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ESWT

Posted by john h on 2/07/03 at 12:35 (108354)

I had an ESWT treatment on my right foot with Dr. A on December 27th. My current pain level varies from 1-2 for the past two weeks. This is an improvement prior to treatment. Having to deal with this for many years an improvement over two weeks is not really long enough to make an informed judgement so I am just putting this out there. I know Dr. Z recommeds heat following ESWT as do some other Doctors. About 4 days ago I begin using the Infrared Heat Pad that I mentioned in a post.It is definitely different than a conventioal heat pad and without question provides deeper heat. I have been using it for 45 minutes a night with the bottom of the feet laying flat on the pad. My sense is that it is helping but of course you can not draw any conclusion from four days of use.Maybe a placebo effect but at any rate if heat is good following ESWT this pad seems the way to go in my estimation. It of course can be used for anything you would normally use a heating pad for. I will let you know 30 days out if this heat following my treatment with the Epos is still working. The pad is manufactured in Canada and is treated as a medical device. Approved by the FDA and the appropriate Canadian authorities.

Re: ESWT

Dr. A on 2/07/03 at 22:02 (108427)

you bring up an interesting point. I have always recommended icing after epos ultra treatment because this is what was traditionally advised by the manifacturer. Maybe at the 4 or 6 week mark, heat can play a positive role toward pain improvement.

Re: ESWT

Michael R on 2/09/03 at 02:25 (108543)

After the more conventional treatments failed to relieve pain, my insurance finally approved eswt. I have been through the horrors of heel pain for 5 years. Shoes, orthotics, shots, drugs, exercizes, nothing worked, I am 5'11 and 185. Now after eswt, [which was 11/6/02] Sorry to say my feet seem worse than ever. Constant pain, burning/throbbing, sharp stabbing pain, soreness that aches when I try to sleep, {my job requires me to be on a sales floor 7 of 8 hrs} icing my feet helps some. My newest Pod wants me to spend 500.00 on a hand made orthotic with a donut inside that cushions each step,though I am not ready to shell out that kind of money.
At 51 and 25 years in sales, its tough to find other work, so I'm rather stuck for now. I have tried nearly every wacko thing for pain, whether it was some electronic stimulater/shocker to pain creams to ionized bracelets and magnets. I have lost confidence in the therapies offered by my first doctors, scared about surgical horrors from my 2nd Pod.
Now the newest wants to sell me expensive stuff. All I want to do is be able to walk, walk without constant pain. Be able to work at an effective level without pain monopolizing my thoughts. Be able to convey to others just how debilitating this pain is. HELP!!!!!

Re: ESWT

Bev N on 2/09/03 at 08:10 (108553)

Hi Michael, When are you having your ESWT and where are you having it done?Be sure to keep us posted as to how you do ,okay? I wish you all the best, this is a nasty thing we all are fighting with(PF). BevN

Re: ESWT

Dr. Z on 2/09/03 at 08:12 (108554)

Sorry to hear that you are in so much pain. Have you though about having a second ESWT treatment at this time. The time frame to call this a failure is between 12-16 weeks after the first treatment. The next thing I would do is have a round of physical therapy for the next six weeks, even if you had physical therapy treatment before. It could help you. Did your initial ESWT doctor think that your ESWT was a failure?

Re: ESWT

Pauline on 2/09/03 at 10:49 (108577)

Michael,
I'm sorry if I'm asking you a question that you already posted, but would you mind refreshing my memory about which ESWT machine was used to provide your ESWT treatment?
Thank you.

Re: ESWT

Dr. A on 2/09/03 at 15:15 (108597)

burning, throbbing pain when you are trying to sleep sounds like a nerve problem. You can try nsaids or low doses of neurontin. Which eswt treatment did you have? When people tell me that NOTHING has worked for plantar fasciitis, I get very curious. Usually, if you have plantar fasciitis one of the many conservative treatments will help for at least a short time. Did any of the treatments help you at all?

