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52 Weeks Post OrthotripsyŽ Synopsis

Posted by Duane E on 6/23/00 at 14:45 (022280)

It has been 52 weeks since I had OssaTron (ESWT) treatments on both feet, and 34 weeks since the second treatment on my right foot.

I believe my plantar fasciitis may be completely cured in the treated areas. Prior to the OssaTron treatments, my feet would become very hot after being used for a short time. I would place my feet on a block of ice (or anything cool) for relief. This ice treatment has been totally unnecessary after the OssaTron treatments. With respect to the ability of my feet to not get hot, I can say that my feet have returned to their pre-injury condition. Since heat is associated with inflammation, I believe the OssaTron treatment cured (resolved) the inflammation (plantar fasciitis).

I am not 100% pain free. The second OssaTron treatment produced no easily noticeable improvement in my condition. At one time I had an excessive amount of fluid in my heel; and was on crutches for several months. With the large area of the heel that was effected, it is likely that some of the resultant scaring entrapped some of the nerves. I did not have pin point pain. I had various levels of pain in a 40 to 50mm by 30 to 40mm area on my heels.

I would never plan to have surgery for plantar fasciitis; mainly because I believe my plantar fasciitis problem is cured.

There is a lot of good information on this message board, and there is also some misinformation. Not all ESWT is the same. I would recommend to anyone contemplating ESWT, to fully investigate the type of ESWT (high or low energy), the equipment used and its approved use, and the practitioner.


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Re: 52 Weeks Post OrthotripsyŽ Synopsis

Dr. Zuckerman on 6/23/00 at 15:08 (022281)

I am very glad that your are satisfied with your ESWT treatment, however anyone reading this board who had your pre-ESWT treatment areas of pain is a very difficult patient to help. Pin point pain is an important criteria for sucessful ESWT. When you have doctors stretching the criteria for ESWT then the sucess rate is going to be changed. The typical patient that can do very well with ESWT is the patient shown on the ossatron video. This is a patient with pin point pain at the plantar medial insertion of the pf. Every one on this board should take a look at this video it is an excellant description of what kind of pf pain can be helped with ESWT.
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Re: 52 Weeks Post OrthotripsyŽ Synopsis

Duane E on 6/24/00 at 22:50 (022354)

The OssaTron and the Orbasone are different machines, with different capabilities; and consequently they have different patient selection criteria. It is true that a mild plantar fasciitis case is easier to treat successfully. However for those less fortunate, the options are more limited.

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Re: 52 Weeks Post OrthotripsyŽ Synopsis

Dr. Zuckerman on 6/25/00 at 08:46 (022360)

It is very important with any procedure (not machines) to have a proper criteria for patient selection. The literature states for all ESWT (not machine), the important of pin point pain within the focal point of energy. This is why I have told you from day one the importance of the physician and not the machine. It may be true for diagnostic machines such as x-ray's etc, but when it comes to procedures the doctor is the first criteria. The diagnosis must be correct and the indications must be correct in order to help the patients. You better look at the ossatron patient video before you talk about patient selection for plantar fasciitis because you are wrong about pf selection criteria for the ossatron !!!! By the way what is the focal point of energy for the ossatron for pf. Do you know them????. It sure isn't 35 joules /mm2 as the broshure for the machine states.

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Re: 52 Weeks Post OrthotripsyŽ Synopsis

Duane E on 6/26/00 at 02:41 (022410)

For the patient that has had extensive diagnostic imaging and examination that clearly indicates a severe case of plantar fasciitis, (which is not pin point pain) what do you do?


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Re: 52 Weeks Post OrthotripsyŽ Synopsis

Dr. Zuckerman on 6/26/00 at 16:17 (022442)

I would do a nerve block at the posterior tibial nerve. I would consider doing epidural nerve block. These are called sympathetic nerve blocks which increase blood flow to the area and can break up the pain cycle. If the this fails or the patient doesn't want the L4-L5 (back) injected, you could consider ESWT and hope for the best. lidcaine besides being used for anesthesia , can be used for what is called a sympathetic nerve block which if used on a nerve such as the posterior tibial nerve ( this go into the medial and lateral plantar nerve)increased blood flow to the area. I use this in patients that have Raynauds syndrome or even PVD ( peripheral vascular disease.

I know you have a very difficult case. The Posterior tibial nerve block can help the entire plantar fascia that is in pain or inflamed.

posted to the eswt board . . . keyword:


Re: 52 Weeks Post OrthotripsyŽ Synopsis

Dr. Zuckerman on 6/23/00 at 15:08 (022281)

I am very glad that your are satisfied with your ESWT treatment, however anyone reading this board who had your pre-ESWT treatment areas of pain is a very difficult patient to help. Pin point pain is an important criteria for sucessful ESWT. When you have doctors stretching the criteria for ESWT then the sucess rate is going to be changed. The typical patient that can do very well with ESWT is the patient shown on the ossatron video. This is a patient with pin point pain at the plantar medial insertion of the pf. Every one on this board should take a look at this video it is an excellant description of what kind of pf pain can be helped with ESWT.
posted to the eswt board . . . keyword:

Re: 52 Weeks Post OrthotripsyŽ Synopsis

Duane E on 6/24/00 at 22:50 (022354)

The OssaTron and the Orbasone are different machines, with different capabilities; and consequently they have different patient selection criteria. It is true that a mild plantar fasciitis case is easier to treat successfully. However for those less fortunate, the options are more limited.

posted to the eswt board . . . keyword:

Re: 52 Weeks Post OrthotripsyŽ Synopsis

Dr. Zuckerman on 6/25/00 at 08:46 (022360)

It is very important with any procedure (not machines) to have a proper criteria for patient selection. The literature states for all ESWT (not machine), the important of pin point pain within the focal point of energy. This is why I have told you from day one the importance of the physician and not the machine. It may be true for diagnostic machines such as x-ray's etc, but when it comes to procedures the doctor is the first criteria. The diagnosis must be correct and the indications must be correct in order to help the patients. You better look at the ossatron patient video before you talk about patient selection for plantar fasciitis because you are wrong about pf selection criteria for the ossatron !!!! By the way what is the focal point of energy for the ossatron for pf. Do you know them????. It sure isn't 35 joules /mm2 as the broshure for the machine states.

posted to the eswt board . . . keyword:

Re: 52 Weeks Post OrthotripsyŽ Synopsis

Duane E on 6/26/00 at 02:41 (022410)

For the patient that has had extensive diagnostic imaging and examination that clearly indicates a severe case of plantar fasciitis, (which is not pin point pain) what do you do?


posted to the eswt board . . . keyword:

Re: 52 Weeks Post OrthotripsyŽ Synopsis

Dr. Zuckerman on 6/26/00 at 16:17 (022442)

I would do a nerve block at the posterior tibial nerve. I would consider doing epidural nerve block. These are called sympathetic nerve blocks which increase blood flow to the area and can break up the pain cycle. If the this fails or the patient doesn't want the L4-L5 (back) injected, you could consider ESWT and hope for the best. lidcaine besides being used for anesthesia , can be used for what is called a sympathetic nerve block which if used on a nerve such as the posterior tibial nerve ( this go into the medial and lateral plantar nerve)increased blood flow to the area. I use this in patients that have Raynauds syndrome or even PVD ( peripheral vascular disease.

I know you have a very difficult case. The Posterior tibial nerve block can help the entire plantar fascia that is in pain or inflamed.

posted to the eswt board . . . keyword: