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ESWT Following Surgery???

Posted by Lee Bunyard on 5/25/02 at 21:54 (085228)

My wife has been diagnosed with PF in both feet. Has had all types of treatments: cortisone shots, hard cast, custom orthotics, finally had the surgical process, I think it's called Fascia release. Nothing has helped, she's as bad or worse than she was over two years ago when this started.
Kaiser is considering referring her out for ESWT, her podiatrist is looking into it.
Has anyone had any success with ESWT treatment in cases where surgery did not help??
Also, where can I find a list of locations in Northern California that do ESWT??
Thank you.

Re: ESWT Following Surgery???

DR Zuckerman on 5/26/02 at 08:33 (085272)

Hi

Yes you can have ESWT so long as the problem isn't nerve damage from the foot surgery AS to treatmetn centers. How about Canada?

Re: ESWT Following Surgery???

john h on 5/28/02 at 09:49 (085440)

Lee: Did you wife have surgery on both feet? When did she have surgery? Do you know if the surgery was performed through a scope or just a regular incision. It usually takes at least a year to see what kind of results you will have from the surgery. In northern California you might want to consider Vancouver for ESWT as it is much less expensive and you may have difficulty getting your insurance carrier to pay for ESWT although I did see a post Healthtronics had reached some agreement in California with Blue Cross/Blue Shield. If money is no object go to http://www.healthtronics.com and you will find a list of Doctors who perform ESWT using the Ossatron. There may be some providers for the EPOS in northern California but I do not know their locations.

Re: ESWT Following Surgery???

john h on 5/29/02 at 09:58 (085600)

Lee: I discussed ESWT with Dr. Gordon in Canada on people who had failed PF surgery. He is one the major experts around on ESWT. He performed ESWT on Scott and some of the other original Ossatron 6. He said he recommed the High Power ESWT for a foot that had surgery due to the fact that there is scar tissue to deal with. With that in mind, you might make sure you get a high power treatment if you go the ESWT route. I had surgery on one foot but have bilaterial PF. I had treatments with the Orby and I got the same results on both feet

Re: ESWT Following Surgery???

Ronnie C on 5/29/02 at 16:53 (085648)

Hi Lee-
I live in Northern California as well. I am currently seeing Dr. Julia Kahan in Los Gatos re: ESWT. She once mentioned to me that she wouldn't do foot surgery for she doesn't feel it cures PF. She has had a number of patients see her after surgery on PF didn't work.
Good luck.

Re: ESWT Following Surgery???

Susan B on 5/30/02 at 19:26 (085840)

Dr. Zuckerman
This is the wife with the chronic heel pain. I've also had accupuncture, and accuscope treatments on my feet. I have tarsal tunnel in both feet as well, but I have refused the surgery to try to correct that condition. Nerve damage has been mentioned as a possible problem with the ossatron treatments. Would the tarsal tunnel be consider the type of nerve damage that could interfere with this treatment? Also, why do you suggest Canada as a place for treatment? Do you see the skill there superior to that in the USA when it comes to using this equipment? I'm also concerned about the healing time, and what that would be like.
Susan B

Re: ESWT Following Surgery???

DR Zuckerman on 5/30/02 at 20:20 (085847)

Hi

The reason I mentioned Canada was that I didn't know anyone in your area doing ESWT The doctors in the USA are just as skilled with ESWT as in Canada. It is very important that it is determined that your foot pain isn't strictly coming from the tarsal tunnel. If you have plantar fasciitis from TTS then there will be no relief with ESWT. You need to have an degeneration of the plantar fascia at the insertion for the ESWT to be effective

Re: ESWT Following Surgery???

Susan B on 5/30/02 at 22:58 (085870)

Dr. Zuckerman,
Thank you for your reply. I have two more questions if I may. How can it be determined if the TTS caused the plantar fasciitis? And how do you determine if there is degeneration of the plantar fascia at the insertion? My physician is trying to get our HMO to cover the cost for this outside treatment. I've had chronic heel pain since October 1999, and had my second surgery a year ago last February. I am still uncomfortable in regular shoes and either wear slippers with my custom orthodics or my post op shoes. Needless to say, this treatment is a last ditch attempt to try to bring me some relief from the pain and allow me to resume a part of my life. But I don't wish to put our insurance through the expense or myself through the trouble of having ESWT if there's a good chance it won't achieve what we hope for.
Susan

Re: ESWT Following Surgery???