Re: ESWT

Mar on 2/09/03 at 16:27 (108610)

Dr A -

When you say - did any treatments help at all even for a short period of time -- do you mean 'reduced' pain or 'eliminate' pain and what is a short period of time? I have done so many things for over a year -- the most relief I ever got was an hour or two or, 2 or 3 times, reduced pain for a week. What do you recommend to your patients if even ESWT doesn;t help? Mar

Re: ESWT

Dr. A on 2/09/03 at 22:52 (108640)

reduced pain is what a mean. Which treatment helped? If I am convinced that plantar fasciitis is causing the pain, then a repeat treatment at the 6 month point is reasonable. For self-pay patients, I charge $600 for repeat. I know of someone who had no relief of pain until the 4 month point after eswt. Even though this is not typical, she is doing very well today. It does not sound like your symptoms are 'classic' plantar fasciitis at this point. Sometimes I will order a bone scan to determine if there is inflammation at the bottom of the heel. This can support the diagnosis of plantar fasciitis. I would probably place you in walking boot for 4 weeks at this point. hope this helps

Re: ESWT

Mar on 2/10/03 at 05:30 (108659)

Dr A-

Of all the treatments I've had, the walking boot was the absolute worst! I wore it for 5 days and was in such extreme pain, I could not walk for the next 10 days. I had to crawl to the bathroom. The pain was just unbelievable, in both the foot with the boot and the other one. Since then (mid Dec), the pain level has reduced but is still worse than it was before the boot. 2nd worse was taping -- increased pain to an unbelievable level. What helped? Swimming helps for about an hour afterwards. The first ESWT gave me about 8-9 days relief at the 4 1/2 week period. Acupuncture gave me a little relief for hours or a day once in a while. Untrasound sometimes gave me relief, other times not. Rest sometimes, sometimes not. Many things I tried would help for the first day or two and then nothing. Thanks for your interest. Mar

Re: ESWT

BrianJ on 2/10/03 at 09:03 (108664)

Michael --

I may have missed your explanation of how you first came to have foot pain. Is your pain bilateral? Could you give a brief history of how the pain started and then progressed?

Re: ESWT

Michael R on 2/11/03 at 13:09 (108811)

Hello Bev
Already had the ESWT back on 11/6/02, so roughly 10 weeks ago.

Re: ESWT

Michael R on 2/11/03 at 13:19 (108813)

Actually the first ESWT was fairly painful, particularly the anesthectic
shots, than 20 minutes or so of ESWT on each foot, sort of like a jackhammer feeling.
I was told that I could go back to work right away. I tried 3 days later, I lasted 2 hours on the sales floor, and had to limp home. Ten weeks later the pain is still very bad. I'm not sure if I would try another round. I have swithced DRs., as my confidence level in the first group is gone.

Re: ESWT

Michael R on 2/11/03 at 13:23 (108814)

Not sure which type of machine was used, I live in a nw suburb of Chicago, the place where it was done, [United Shockwave services Ltd]don't really know more than that.

Re: ESWT

Michael R on 2/11/03 at 13:49 (108815)

Remember I work on my feet 7 of 8 hours, 5 days a week, I also watch my 22 month old son Monday thru Friday days. When I get home my feet burn and throb, the only relief is icing. I use freeze paks [put inside a strong plastic reclosable baggie, to keep from leaking]. I wrap it in a towel. I move my feet around from arch to heal usually till the freeze paks are mushy.
I'm not sure what nsaids are? If it is Viox, tried it and it didn't help. I mentioned in an earlier post about losing confidence in my first group of Pod's. Heres one reason. Upon seeing my 2nd Pod, who has been one for 34 years and taught for 10. The first thing he said was the orthotics that were prescribed for me, were fine for shin splints and bad knees, but the hard heel was terrible for heel spurs. That I needed one that had donut inside to cushion the blows [this made more sense to me] though the cost of these special handmade orthotics were 500.00 a pair. Right now I am waiting to see if my insurance will help pay for these.

Re: ESWT

Michael R on 2/11/03 at 13:50 (108816)

Not sure??

Re: ESWT

Michael R on 2/11/03 at 13:57 (108817)

As I stated earlier the only real relief was from icing. Without doing this I could not sleep. I take short breaks on my job when I can barely walk. This affects my ability to sell, and therefore my paycheck, so I just try to grit through it. I have changed my schedule to Sat-Sun-Mon off Tues, work Wed-Thur, off Friday. I can't work 5 in a row.

