Home The Book Dr Articles Products Message Boards Journal Articles Search Our Surveys Surgery ESWT Dr Messages Find Good Drs video

results of ESWT study for plantar fascitis

Posted by Dr. Weil, Jr. on 1/24/01 at 21:31 (037281)

The Weil Foot & Ankle Institute has just completed the first American clinical study regarding ESWT and plantar fascitis. All previous studies were performed for FDA approval.

Our study followed patients after ESWT for >3 months and up to 9 months.

28 cases of plantar fascitis were treated with ESWT with a patient satisfaction rate of 80.3%. 89.7% of patients experienced some benefit with ESWT with none being made worse.

57% of patients had >50% improvement of pain on a visual analog pain scale, 18% had 33-50% improvement and 25% had <33% improvement.

There was a statistical significance in the energy used for ESWT. There was a higher satisfaction rate when the Kv used by the machine was >20. Kv<20 had a higher rate of failure.

Patients in our study had the procedure done only once, and under IV sedation. The energy used to obtain best results was too powerful for local anesthesia alone. Only 2 patients in the study were retreated and both went on to successful outcomes. It took an average of four days for patients to experience benefits from the procedure.

I will be presenting these results and results regarding posterior heel pain and achilles tendinitis at the American College of Foot and Ankle Surgeons Annual Meeting in New Orleans on February 7 - 11, 2001.

I will also be presenting these results at the Tenth Annual Combined Meeting of the German, Swiss, and Austrian Societies of Musculoskeletal Shock Wave Therapy in Mainz, Germany on March 30-31, 2001.

This scientific paper has been submitted to the Journal of Foot and Ankle Surgery for publication.

Lowell Weil, Jr., DPM, FACFAS
Director of ESWT, Weil Foot & Ankle Institute
http://www.WEIL4FEET.COM
847-390-7666

Re: results of ESWT study for plantar fascitis

john h on 1/24/01 at 23:08 (037289)

good info dr weil!

Re: results of ESWT study for plantar fascitis

Scott R on 1/25/01 at 00:15 (037301)

I posted a little while ago but made an error. It would require at least a 40% difference to show a statistically significant difference between the high and low energy groups with only 28 heels.

Re: To Dr. Weil re: info and one other little thing.

Dr. Zuckerman on 1/25/01 at 18:52 (037363)

I have performed one so far and so far very little relief . If this could be benefical for FM then the world would be a lot less painful

I have another patient that I just did today. Will let you know the
results.

I would have no problem doing a study just that I don't know how to go about this.

Please tell me what a classic case is . What patients do we include and what patients do we eliminate. I have no problem so long as there aren't any medical regulations stating that I can't do this. I live and practice in a state where there are special rules for this kind of study.

Will you lead this study. Help set it up. I am interested just would need some adminstrative help.

Re: To Dr. Weil re: info and one other little thing.

Dr. Weil, Jr. on 1/25/01 at 20:04 (037371)

Unfortuneately, fibromyalgia, in many cases, is a total body problem that is very complex. Pain associated with fibromyalgia certainly can be treated by ESWT. The treatment is not unlike treating any other painful area with ESWT. The painful area is isolated and ESWT is applied.

There is German literature discussing treatment of fibromyalgia with ESWT.

Re: Doctors, and others, interested in Fibromyalgia

Kim B. on 1/25/01 at 23:46 (037393)

Hello Doctors,

I appreciate your interest in FM and how ESWT may someday help with it too. There is no way to decribe how much it could mean to so many people. So, while I have your ear, or rather eyes, I would like to point out a few excellent websites where you can find further information on FM, if you, or anyone else here cares to learn more about it.

http://www.teleport.com/~nfra/ National Fibromyagia Research Association

http://www.co-cure.org/index.htm Co-Cure

http://www.fmnetnews.com/pages/basics.html Fibromylagia Network News

Dr. Z., I'd love to help, and will assist you in any way I can, but, unfortunately, I'm an 8 cylinder Cadillac running on a 4 cylinder Mitsubisi engine. I fear that do you a disservice if you are counting only on me. That's hard to admit, but it's true. I hope this won't always be the case. Someday, I plan to tackle a lot of projects, and more than just one at a time! I appreciate your suggestion and vote of confidence very much. Like I said, I'll assist as much as I can, but you may need someone else to lead it. I can certainly save you a lot of legwork on the initial research of it. For starters, check out the very informative sites above!

