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

ESWT - Dornier treatment

Posted by Alison L. on 1/28/03 at 10:35 (107131)

Hi, I had both feet treated with ESWT using the Dornier Epos Ultra 6 weeks ago. I am not hobbling around like I used and not experiencing the extreme heel pain that I was. On the other hand I get twinges and slight sharp pains that hint if I'm not careful the pain may return. My questions are: 1)how long can improvement be expected to continue? 12 weeks? up to a year? 2) I have not taken any NSAIDs for fear they might interfer with the heeling - is this correct? 3) When do you think I could return to aerobics without fear of reinjury? (I am about 40 lbs overweight - 40 yrs old!) I have been stretching daily - is there a chance I am overstretching and causing damage?

I know that is a lot of questions but any information would help. To those of you out there considering ESWT I would say that at 6 weeks I am 70% better but of course I have been resting and not excercising in anyway. I had PF on and off for 10 years. The podiatrist doing the ESWT said I had the thickest PF he had ever seen! What an honor :)! 10mm on both feet as seen with the ultrasound on the Dornier machine.

Good luck to all of you with foot pain

Re: ESWT - Dornier treatment

Dr. Z on 1/28/03 at 15:35 (107158)

Glad that you are doing so well. Some of your questions are very difficult to answer without seeing you or talking to you over the phone.
Are you doing the stretching on your own or is this your doctor's specific advice. There are many different post-eswt instructions that are so specific to the patient that it is very hard to answer your questions. That is a very thick pf measurement. Reduce in the thickness usually starts to take place at about six weeks.
Where did you have your treatment.?

Re: ESWT - Dornier treatment

Alison L. on 1/28/03 at 16:02 (107162)

My post treatment instructions were very generic - to be handed to every patient. I just do stretches on my own - calf stretches, toe circles, pulling on toes toward me with outstretched leg, etc. The Dornier machine's nurse told me patients with thicker PF have better success rates. Do you agree or do you think he was just trying to make me feel better? I assumed a thicker PF would be tougher to treat. If the reduction in thickness is just starting to happen at six weeks I wonder if now is a time I should be extra careful to not hurt it. I am really hoping to still see improvement. I am thinking of doing stationary biking, short walks, and weight lifting and skipping low impact aerobics until at least the 12 week mark. Does that seem sensible? I am really trying to lose weight but without exercise it seems to be difficult. I am very interested in the mechanics of the healing process as well as the time frame. I got my treatment done in Austin, TX.

Re: ESWT - Dornier treatment

Dr. Z on 1/28/03 at 16:10 (107165)

I would avoid all high impact activity for another six weeks. No bare feet
Statinary bike and swimming are very good activities to start with you
The thickness. Well we really don't know. What we do know is that if the pf goes down in thickness that is a physical sign that healing is occurring. It can take up to four months to really see a difference . It sounds like you are healing just perfect. In the FDA study 62% were cured at 12 weeks that means no pain and the average pain reduction was about 59% So your are at 70% at the six week mark. I am willing to bet you are going to be cured cause your case is one that sounds like it is on it way.
The healing process is where due to micro-trauma you have a repairing cycle started with actual new tissue cells being laid down to heal and strenght the insertinal atttachment of your pf

Re: ESWT - Dornier treatment

Alison L. on 1/28/03 at 16:26 (107170)

Thank you for the information. Very helpful. One more question for you - the Dr. did what seemed to be a test for PF where he 'pushed' his thumbs into my heel at different spots and asked about the pain. In certain spots the pain was intense. Now I am doing that test to myself and can still find the spot that causes pain. My question is do normal people with no heel problems have this same reaction - pain in a certain spot deep in the heel or only people with PF?

Re: ESWT - Dornier treatment

nancy s. on 1/28/03 at 17:16 (107182)

alison: normal people with no heel problems do not feel that (horrible) pain when the spot is pressed. i'm just a long-term patient, not a doc, but i thought i'd tell you in case your post gets missed. i'll be shocked if a doc posts and says i'm wrong about this. i've been wrong before, but about this i'm pretty certain.

nancy
.

