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ESWT disappointment

Posted by john a on 3/21/02 at 15:47 (077122)

Well, I'm just checking in to report disappointment with my second ESWT treatment with Dr. Z. The first one I had with him in November 2001 went well I thought, and seemed to leave me in slightly less pain after the soreness wore off. During that first treatment, he zapped the instep side of the PF insertion point into the calcaneous bone. Ten weeks after that, I optimistically went for a second treatment on 1/7/02 hoping for yet more improvement. Unfortunately, here I am 10 weeks later, still with what I can only describe as some sort of nerve damage that causes my heel to feel 'tingly' - not at rest, but after I'm on it for a little bit (5 - 10 minutes). The 'tingling' can also be felt just by flexing my ankle around.

Now, the thing is, I asked that the second shock treatments be directed more to the bottom part of the PF insertion into the heel, as that's where I thought the pain was the greatest, and after some initial hesitation on Dr. Z's part, we went ahead with it. Also, the second treatment was much more painful than the first - I was told because the shock head had more fluid in it, or more gel was applied to the heel, or the machine was in better 'tune', or something - I wasn't really sure what the reason was. But perhaps the excessive pain was due to a nerve being directly zapped? I don't know. I didn't need local anaesthesia in any case, but it took much longer for me to be able to stand the maximum voltage level that they wanted to reach.

So, I'm now worse off than I was 10 weeks ago before the second treatment.

I think for me, anyway, ESWT is certainly no miracle cure.

John.

Re: ESWT disappointment

BrianJ on 3/21/02 at 17:23 (077137)

John A --

Sorry to hear that ESWT hasn't helped you. Question: Are saying that the second ESWT was directed more laterally (toward the pinky toe side of the foot)than the first treatment? Do you have significant pain on palpation of this area (the lateral PF origin), or does it only hurt when you stand or walk on a hard surface?

You may want to look at the 'Baxter's Neuritis' article in the online version of Podiatry Today. Some doctors believe pain like yours can be caused by nerve entrapment, but this is somewhat controversial. Take a look at the article and let us know what you think.

Re: ESWT disappointment

john a on 3/22/02 at 08:25 (077174)

The first ESWT treatment was directed at the big toe side of the PF heel insertion point. And yes, the second was directed more to the pinky toe side of the heel, but is better described as being about midway between the two sides of the heel.

I'd say that there was definite palpation pain prior to treatment, but perhaps not so much now (though I am wary of pressing as hard as Dr. Z. did to localize the pain, for fear of making it worse). And my particular case of PF is definitely 'atypical' in that I have little to no 'first step' pain, but quickly worsening pain the longer I stand or walk, with 'longer' meaning more than 5 minutes.

I am more inclined now than ever to believe this is nerve related. I had read the Baster's Neuritis article before, but it didn't seem to divulge much wisdom.

Re: ESWT disappointment

BrianJ on 3/22/02 at 09:04 (077184)

John A --

I am paying particular attention to your comments because your symptoms seems to be the same as mine. I have another good article on nerve entrapment and would be glad to fax it to you if you give me your fax number.

Re: ESWT disappointment

john a on 3/22/02 at 10:25 (077199)

Thanks BrianJ, you're too generous. I guess the article is not in electronic format already? I wouldn't want you to have to pay for a call to New York unnecessarily. Anyway, my fax is 516-346-7625, or, if you can, email: (email removed). The fax is shared, so if you could, please put a header page on it to my attention (John Allen). Thanks again.

Re: ESWT disappointment

john h on 3/22/02 at 11:30 (077215)

John do not jump ship to quick. Only recently Mohez who was one of the first people I remember getting ESWT 3-4 years ago posted that he was now cured. He had ELEVEN (11) ESWT treatments in Canada and I think had Ossatron, Sonnocur, and Dornier treatments. Mohez is back to running and doing all the things he once did. I have read several other stories of persons who finally got a cure or at least extremely better after several treatments and some time. Do a search under Mohez and read his most recent post and his earlier post as it is quiet a story. There are of course many people who will not be helped by EWST. I do not remember the FDA studies stats but perhaps 30% or near that will not be helped. Stats in Europe and Canada seem a bit better. In all the studies I have read about no one was permenantly damaged with ESWT but some did develop problems that resolved themselves in weeks or a few months. I do not think we have any miracle cures that exist for PF. Just keep on plugging away and trying various treatments until you find one that helps you. Good luck. I had 4 ESWT treatments on both feet with Dr. Z. I think Steve P has had 4 ESWT treatments with Dr. Z. I remember the original 6 people from this board that went to Canada for the Ossatron treatment had various experiences. Some were really sore for some time. Seems to effect all of us differently. I have never had any soreness whatsoever from the treatment. I am not cured but better than before treatment. I will certainly give the Dornier EPOS a try if Dr. Zuckeman gets it and I can afford it. The approach and protocol for this equipment is different than other equipment.