DR Zuckerman on 5/26/02 at 08:33 (085272)

Hi

Yes you can have ESWT so long as the problem isn't nerve damage from the foot surgery AS to treatmetn centers. How about Canada?

Re: ESWT Following Surgery???

john h on 5/28/02 at 09:49 (085440)

Lee: Did you wife have surgery on both feet? When did she have surgery? Do you know if the surgery was performed through a scope or just a regular incision. It usually takes at least a year to see what kind of results you will have from the surgery. In northern California you might want to consider Vancouver for ESWT as it is much less expensive and you may have difficulty getting your insurance carrier to pay for ESWT although I did see a post Healthtronics had reached some agreement in California with Blue Cross/Blue Shield. If money is no object go to http://www.healthtronics.com and you will find a list of Doctors who perform ESWT using the Ossatron. There may be some providers for the EPOS in northern California but I do not know their locations.

Re: ESWT Following Surgery???

john h on 5/29/02 at 09:58 (085600)

Lee: I discussed ESWT with Dr. Gordon in Canada on people who had failed PF surgery. He is one the major experts around on ESWT. He performed ESWT on Scott and some of the other original Ossatron 6. He said he recommed the High Power ESWT for a foot that had surgery due to the fact that there is scar tissue to deal with. With that in mind, you might make sure you get a high power treatment if you go the ESWT route. I had surgery on one foot but have bilaterial PF. I had treatments with the Orby and I got the same results on both feet

Re: ESWT Following Surgery???

Ronnie C on 5/29/02 at 16:53 (085648)

Hi Lee-
I live in Northern California as well. I am currently seeing Dr. Julia Kahan in Los Gatos re: ESWT. She once mentioned to me that she wouldn't do foot surgery for she doesn't feel it cures PF. She has had a number of patients see her after surgery on PF didn't work.
Good luck.

Re: ESWT Following Surgery???

Susan B on 5/30/02 at 19:26 (085840)

Dr. Zuckerman
This is the wife with the chronic heel pain. I've also had accupuncture, and accuscope treatments on my feet. I have tarsal tunnel in both feet as well, but I have refused the surgery to try to correct that condition. Nerve damage has been mentioned as a possible problem with the ossatron treatments. Would the tarsal tunnel be consider the type of nerve damage that could interfere with this treatment? Also, why do you suggest Canada as a place for treatment? Do you see the skill there superior to that in the USA when it comes to using this equipment? I'm also concerned about the healing time, and what that would be like.
Susan B

Re: ESWT Following Surgery???

DR Zuckerman on 5/30/02 at 20:20 (085847)

Hi

The reason I mentioned Canada was that I didn't know anyone in your area doing ESWT The doctors in the USA are just as skilled with ESWT as in Canada. It is very important that it is determined that your foot pain isn't strictly coming from the tarsal tunnel. If you have plantar fasciitis from TTS then there will be no relief with ESWT. You need to have an degeneration of the plantar fascia at the insertion for the ESWT to be effective

Re: ESWT Following Surgery???

Susan B on 5/30/02 at 22:58 (085870)

Dr. Zuckerman,
Thank you for your reply. I have two more questions if I may. How can it be determined if the TTS caused the plantar fasciitis? And how do you determine if there is degeneration of the plantar fascia at the insertion? My physician is trying to get our HMO to cover the cost for this outside treatment. I've had chronic heel pain since October 1999, and had my second surgery a year ago last February. I am still uncomfortable in regular shoes and either wear slippers with my custom orthodics or my post op shoes. Needless to say, this treatment is a last ditch attempt to try to bring me some relief from the pain and allow me to resume a part of my life. But I don't wish to put our insurance through the expense or myself through the trouble of having ESWT if there's a good chance it won't achieve what we hope for.
Susan