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Wondering if I am a candidate for ESWT

Posted by Bubs C. on 4/10/01 at 20:08 (044208)

Hi...Have suffered for too many years with Plantar Fascitis and have undergone most procedures (physical therapy, night splints, walking cast, cortisone shots, and orthodics) and am still suffering greatly. I heard about the Ossatron from my physical therapist and it sounds promising. However, I was browsing for info and I came across a piece that said if you have Tarsal Tunnel Syndrome that you cannot have the procedure. I remember my surgeon saying that I also have TTS. Doea this mean that I am excluded from having it done? I have an appointment for a consult in a few weeks. Will the Dr. conduct any tests to see if I do in fact have TTS?

Re: Wondering if I am a candidate for ESWT

Dr. Zuckerman on 4/10/01 at 21:14 (044214)

Hi.

Is your TTS is the main complaint or is the plantar fascia the main complaint. In my one year experience I have found that if you have a true TTS and not plantar fasciitis the ESWT will be non-responding. Now if you have true insertional pf then this is another story. Hand on physical examination is very important to determine this difference. There are tests such as EMG that are helpful but the clinical examination by the treating doctor is very important.

Re: Buyer Beware, All ESWT is not the same thing.

Kim B. on 4/11/01 at hrmin (044232)

Hi Bubs C. Welcome to the HS.com board. My advice to you is be sure to do your homework. There are currently two different kind of ESWT available for your consideration, but from what I uderstand, more will be entering the playing field soon. There is a lot of cross confussion that could cause one to rule ESWT out immediately, or cause them to perhaps travel for treatment, when the best treatment for them may be in their own back yard, so to speak.

Since I am giving you that much of my opinion, I suppose I should explain myself a little. I would also like to take this opportunity to give voice to a few of my concerns, especially for the sake of the newbies, who come here looking for unbiased information and guidance. As old timers, many here should feel some responsibility for helping them not be led astray. We should actually be going out of our way to be sure everyone who is considering ESWT knows that all ESWT is not created or administered the same. The result are varied by machine, doctor, and the condition and attitude of the patient.

The current ESWT machines available are the 'OssaTron' and the 'Orbasone.' The OssaTron has been approved by the FDA as a successful treatment to be marketed for PF. The Orbasone is not. So buyer beware. The results are somewhat inconsistant. You'll have to gather all the facts and then hedge your bet on what will provide the best outcome for you, based on your problems and what resources you have.

I personally think that the ESWT offered by Doctors using the OssaTron machine is your currently your best bet. Especially if you can find one near you. And if you can wait, bear in mind that there are more being put in to operation all the time. OssaTron is probably the leader in ESWT today. In my opinion, when insurance assists in paying for it, OssaTron is the safest, most pratical, painless, and successful treatment available. It's not the cheapest, the best product never is. Again, if you can wait a while longer. More insuance companies will be jumping at the chance to see that their patients have access to ESWT treatments that are approved by the FDA. Then, the prices will start coming down, because the volume of poeple having this procedure is going to go up, up, up! Like CDs and VCRs the technology is so new, the first ones are going to be more expensive. When the competition comes along, all of them have to be competitive.

If you can, I strongly suggest that you hold out until more, or all, of the insurance companies are paying for the treatment. If money is no object when it comes to your feet, You should do your homework and have ESWT ASAP! I think it's possible that the OssaTron will be the standard of care for PF (when more conserative treatements have failed) someday.

Some of the insurance companies already pay for ESWT performed on the OssaTron because it has been approved by the FDA to be marketed for PF, and because it is safe and proven effective, often in ONE treatment. This gets people back to work sooner, so, I know workman's comp is going to be pleased by it's success. My best, un-educated guess is that almost all of the insurance companies will have happily jumped on the OssaTron ban-wagon within the next 3 months to one year. I've been studying and reading at this board for 2 years now. I have watched ESWT go from being a possible cure, to being the real deal. There is still I don't understand, but I am being as truthful as I know how reagarding this hot topic. I think we will see a lot more newbies coming to the board as ESWT is seen more and more in the media.