Re: ESWT disappointment

john a on 3/22/02 at 16:02 (077240)

I just picked up the fax. I'll read it this weekend. Thanks BrianJ!

Re: ESWT disappointment

DR Zuckerman on 3/22/02 at 17:23 (077248)

John I would wait the full twelve weeks give me an e-mail at (email removed) and lets do another treatment . I know have the Dornier Epos

Re: Did you notice...............

JudyS on 3/22/02 at 18:00 (077251)

The 'real' Dr. Z has rejoined us (I'd long suspected that he'd been replaced by an alien..). How can I tell, you ask? Check out the spelling in his recent two posts........:) Welcome home, Davey!

Re: Did you notice...............

DR Zuckerman on 3/22/02 at 18:21 (077252)

Hey it feels good to be back !!!

Re: Did you notice...............Dr. Z

John h on 3/22/02 at 19:01 (077256)

Dr. Z at last a man who spells like me. At last the infamous Epos is on the way. It is like having a new baby I expect. What will become of the Orby? I will retain my pictures of the original Orby becuase it may become a collectors item. Now for the important stuff what is your protocol for the number of treatments? As you know in Australia Allan does a 3 treatment protocol with 1 week between treatments. In Canada they are doing a 3 treatment protocol with one day between treatments (this may be to accomodate U.S. residents?). What will become of your stock of spark plugs? Will the Epos be set up in your trailer to move around?

Re: Did you notice...............Dr. Z

DR Zuckerman on 3/22/02 at 20:33 (077260)

EPOS protocol is one treatment then wait 12 weeks to see if we are going to do a second treatment. Not sure if I will need local anesthesia. I have some ideas to avoid any local anesthesia , but will have to take a look at all of the control levels. I think i can combine the USA with the Australia method. I did this with the orbie and the EPOS has much more lower energy controls then any machine out there.

Orby will is around and will make a comeback in the fuure. The EPOS will be set up in our mobile unit. We can the mobile unit ZAP ONE . Spark plugs well, will have to see if there is a market. Probaby going to collect dust

Re: ESWT disappointment

john a on 3/25/02 at 14:05 (077510)

Well, in another week it will be twelve weeks. But I am now quite a bit wary of ESWT doing more harm than good, so I probably won't be scheduling an appointment soon. Maybe in a few more weeks I'll see some improvement, but even if I do, who's to say it's because of ESWT 10+ weeks ago, or just random unrelated circumstances.

Re: ESWT disappointment

john a on 3/25/02 at 14:11 (077513)

Well, I read the article about nerve entrapment, but it looks like I don't have the primary diagnosing symptom, which is significant pain when pressing on what looks to be the side of the heel. (I admit to not quite being able to understand where exactly the pressure was to be applied - the diagrams were not that clear to me, and my knowledge of foot anatomy is limited.) I still think my PF problem is nerve related though.

Re: ESWT disappointment

BrianJ on 3/21/02 at 17:23 (077137)

John A --

Sorry to hear that ESWT hasn't helped you. Question: Are saying that the second ESWT was directed more laterally (toward the pinky toe side of the foot)than the first treatment? Do you have significant pain on palpation of this area (the lateral PF origin), or does it only hurt when you stand or walk on a hard surface?

You may want to look at the 'Baxter's Neuritis' article in the online version of Podiatry Today. Some doctors believe pain like yours can be caused by nerve entrapment, but this is somewhat controversial. Take a look at the article and let us know what you think.

Re: ESWT disappointment

john a on 3/22/02 at 08:25 (077174)

The first ESWT treatment was directed at the big toe side of the PF heel insertion point. And yes, the second was directed more to the pinky toe side of the heel, but is better described as being about midway between the two sides of the heel.

I'd say that there was definite palpation pain prior to treatment, but perhaps not so much now (though I am wary of pressing as hard as Dr. Z. did to localize the pain, for fear of making it worse). And my particular case of PF is definitely 'atypical' in that I have little to no 'first step' pain, but quickly worsening pain the longer I stand or walk, with 'longer' meaning more than 5 minutes.

I am more inclined now than ever to believe this is nerve related. I had read the Baster's Neuritis article before, but it didn't seem to divulge much wisdom.

Re: ESWT disappointment

BrianJ on 3/22/02 at 09:04 (077184)

John A --

I am paying particular attention to your comments because your symptoms seems to be the same as mine. I have another good article on nerve entrapment and would be glad to fax it to you if you give me your fax number.