Re: ESWT

Michael R on 2/11/03 at 14:13 (108819)

I'm not sure what you mean by bilateral? I have been a saleman for over 25 years. From outside knocking on doors to inside retail on a hard [rug covered concrete floors]. About 5 years ago the problem started with my right heel becoming very sore after work. I changed shoes/pads more often and went thru a ton of ibuprofin. Near the end of 2000 the pain was so bad in both feet I could not work or even stand, and had to take an unpaid med. leave of absense. The pain was worse some days, others I would just tolerate it.
I blew through my savings after a 13 month leave, during which I was started on pregnasone/orthotics/exercize. This helped a little, next was cortisone shots/more exercize. Then ESWT {it took nearly 6 months of leters and calls to my insurer to get it covered} I thought this was it.
Ten weeks after the ESWT my pain seems as bad as ever. Just getting out of bed in the morning for the walk to the bathroom was excrutiaing. I have missed more workdays and my sales production has dropped. I am not sure what is next?

Re: ESWT

Mar on 2/11/03 at 14:57 (108824)

Michael -

I have severe pain in both feet (bilateral) and finally got myself an electric scooter to use for work. I thought this might be a suggestion for you as a salesman. The scooter disassembles in less than a minute and fits into a normal size trunk very easily. It doesn;t heel the feet, but at least you could work without so much pain. I feel for you -- Mar

Re: ESWT

elainek on 2/11/03 at 19:27 (108848)

I have just had my first EWST treatment. I am involved in a research study.I do not know if I received the placebo or the real thing. My heel is still feeling tender and sore. Has anyone been unable to work, because of chronic plantar fasciitis? I have not been able to work for over a year.
I am beginning to feel I will never get back to work. I have exhausted all means of treatment for this chronic plantar faciitis. I am hoping that this will be the answer.

Re: ESWT

Dr. Z on 2/11/03 at 19:31 (108850)

Tell us more about the research ESWT . Where, which machine , will you placed under general anesthesia. Tell us more about your experience

Re: ESWT

elainek on 2/11/03 at 19:35 (108851)

Machine is by Wolfe. I was palced under general anestesia. Then my foot was fromzen. This was just done Sunday. I am presently in a research study it has just begun. Will keep posted

Re: ESWT

elainek on 2/11/03 at 19:42 (108852)

Is chronic plantar fasciitis considered disability?

Re: ESWT

Dr. Z on 2/11/03 at 19:42 (108853)

wow ! Another machine. Was this done in Chicago at the Weil clinic

Re: ESWT

elainek on 2/11/03 at 19:45 (108855)

no it was not. I live on the east coast

Re: ESWT

Dr. Z on 2/11/03 at 19:46 (108856)

that is the one million question or should I say fight between your employer, insurance company and doctor. My opinion is that it can be a work
related disability. Very hard to prove

Re: ESWT

Dr. Z on 2/11/03 at 19:48 (108858)

So where did you have the treatment done

Re: ESWT

elainek on 2/11/03 at 19:48 (108859)

I am already on long term disability

Re: ESWT

elainek on 2/11/03 at 19:50 (108861)

are you a podiatrist?

Re: ESWT

Dr. Z on 2/11/03 at 19:51 (108867)

Yes. I have been on this board for the past few years. I have been using ESWT since 1999. I am now using the Dornier Epos. I have a friend who told me about the Wolfe. I curious about this machine

Re: ESWT

elainek on 2/11/03 at 19:53 (108868)

I believe that this is the first time it is being used. Actually, I met the man that came with the machine.

Re: ESWT

Dr. Z on 2/11/03 at 19:56 (108872)

Where is the study being conducted on the East Coast. Who is running this research. This would be very helpful to this board

Re: ESWT

elainek on 2/11/03 at 19:57 (108873)

Massachusetts.

Re: ESWT

Dr. Z on 2/11/03 at 20:06 (108876)

Could you tell us where . What institute and who is leading the research.

Re: ESWT

elainek on 2/11/03 at 20:27 (108880)

I am returning next Tuesday for a office visit. I do know it is the Wolf PIEZOSON 300 ESWT. I am not really sure about who is actually doing this study. I will find out and let you know. I enrolled in this research program per my doctor.