For the sake of those who are planning to risk their feet and for some who will risk a lot of ($$$) money to get rid of their foot pain, I wish that when we discuss ESWT here at the HS.com site, we would be more specific about what kind of ESWT one had and/or who it was done by. That will take a lot of '??mystery??' out of the research effort which in turn helps people decide which treatment is most likely to give them the results they are looking for. People do have different needs. What might be right for me, may not be right for someone else. For example, I don't mind being sedated to have ESWT done, others here would rather not be sedated if they have a choice. Anyway, the term 'ESWT' is simply not specific enough anymore. Now that ESWT is a reality, we need to help people understand that there is more than just one way to skin a rabbit! (if you will.)

I see a lot of post ESWT patients saying that they are experiencing post proceedure pain that is more intense than before they had ESWT done. Not just for a day or so afterward, for days and weeks after their procedure. Am I the only person who is puzzled or concerned about this? Doesn't anyone else care WHY this is coming about? And what can be done to avoid it? Based on the honesty of those statements, some people my unknowingly through the baby out with the bathwater. We need the honest input desperately, and I applaude those who are honest enough to paint an accurate picture of what they are dealing with. It helps people know what to expect and provides a lot of use for this board.

In the past, people either felt better or unchanged after the proceedure. But, actually feeling 'worse' was un-heard of. The HS.com Database of Patients Progress Reports and Messeages' (link at the top of the ESWT mesage board) also reflects this fact!! I've never seen anyone post that they felt worse for an extended period afterward, but I'm seeing it posted here these days.

Btw, I don't mean to deminish the value of that data base, but, I don't particularly live and die by that data base report. In my opinion, the reporting in it was not handled seriously and confidentually, and I believe the numbers there have been swayed to spare some of the Doctor's feelings, and also because they were still under the umbrella of possibly needing more treatements, they are unlikely to be perfectly honest if they were having a bad experined. In addition, many people never came back to continue their part in the reporting process or give a final opinion if the overall outcome. Yet that Progress Report sits there as if it is in some way, a scientific report of patiet outcomes. It's too bad that by trying to help people, we may be misleading them.

I hope this post is taken in the spirit in which it is intended. I don't want to confuse you more than you may already be by ESWT. I simply think it is time for more clarification, accountabillity and unbiassed postings to be made available. I simply would like to have these things put out on the table more, instead of being swept under the rug. It's the only fair thing to do.

Best Regards, Kim B.

Re: Looks like a dead heat to me.............

Steve P on 4/12/01 at 21:02 (044412)

The ESWT patients' database shows some interesting results for the 3 machines. The average 'Pain before treatment' and 'Current pain' numbers for the Ossatron are 7.6 and 3.8; for the Orbasone 8.5 and 3.4; and for the Sonocur 8.2 and 1.8. (This is just today's 'snapshot'. With new data constantly being entered, the averages change slightly from day to day.)

As an amateur statistician, I think that this can be considered a statistical dead heat, particularly between the Ossatron & Orbasone. The Sonocur's numbers look slightly better, but it also has the smallest sample size. So, I'm really not sure that there are any statistically significant differences among the 3 machines.

Over time, and with larger sample sizes, differences might become clearer.

Re: Looks like a dead heat to me.............

Pauline on 4/13/01 at 22:14 (044515)

What about looking at the scientic studies that were submitted to the FDA for their stats? These were done in controled settings which might offer additional information. I think the companies can provide their printed research for you.

Re: Looks like a dead heat to me.............

Dr. Zuckerman on 4/14/01 at 09:43 (044560)

They are on this board under the FDA reports for the ossatron . I believe that this can be found in the ESWT page. The FDA studies were only slightly better then the controlled study. Scott has many posts that he talks about this.

Re: Buyer Beware, All ESWT is not the same thing.

Bubs C on 4/14/01 at 12:25 (044589)

Kim, Thanks for your input. I am currently doing research in the area and getting another opinion. Best to you.