Dr. Weil, I caught that little part in your post about 'isolate the area'. As you probably know, even the 'trigger point areas' are wrapped up by tissue (good), nerves, tendons, ligaments and such things that are bad for ESWT to come in contact with. I can put my fingers on many of the more painful areas. They tend to migrate around some too. Some, but not all of them are considered ' trigger points.' The trigger points are merely symptoms, along with many other things of FM, and the real FM culprit lies hidden somewhere else. To relieve FM pain, you could zap the 'painful areas' as they crop up, but then, there is that aspect of 'referred pain' that has to be taken into consideration.

Anyway, if we could find the true culprit of FM, we could try to ESWT zap it! End of FM. These days, I strongly suspect that the culprit is in the Central Nervous System and/or spinal area and spinal fluid. Can you drain my spinal fluid out, zap it and put it back in without making me worse? All this definitely makes zapping PF and heel spurs sound a lot easier, doesn't it?

I've researched FM for about 6 years now. I have suffered from it for about the past 15 or 20 years. It's hard to pin-point because I tried to ignore 'it' for a long time. When I was diagnosed 6 years ago, I was told that it was not a 'progressive illness', but now I'm afraid the opposite is true. My pain is getting worse and harder to manage as the years go by and seems to be branching off in to new areas.

One example is the PF. About 2 years ago, I developed PF. I strongly suspect that MY PF is related to the FM illness. Before, I thought them to be co-existing conditions (You can get the jest of one of the reasons I feel this way, by reading my post to the 'Ask The Doctors' board re: Whether PF would respond to Methadone or not.) There are other indicators and even my Internist now suspects this to be the case. BTW, both an orthopedic surgeon and my internist diagnosed my foot ailment as classic PF at first. Probably because small heel spurs were present on the initial x-rays.

This gives you a little more background on my line of thinking. I hope you find this mound of information useful if only in a small way. Again, I'll help out, I have lots of literature and gathered information. If I don't know the right answer, but I'll help you find someone that does.

Scott and others, please forgive this 'long shot' at promoting my own agenda at your board. What the heck, some others my find some of it useful.

Sincerely,
Kim B.

Re: To Dr. Weil re: info and one other little thing.

Imogene Bennett on 1/27/01 at 00:37 (037492)

I recently read that NSAIDS (aspirin, ibuprofin, etc) are thought to be a cause of fibromyalgia. Of course, with severe heel pain, we take lots of NSAIDS. I also read that some doctors are experimenting with guaifenessin (not sure of spelling)a common ingredient in some cough syrups. The article advised to avoid NSAIDS.

Re: results of ESWT study for plantar fascitis

john h on 1/24/01 at 23:08 (037289)

good info dr weil!

Re: results of ESWT study for plantar fascitis

Scott R on 1/25/01 at 00:15 (037301)

I posted a little while ago but made an error. It would require at least a 40% difference to show a statistically significant difference between the high and low energy groups with only 28 heels.

Re: To Dr. Weil re: info and one other little thing.

Dr. Zuckerman on 1/25/01 at 18:52 (037363)

I have performed one so far and so far very little relief . If this could be benefical for FM then the world would be a lot less painful

I have another patient that I just did today. Will let you know the
results.

I would have no problem doing a study just that I don't know how to go about this.

Please tell me what a classic case is . What patients do we include and what patients do we eliminate. I have no problem so long as there aren't any medical regulations stating that I can't do this. I live and practice in a state where there are special rules for this kind of study.

Will you lead this study. Help set it up. I am interested just would need some adminstrative help.

Re: To Dr. Weil re: info and one other little thing.