Re: ESWT

Bev N on 2/12/03 at 08:27 (108912)

elainek, How did you get your long term disability , and for how long will it be effective? I have been off work going on 4 months due to PF, I am a nurse and had to stop working due to the extreme pain that I am in. I too have been through the gammit of tests and all of that. How did you get in a reserch project, and where is it? Thankyou, Bev

Re: ESWT

Dr. A on 2/07/03 at 22:02 (108427)

you bring up an interesting point. I have always recommended icing after epos ultra treatment because this is what was traditionally advised by the manifacturer. Maybe at the 4 or 6 week mark, heat can play a positive role toward pain improvement.

Re: ESWT

Michael R on 2/09/03 at 02:25 (108543)

After the more conventional treatments failed to relieve pain, my insurance finally approved eswt. I have been through the horrors of heel pain for 5 years. Shoes, orthotics, shots, drugs, exercizes, nothing worked, I am 5'11 and 185. Now after eswt, [which was 11/6/02] Sorry to say my feet seem worse than ever. Constant pain, burning/throbbing, sharp stabbing pain, soreness that aches when I try to sleep, {my job requires me to be on a sales floor 7 of 8 hrs} icing my feet helps some. My newest Pod wants me to spend 500.00 on a hand made orthotic with a donut inside that cushions each step,though I am not ready to shell out that kind of money.
At 51 and 25 years in sales, its tough to find other work, so I'm rather stuck for now. I have tried nearly every wacko thing for pain, whether it was some electronic stimulater/shocker to pain creams to ionized bracelets and magnets. I have lost confidence in the therapies offered by my first doctors, scared about surgical horrors from my 2nd Pod.
Now the newest wants to sell me expensive stuff. All I want to do is be able to walk, walk without constant pain. Be able to work at an effective level without pain monopolizing my thoughts. Be able to convey to others just how debilitating this pain is. HELP!!!!!

Re: ESWT

Bev N on 2/09/03 at 08:10 (108553)

Hi Michael, When are you having your ESWT and where are you having it done?Be sure to keep us posted as to how you do ,okay? I wish you all the best, this is a nasty thing we all are fighting with(PF). BevN

Re: ESWT

Dr. Z on 2/09/03 at 08:12 (108554)

Sorry to hear that you are in so much pain. Have you though about having a second ESWT treatment at this time. The time frame to call this a failure is between 12-16 weeks after the first treatment. The next thing I would do is have a round of physical therapy for the next six weeks, even if you had physical therapy treatment before. It could help you. Did your initial ESWT doctor think that your ESWT was a failure?

Re: ESWT

Pauline on 2/09/03 at 10:49 (108577)

Michael,
I'm sorry if I'm asking you a question that you already posted, but would you mind refreshing my memory about which ESWT machine was used to provide your ESWT treatment?
Thank you.

Re: ESWT

Dr. A on 2/09/03 at 15:15 (108597)

burning, throbbing pain when you are trying to sleep sounds like a nerve problem. You can try nsaids or low doses of neurontin. Which eswt treatment did you have? When people tell me that NOTHING has worked for plantar fasciitis, I get very curious. Usually, if you have plantar fasciitis one of the many conservative treatments will help for at least a short time. Did any of the treatments help you at all?

Re: ESWT

Mar on 2/09/03 at 16:27 (108610)

Dr A -

When you say - did any treatments help at all even for a short period of time -- do you mean 'reduced' pain or 'eliminate' pain and what is a short period of time? I have done so many things for over a year -- the most relief I ever got was an hour or two or, 2 or 3 times, reduced pain for a week. What do you recommend to your patients if even ESWT doesn;t help? Mar

Re: ESWT

Dr. A on 2/09/03 at 22:52 (108640)

reduced pain is what a mean. Which treatment helped? If I am convinced that plantar fasciitis is causing the pain, then a repeat treatment at the 6 month point is reasonable. For self-pay patients, I charge $600 for repeat. I know of someone who had no relief of pain until the 4 month point after eswt. Even though this is not typical, she is doing very well today. It does not sound like your symptoms are 'classic' plantar fasciitis at this point. Sometimes I will order a bone scan to determine if there is inflammation at the bottom of the heel. This can support the diagnosis of plantar fasciitis. I would probably place you in walking boot for 4 weeks at this point. hope this helps

Re: ESWT

Mar on 2/10/03 at 05:30 (108659)