Re: Buyer Beware, All ESWT is not the same thing.

Kim B. on 4/16/01 at hrmin (044751)

You're welcome and don't be a stanger around here. This site has a lot to offer those who have problems with their feet. Keep us posted on how you are. Misery loves company, unfortunately. :-) Kim B.

Re: Wondering if I am a candidate for ESWT

Dr. Zuckerman on 4/10/01 at 21:14 (044214)

Hi.

Is your TTS is the main complaint or is the plantar fascia the main complaint. In my one year experience I have found that if you have a true TTS and not plantar fasciitis the ESWT will be non-responding. Now if you have true insertional pf then this is another story. Hand on physical examination is very important to determine this difference. There are tests such as EMG that are helpful but the clinical examination by the treating doctor is very important.

Re: Buyer Beware, All ESWT is not the same thing.

Kim B. on 4/11/01 at hrmin (044232)

Hi Bubs C. Welcome to the HS.com board. My advice to you is be sure to do your homework. There are currently two different kind of ESWT available for your consideration, but from what I uderstand, more will be entering the playing field soon. There is a lot of cross confussion that could cause one to rule ESWT out immediately, or cause them to perhaps travel for treatment, when the best treatment for them may be in their own back yard, so to speak.

Since I am giving you that much of my opinion, I suppose I should explain myself a little. I would also like to take this opportunity to give voice to a few of my concerns, especially for the sake of the newbies, who come here looking for unbiased information and guidance. As old timers, many here should feel some responsibility for helping them not be led astray. We should actually be going out of our way to be sure everyone who is considering ESWT knows that all ESWT is not created or administered the same. The result are varied by machine, doctor, and the condition and attitude of the patient.

The current ESWT machines available are the 'OssaTron' and the 'Orbasone.' The OssaTron has been approved by the FDA as a successful treatment to be marketed for PF. The Orbasone is not. So buyer beware. The results are somewhat inconsistant. You'll have to gather all the facts and then hedge your bet on what will provide the best outcome for you, based on your problems and what resources you have.

I personally think that the ESWT offered by Doctors using the OssaTron machine is your currently your best bet. Especially if you can find one near you. And if you can wait, bear in mind that there are more being put in to operation all the time. OssaTron is probably the leader in ESWT today. In my opinion, when insurance assists in paying for it, OssaTron is the safest, most pratical, painless, and successful treatment available. It's not the cheapest, the best product never is. Again, if you can wait a while longer. More insuance companies will be jumping at the chance to see that their patients have access to ESWT treatments that are approved by the FDA. Then, the prices will start coming down, because the volume of poeple having this procedure is going to go up, up, up! Like CDs and VCRs the technology is so new, the first ones are going to be more expensive. When the competition comes along, all of them have to be competitive.

If you can, I strongly suggest that you hold out until more, or all, of the insurance companies are paying for the treatment. If money is no object when it comes to your feet, You should do your homework and have ESWT ASAP! I think it's possible that the OssaTron will be the standard of care for PF (when more conserative treatements have failed) someday.

Some of the insurance companies already pay for ESWT performed on the OssaTron because it has been approved by the FDA to be marketed for PF, and because it is safe and proven effective, often in ONE treatment. This gets people back to work sooner, so, I know workman's comp is going to be pleased by it's success. My best, un-educated guess is that almost all of the insurance companies will have happily jumped on the OssaTron ban-wagon within the next 3 months to one year. I've been studying and reading at this board for 2 years now. I have watched ESWT go from being a possible cure, to being the real deal. There is still I don't understand, but I am being as truthful as I know how reagarding this hot topic. I think we will see a lot more newbies coming to the board as ESWT is seen more and more in the media.