Re: ESWT - Dornier treatment

Mar on 1/29/03 at 13:11 (107250)

Dr Z -

I noticed that you suggested stationary bike as a form of exercise. I bought one several months ago and even though I felt very little pressure on my feet, when I was finished exercising, the pain seemed worse. Is that possible or do you think it was just a coincidence? After about a week I stopped using it and really miss it. I do LOVE THE SWIMMING though! Thanks for your opinion - Mar

Re: ESWT - Dornier treatment

Dr. Z on 1/29/03 at 13:42 (107254)

You have to have the foot flat on the pedals and not beable to lift you feet off the foot pedals.

Re: ESWT - Dornier treatment

Dr. Z on 1/28/03 at 15:35 (107158)

Glad that you are doing so well. Some of your questions are very difficult to answer without seeing you or talking to you over the phone.
Are you doing the stretching on your own or is this your doctor's specific advice. There are many different post-eswt instructions that are so specific to the patient that it is very hard to answer your questions. That is a very thick pf measurement. Reduce in the thickness usually starts to take place at about six weeks.
Where did you have your treatment.?

Re: ESWT - Dornier treatment

Alison L. on 1/28/03 at 16:02 (107162)

My post treatment instructions were very generic - to be handed to every patient. I just do stretches on my own - calf stretches, toe circles, pulling on toes toward me with outstretched leg, etc. The Dornier machine's nurse told me patients with thicker PF have better success rates. Do you agree or do you think he was just trying to make me feel better? I assumed a thicker PF would be tougher to treat. If the reduction in thickness is just starting to happen at six weeks I wonder if now is a time I should be extra careful to not hurt it. I am really hoping to still see improvement. I am thinking of doing stationary biking, short walks, and weight lifting and skipping low impact aerobics until at least the 12 week mark. Does that seem sensible? I am really trying to lose weight but without exercise it seems to be difficult. I am very interested in the mechanics of the healing process as well as the time frame. I got my treatment done in Austin, TX.

Re: ESWT - Dornier treatment

Dr. Z on 1/28/03 at 16:10 (107165)

I would avoid all high impact activity for another six weeks. No bare feet
Statinary bike and swimming are very good activities to start with you
The thickness. Well we really don't know. What we do know is that if the pf goes down in thickness that is a physical sign that healing is occurring. It can take up to four months to really see a difference . It sounds like you are healing just perfect. In the FDA study 62% were cured at 12 weeks that means no pain and the average pain reduction was about 59% So your are at 70% at the six week mark. I am willing to bet you are going to be cured cause your case is one that sounds like it is on it way.
The healing process is where due to micro-trauma you have a repairing cycle started with actual new tissue cells being laid down to heal and strenght the insertinal atttachment of your pf

Re: ESWT - Dornier treatment

Alison L. on 1/28/03 at 16:26 (107170)

Thank you for the information. Very helpful. One more question for you - the Dr. did what seemed to be a test for PF where he 'pushed' his thumbs into my heel at different spots and asked about the pain. In certain spots the pain was intense. Now I am doing that test to myself and can still find the spot that causes pain. My question is do normal people with no heel problems have this same reaction - pain in a certain spot deep in the heel or only people with PF?

Re: ESWT - Dornier treatment

nancy s. on 1/28/03 at 17:16 (107182)

alison: normal people with no heel problems do not feel that (horrible) pain when the spot is pressed. i'm just a long-term patient, not a doc, but i thought i'd tell you in case your post gets missed. i'll be shocked if a doc posts and says i'm wrong about this. i've been wrong before, but about this i'm pretty certain.

nancy
.

Re: ESWT - Dornier treatment

Mar on 1/29/03 at 13:11 (107250)

Dr Z -

I noticed that you suggested stationary bike as a form of exercise. I bought one several months ago and even though I felt very little pressure on my feet, when I was finished exercising, the pain seemed worse. Is that possible or do you think it was just a coincidence? After about a week I stopped using it and really miss it. I do LOVE THE SWIMMING though! Thanks for your opinion - Mar

Re: ESWT - Dornier treatment

Dr. Z on 1/29/03 at 13:42 (107254)

You have to have the foot flat on the pedals and not beable to lift you feet off the foot pedals.