Dr A-

Of all the treatments I've had, the walking boot was the absolute worst! I wore it for 5 days and was in such extreme pain, I could not walk for the next 10 days. I had to crawl to the bathroom. The pain was just unbelievable, in both the foot with the boot and the other one. Since then (mid Dec), the pain level has reduced but is still worse than it was before the boot. 2nd worse was taping -- increased pain to an unbelievable level. What helped? Swimming helps for about an hour afterwards. The first ESWT gave me about 8-9 days relief at the 4 1/2 week period. Acupuncture gave me a little relief for hours or a day once in a while. Untrasound sometimes gave me relief, other times not. Rest sometimes, sometimes not. Many things I tried would help for the first day or two and then nothing. Thanks for your interest. Mar

Re: ESWT

BrianJ on 2/10/03 at 09:03 (108664)

Michael --

I may have missed your explanation of how you first came to have foot pain. Is your pain bilateral? Could you give a brief history of how the pain started and then progressed?

Re: ESWT

Michael R on 2/11/03 at 13:09 (108811)

Hello Bev
Already had the ESWT back on 11/6/02, so roughly 10 weeks ago.

Re: ESWT

Michael R on 2/11/03 at 13:19 (108813)

Actually the first ESWT was fairly painful, particularly the anesthectic
shots, than 20 minutes or so of ESWT on each foot, sort of like a jackhammer feeling.
I was told that I could go back to work right away. I tried 3 days later, I lasted 2 hours on the sales floor, and had to limp home. Ten weeks later the pain is still very bad. I'm not sure if I would try another round. I have swithced DRs., as my confidence level in the first group is gone.

Re: ESWT

Michael R on 2/11/03 at 13:23 (108814)

Not sure which type of machine was used, I live in a nw suburb of Chicago, the place where it was done, [United Shockwave services Ltd]don't really know more than that.

Re: ESWT

Michael R on 2/11/03 at 13:49 (108815)

Remember I work on my feet 7 of 8 hours, 5 days a week, I also watch my 22 month old son Monday thru Friday days. When I get home my feet burn and throb, the only relief is icing. I use freeze paks [put inside a strong plastic reclosable baggie, to keep from leaking]. I wrap it in a towel. I move my feet around from arch to heal usually till the freeze paks are mushy.
I'm not sure what nsaids are? If it is Viox, tried it and it didn't help. I mentioned in an earlier post about losing confidence in my first group of Pod's. Heres one reason. Upon seeing my 2nd Pod, who has been one for 34 years and taught for 10. The first thing he said was the orthotics that were prescribed for me, were fine for shin splints and bad knees, but the hard heel was terrible for heel spurs. That I needed one that had donut inside to cushion the blows [this made more sense to me] though the cost of these special handmade orthotics were 500.00 a pair. Right now I am waiting to see if my insurance will help pay for these.

Re: ESWT

Michael R on 2/11/03 at 13:50 (108816)

Not sure??

Re: ESWT

Michael R on 2/11/03 at 13:57 (108817)

As I stated earlier the only real relief was from icing. Without doing this I could not sleep. I take short breaks on my job when I can barely walk. This affects my ability to sell, and therefore my paycheck, so I just try to grit through it. I have changed my schedule to Sat-Sun-Mon off Tues, work Wed-Thur, off Friday. I can't work 5 in a row.

Re: ESWT

Michael R on 2/11/03 at 14:13 (108819)

I'm not sure what you mean by bilateral? I have been a saleman for over 25 years. From outside knocking on doors to inside retail on a hard [rug covered concrete floors]. About 5 years ago the problem started with my right heel becoming very sore after work. I changed shoes/pads more often and went thru a ton of ibuprofin. Near the end of 2000 the pain was so bad in both feet I could not work or even stand, and had to take an unpaid med. leave of absense. The pain was worse some days, others I would just tolerate it.
I blew through my savings after a 13 month leave, during which I was started on pregnasone/orthotics/exercize. This helped a little, next was cortisone shots/more exercize. Then ESWT {it took nearly 6 months of leters and calls to my insurer to get it covered} I thought this was it.
Ten weeks after the ESWT my pain seems as bad as ever. Just getting out of bed in the morning for the walk to the bathroom was excrutiaing. I have missed more workdays and my sales production has dropped. I am not sure what is next?