For the sake of those who are planning to risk their feet and for some who will risk a lot of ($$$) money to get rid of their foot pain, I wish that when we discuss ESWT here at the HS.com site, we would be more specific about what kind of ESWT one had and/or who it was done by. That will take a lot of '??mystery??' out of the research effort which in turn helps people decide which treatment is most likely to give them the results they are looking for. People do have different needs. What might be right for me, may not be right for someone else. For example, I don't mind being sedated to have ESWT done, others here would rather not be sedated if they have a choice. Anyway, the term 'ESWT' is simply not specific enough anymore. Now that ESWT is a reality, we need to help people understand that there is more than just one way to skin a rabbit! (if you will.)

I see a lot of post ESWT patients saying that they are experiencing post proceedure pain that is more intense than before they had ESWT done. Not just for a day or so afterward, for days and weeks after their procedure. Am I the only person who is puzzled or concerned about this? Doesn't anyone else care WHY this is coming about? And what can be done to avoid it? Based on the honesty of those statements, some people my unknowingly through the baby out with the bathwater. We need the honest input desperately, and I applaude those who are honest enough to paint an accurate picture of what they are dealing with. It helps people know what to expect and provides a lot of use for this board.

In the past, people either felt better or unchanged after the proceedure. But, actually feeling 'worse' was un-heard of. The HS.com Database of Patients Progress Reports and Messeages' (link at the top of the ESWT mesage board) also reflects this fact!! I've never seen anyone post that they felt worse for an extended period afterward, but I'm seeing it posted here these days.

Btw, I don't mean to deminish the value of that data base, but, I don't particularly live and die by that data base report. In my opinion, the reporting in it was not handled seriously and confidentually, and I believe the numbers there have been swayed to spare some of the Doctor's feelings, and also because they were still under the umbrella of possibly needing more treatements, they are unlikely to be perfectly honest if they were having a bad experined. In addition, many people never came back to continue their part in the reporting process or give a final opinion if the overall outcome. Yet that Progress Report sits there as if it is in some way, a scientific report of patiet outcomes. It's too bad that by trying to help people, we may be misleading them.

I hope this post is taken in the spirit in which it is intended. I don't want to confuse you more than you may already be by ESWT. I simply think it is time for more clarification, accountabillity and unbiassed postings to be made available. I simply would like to have these things put out on the table more, instead of being swept under the rug. It's the only fair thing to do.

Best Regards, Kim B.

Re: Looks like a dead heat to me.............

Steve P on 4/12/01 at 21:02 (044412)

The ESWT patients' database shows some interesting results for the 3 machines. The average 'Pain before treatment' and 'Current pain' numbers for the Ossatron are 7.6 and 3.8; for the Orbasone 8.5 and 3.4; and for the Sonocur 8.2 and 1.8. (This is just today's 'snapshot'. With new data constantly being entered, the averages change slightly from day to day.)

As an amateur statistician, I think that this can be considered a statistical dead heat, particularly between the Ossatron & Orbasone. The Sonocur's numbers look slightly better, but it also has the smallest sample size. So, I'm really not sure that there are any statistically significant differences among the 3 machines.

Over time, and with larger sample sizes, differences might become clearer.

Re: Looks like a dead heat to me.............

Pauline on 4/13/01 at 22:14 (044515)

What about looking at the scientic studies that were submitted to the FDA for their stats? These were done in controled settings which might offer additional information. I think the companies can provide their printed research for you.

Re: Looks like a dead heat to me.............

Dr. Zuckerman on 4/14/01 at 09:43 (044560)

They are on this board under the FDA reports for the ossatron . I believe that this can be found in the ESWT page. The FDA studies were only slightly better then the controlled study. Scott has many posts that he talks about this.

Re: Buyer Beware, All ESWT is not the same thing.

Bubs C on 4/14/01 at 12:25 (044589)

Kim, Thanks for your input. I am currently doing research in the area and getting another opinion. Best to you.

Re: Buyer Beware, All ESWT is not the same thing.

Kim B. on 4/16/01 at hrmin (044751)

You're welcome and don't be a stanger around here. This site has a lot to offer those who have problems with their feet. Keep us posted on how you are. Misery loves company, unfortunately. :-) Kim B.