Dr. Weil, Jr. on 1/25/01 at 20:04 (037371)

Unfortuneately, fibromyalgia, in many cases, is a total body problem that is very complex. Pain associated with fibromyalgia certainly can be treated by ESWT. The treatment is not unlike treating any other painful area with ESWT. The painful area is isolated and ESWT is applied.

There is German literature discussing treatment of fibromyalgia with ESWT.

Re: Doctors, and others, interested in Fibromyalgia

Kim B. on 1/25/01 at 23:46 (037393)

Hello Doctors,

I appreciate your interest in FM and how ESWT may someday help with it too. There is no way to decribe how much it could mean to so many people. So, while I have your ear, or rather eyes, I would like to point out a few excellent websites where you can find further information on FM, if you, or anyone else here cares to learn more about it.

http://www.teleport.com/~nfra/ National Fibromyagia Research Association

http://www.co-cure.org/index.htm Co-Cure

http://www.fmnetnews.com/pages/basics.html Fibromylagia Network News

Dr. Z., I'd love to help, and will assist you in any way I can, but, unfortunately, I'm an 8 cylinder Cadillac running on a 4 cylinder Mitsubisi engine. I fear that do you a disservice if you are counting only on me. That's hard to admit, but it's true. I hope this won't always be the case. Someday, I plan to tackle a lot of projects, and more than just one at a time! I appreciate your suggestion and vote of confidence very much. Like I said, I'll assist as much as I can, but you may need someone else to lead it. I can certainly save you a lot of legwork on the initial research of it. For starters, check out the very informative sites above!

Dr. Weil, I caught that little part in your post about 'isolate the area'. As you probably know, even the 'trigger point areas' are wrapped up by tissue (good), nerves, tendons, ligaments and such things that are bad for ESWT to come in contact with. I can put my fingers on many of the more painful areas. They tend to migrate around some too. Some, but not all of them are considered ' trigger points.' The trigger points are merely symptoms, along with many other things of FM, and the real FM culprit lies hidden somewhere else. To relieve FM pain, you could zap the 'painful areas' as they crop up, but then, there is that aspect of 'referred pain' that has to be taken into consideration.

Anyway, if we could find the true culprit of FM, we could try to ESWT zap it! End of FM. These days, I strongly suspect that the culprit is in the Central Nervous System and/or spinal area and spinal fluid. Can you drain my spinal fluid out, zap it and put it back in without making me worse? All this definitely makes zapping PF and heel spurs sound a lot easier, doesn't it?

I've researched FM for about 6 years now. I have suffered from it for about the past 15 or 20 years. It's hard to pin-point because I tried to ignore 'it' for a long time. When I was diagnosed 6 years ago, I was told that it was not a 'progressive illness', but now I'm afraid the opposite is true. My pain is getting worse and harder to manage as the years go by and seems to be branching off in to new areas.

One example is the PF. About 2 years ago, I developed PF. I strongly suspect that MY PF is related to the FM illness. Before, I thought them to be co-existing conditions (You can get the jest of one of the reasons I feel this way, by reading my post to the 'Ask The Doctors' board re: Whether PF would respond to Methadone or not.) There are other indicators and even my Internist now suspects this to be the case. BTW, both an orthopedic surgeon and my internist diagnosed my foot ailment as classic PF at first. Probably because small heel spurs were present on the initial x-rays.

This gives you a little more background on my line of thinking. I hope you find this mound of information useful if only in a small way. Again, I'll help out, I have lots of literature and gathered information. If I don't know the right answer, but I'll help you find someone that does.

Scott and others, please forgive this 'long shot' at promoting my own agenda at your board. What the heck, some others my find some of it useful.

Sincerely,
Kim B.

Re: To Dr. Weil re: info and one other little thing.

Imogene Bennett on 1/27/01 at 00:37 (037492)

I recently read that NSAIDS (aspirin, ibuprofin, etc) are thought to be a cause of fibromyalgia. Of course, with severe heel pain, we take lots of NSAIDS. I also read that some doctors are experimenting with guaifenessin (not sure of spelling)a common ingredient in some cough syrups. The article advised to avoid NSAIDS.