results.
  • There’s no risk of drug interactions because no pharmaceuticals are involved.
  • There isn’t an incision, so there’s not a risk of infection as there often is with surgery.
  • Results from a 2021 study determined that just four sessions of ESWT could reduce the thickness of the plantar fascia.
  • Between 44 and 92 percent of patients who receive shock wave therapy report improvement.
  • ESWT can be stopped at any time without adverse effects.

Cons of ESWT

  • ESWT doesn’t work for everyone with the specified conditions.
  • Some patients experience mild discomfort from the shockwaves.
  • More severe plantar fasciitis will likely require a series of ESWT sessions.
  • Many insurance companies don’t cover ESWT.
  • Some people experience pain, bruising, swelling, minor bleeding, and numbness after treatment.
  • There’s a small risk that ESWT can rupture the Achilles tendon.
  • Because patients may receive local anesthesia or a sedative before the procedure, they should plan to have someone drive them home after sessions.

Preparation for ESWT

Before your first shockwave therapy session, we would:

  • Review your medical history.
  • Request a comprehensive list of medications, vitamins, and supplements.
  • Ask you to stop any anti-inflammatory medications you’re taking at least five days before the procedure.
  • Obtain your written consent stating that you understand what ESWT entails.

What to Expect With Massapequa Podiatry Associates’ Shockwave Therapy for Plantar Fasciitis

During ESWT, your doctor finds the area of the foot that needs to be treated and applies ultrasound gel to help the waves travel into the foot better. The doctor then applies the probe to the exterior of the foot and administers the compressed airwaves to the impacted area, before wiping off the gel and sending the patient home. 

Airwaves are typically administered for 5–10 minutes, although up to 20 minutes may be needed in certain cases. Most patients say the waves feel similar to the sensation of a rubber band being repeatedly snapped against the skin. Many people find this discomfort tolerable, but if someone cannot tolerate the pain, we make adjustments to reduce the sensations.

Aftercare Instructions for ESWT

After ESWT, most people can walk out of their session and return to normal activities, including work. However, there are some limitations following treatment:

  • Rest the foot and keep it elevated for a day or two.
  • Don’t engage in strenuous activities, heavy lifting, or high-impact exercise for two days or more. Avoid running for at least a week after ESWT. If you’re extremely active, curb the overall intensity of your workouts post-treatment based on your podiatrist’s advice.  
  • Complete our recommended gentle stretching exercises to make recovery easier.
  • Avoid icing and anti-inflammatory medications for at least two days following the procedure.
  • Make certain to attend all follow-up appointments so your doctor can monitor your progress.

Additional Treatment Options for Plantar Fasciitis

At Massapequa Podiatry Associates, we consider a wide range of treatment options for all patients, with the ultimate goal of addressing their problems without resorting to surgery whenever possible.

Often, we recommend some or all of the options below as part of our patients’ individualized treatment plans and then move to shockwave treatment for plantar fasciitis if the other options aren’t effective. If six months of these less invasive treatments prove ineffective, we might then advise the patient to consider surgery.

One of the most important things you can do right away to alleviate plantar fasciitis pain is to incorporate some lifestyle changes. Rest your feet and avoid activities that trigger pain. Using crutches or a walking boot may help to prevent putting too much weight on the foot while it heals. It may also be necessary to replace worn-out or unsupportive footwear.

Here are some other home remedies for plantar fasciitis. 

  • Applying an ice pack for 20 minutes a few times per day can help reduce swelling and relieve pain.
  • Over-the-counter anti-inflammatory medications may also lessen swelling and provide pain relief. Prescription medications may also be considered in some cases.
  • Increasing muscle strength and flexibility can be very helpful in reducing pain and helping the foot to heal. Stretches are a great way to develop more limber and strong feet.
  • Doctors might recommend splints at night and arch supports or custom orthotics during the day, to support the foot. Zinc oxide-containing tape may also be used to help stabilize the foot and limit movement.
  • Steroid injections can help to quickly, but temporarily relieve pain. Injections may be needed every few months if inflammation is chronic.
  • Massapequa Podiatry Associates also offers Tenex and laser therapy as treatment options for plantar fasciitis.

Left untreated, plantar fasciitis quickly becomes a chronic source of pain and irritation, as symptoms can persist for weeks, months, or even years.