Re: ESWT

Mar on 2/11/03 at 14:57 (108824)

Michael -

I have severe pain in both feet (bilateral) and finally got myself an electric scooter to use for work. I thought this might be a suggestion for you as a salesman. The scooter disassembles in less than a minute and fits into a normal size trunk very easily. It doesn;t heel the feet, but at least you could work without so much pain. I feel for you -- Mar

Re: ESWT

elainek on 2/11/03 at 19:27 (108848)

I have just had my first EWST treatment. I am involved in a research study.I do not know if I received the placebo or the real thing. My heel is still feeling tender and sore. Has anyone been unable to work, because of chronic plantar fasciitis? I have not been able to work for over a year.
I am beginning to feel I will never get back to work. I have exhausted all means of treatment for this chronic plantar faciitis. I am hoping that this will be the answer.

Re: ESWT

Dr. Z on 2/11/03 at 19:31 (108850)

Tell us more about the research ESWT . Where, which machine , will you placed under general anesthesia. Tell us more about your experience

Re: ESWT

elainek on 2/11/03 at 19:35 (108851)

Machine is by Wolfe. I was palced under general anestesia. Then my foot was fromzen. This was just done Sunday. I am presently in a research study it has just begun. Will keep posted

Re: ESWT

elainek on 2/11/03 at 19:42 (108852)

Is chronic plantar fasciitis considered disability?

Re: ESWT

Dr. Z on 2/11/03 at 19:42 (108853)

wow ! Another machine. Was this done in Chicago at the Weil clinic

Re: ESWT

elainek on 2/11/03 at 19:45 (108855)

no it was not. I live on the east coast

Re: ESWT

Dr. Z on 2/11/03 at 19:46 (108856)

that is the one million question or should I say fight between your employer, insurance company and doctor. My opinion is that it can be a work
related disability. Very hard to prove

Re: ESWT

Dr. Z on 2/11/03 at 19:48 (108858)

So where did you have the treatment done

Re: ESWT

elainek on 2/11/03 at 19:48 (108859)

I am already on long term disability

Re: ESWT

elainek on 2/11/03 at 19:50 (108861)

are you a podiatrist?

Re: ESWT

Dr. Z on 2/11/03 at 19:51 (108867)

Yes. I have been on this board for the past few years. I have been using ESWT since 1999. I am now using the Dornier Epos. I have a friend who told me about the Wolfe. I curious about this machine

Re: ESWT

elainek on 2/11/03 at 19:53 (108868)

I believe that this is the first time it is being used. Actually, I met the man that came with the machine.

Re: ESWT

Dr. Z on 2/11/03 at 19:56 (108872)

Where is the study being conducted on the East Coast. Who is running this research. This would be very helpful to this board

Re: ESWT

elainek on 2/11/03 at 19:57 (108873)

Massachusetts.

Re: ESWT

Dr. Z on 2/11/03 at 20:06 (108876)

Could you tell us where . What institute and who is leading the research.

Re: ESWT

elainek on 2/11/03 at 20:27 (108880)

I am returning next Tuesday for a office visit. I do know it is the Wolf PIEZOSON 300 ESWT. I am not really sure about who is actually doing this study. I will find out and let you know. I enrolled in this research program per my doctor.

Re: ESWT

Bev N on 2/12/03 at 08:27 (108912)

elainek, How did you get your long term disability , and for how long will it be effective? I have been off work going on 4 months due to PF, I am a nurse and had to stop working due to the extreme pain that I am in. I too have been through the gammit of tests and all of that. How did you get in a reserch project, and where is it? Thankyou, Bev

Re: ESWT

elainek on 2/14/03 at 15:20 (109181)

Cambridge Massachusetts. The study of being done by the United Medical Systems, Inc., at least that is the company with the machine being used

Re: ESWT

Bev N on 2/15/03 at 09:05 (109221)

Elaine, Did I ask you this before, but how did you get your long term disability? What hoops did you have to 'jump' (haha) through to get it? A lot of us would be interested out here in PF land. Thankyou, Bev

Re: ESWT

elainek on 2/17/03 at 08:24 (109442)

I did not have to jump through hoops. I can not do my job, which required standing 75% of the time. I envy those that can. I think my company understands this. I am in constant pain. My pf is chronic. I am also at this time having trouble with my back, from favoring my foot. Have you devloped a limp? I do not know how people can stand and work all day, with out being in excruciating pain.