Re: ESWT disappointment

john a on 3/22/02 at 10:25 (077199)

Thanks BrianJ, you're too generous. I guess the article is not in electronic format already? I wouldn't want you to have to pay for a call to New York unnecessarily. Anyway, my fax is 516-346-7625, or, if you can, email: (email removed). The fax is shared, so if you could, please put a header page on it to my attention (John Allen). Thanks again.

Re: ESWT disappointment

john h on 3/22/02 at 11:30 (077215)

John do not jump ship to quick. Only recently Mohez who was one of the first people I remember getting ESWT 3-4 years ago posted that he was now cured. He had ELEVEN (11) ESWT treatments in Canada and I think had Ossatron, Sonnocur, and Dornier treatments. Mohez is back to running and doing all the things he once did. I have read several other stories of persons who finally got a cure or at least extremely better after several treatments and some time. Do a search under Mohez and read his most recent post and his earlier post as it is quiet a story. There are of course many people who will not be helped by EWST. I do not remember the FDA studies stats but perhaps 30% or near that will not be helped. Stats in Europe and Canada seem a bit better. In all the studies I have read about no one was permenantly damaged with ESWT but some did develop problems that resolved themselves in weeks or a few months. I do not think we have any miracle cures that exist for PF. Just keep on plugging away and trying various treatments until you find one that helps you. Good luck. I had 4 ESWT treatments on both feet with Dr. Z. I think Steve P has had 4 ESWT treatments with Dr. Z. I remember the original 6 people from this board that went to Canada for the Ossatron treatment had various experiences. Some were really sore for some time. Seems to effect all of us differently. I have never had any soreness whatsoever from the treatment. I am not cured but better than before treatment. I will certainly give the Dornier EPOS a try if Dr. Zuckeman gets it and I can afford it. The approach and protocol for this equipment is different than other equipment.

Re: ESWT disappointment

john a on 3/22/02 at 16:02 (077240)

I just picked up the fax. I'll read it this weekend. Thanks BrianJ!

Re: ESWT disappointment

DR Zuckerman on 3/22/02 at 17:23 (077248)

John I would wait the full twelve weeks give me an e-mail at (email removed) and lets do another treatment . I know have the Dornier Epos

Re: Did you notice...............

JudyS on 3/22/02 at 18:00 (077251)

The 'real' Dr. Z has rejoined us (I'd long suspected that he'd been replaced by an alien..). How can I tell, you ask? Check out the spelling in his recent two posts........:) Welcome home, Davey!

Re: Did you notice...............

DR Zuckerman on 3/22/02 at 18:21 (077252)

Hey it feels good to be back !!!

Re: Did you notice...............Dr. Z

John h on 3/22/02 at 19:01 (077256)

Dr. Z at last a man who spells like me. At last the infamous Epos is on the way. It is like having a new baby I expect. What will become of the Orby? I will retain my pictures of the original Orby becuase it may become a collectors item. Now for the important stuff what is your protocol for the number of treatments? As you know in Australia Allan does a 3 treatment protocol with 1 week between treatments. In Canada they are doing a 3 treatment protocol with one day between treatments (this may be to accomodate U.S. residents?). What will become of your stock of spark plugs? Will the Epos be set up in your trailer to move around?

Re: Did you notice...............Dr. Z

DR Zuckerman on 3/22/02 at 20:33 (077260)

EPOS protocol is one treatment then wait 12 weeks to see if we are going to do a second treatment. Not sure if I will need local anesthesia. I have some ideas to avoid any local anesthesia , but will have to take a look at all of the control levels. I think i can combine the USA with the Australia method. I did this with the orbie and the EPOS has much more lower energy controls then any machine out there.

Orby will is around and will make a comeback in the fuure. The EPOS will be set up in our mobile unit. We can the mobile unit ZAP ONE . Spark plugs well, will have to see if there is a market. Probaby going to collect dust

Re: ESWT disappointment

john a on 3/25/02 at 14:05 (077510)

Well, in another week it will be twelve weeks. But I am now quite a bit wary of ESWT doing more harm than good, so I probably won't be scheduling an appointment soon. Maybe in a few more weeks I'll see some improvement, but even if I do, who's to say it's because of ESWT 10+ weeks ago, or just random unrelated circumstances.

Re: ESWT disappointment

john a on 3/25/02 at 14:11 (077513)

Well, I read the article about nerve entrapment, but it looks like I don't have the primary diagnosing symptom, which is significant pain when pressing on what looks to be the side of the heel. (I admit to not quite being able to understand where exactly the pressure was to be applied - the diagrams were not that clear to me, and my knowledge of foot anatomy is limited.) I still think my PF problem is nerve related though.