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ESWT questions, amount, voltage suggestions

Posted by Janet J on 3/06/03 at 18:25 (112052)

My sister, brother and I all have PF. I am sitting with a cast on my foot as I write. After five weeks my foot (on the top) desperately hurts when I lift my walking cast. My sister had surgery last summer. It didn't help. My cast isn't helping. My sister has an appt. with a othopedic surgeon for ESWT April 11. I told her since I can only sit, I would ask the boards and search the net for answers.

What questions would you ask a doctor BEFORE ESWT.

When would you run from the doctor rather than stay?

What is a realistic recovery, and how much rest is needed?

My sister has a sitting job, I am a school librarian working presently from a wheelchair (can't walk without severe pain for more than a half hour). My brother is in construction but is still able to control with night splints.

Re: ESWT questions, amount, voltage suggestions

Dr Z on 3/06/03 at 19:54 (112062)

Hi

First of all you have chosen an excellent procedure for chronic heel pain
that being ESWT. So what questions would I ask.?
1. Is the doctor a foot and ankle specialist or just a general orthopedics
2. Being a podiatrist I do favor podiatrist over orthopedic surgeons. We see more cases of plantar fasciitis.
3. How many cases has he done
4. What complications has he or she seen with ESWT
5 Ask the doctor how long it takes to heal . It is at least 12 weeks
6. What ESWT equimpment and why
7. What are the indications for ESWT.
8 If he tells you that you will be cured in five minutes well

You should be able to return to your job within a day or two without any problems

Re: ESWT questions, amount, voltage suggestions

Dr. A on 3/06/03 at 22:17 (112077)

I agree with Dr. Z.
You would also want to ask if the procedure is going to be covered by your insurance carrier, since this procedure is covered at this time by a only a small number of insurance companies. Also, it may take as long as 3 months for the treatment to work. I have one patient that I thought this did not work for on both of her feet, but after 4 months, the pain went from 8 to 2 on both of her feet. ESWT has worked for people who have failed surgery.

Re: ESWT questions, amount, voltage suggestions

DrMan on 3/06/03 at 22:20 (112078)

Basically we all know ESWT works 80-85%. So this is the best treatment for you. The results of minimally invasive surgery on the plantar fascia is 80-85%. So, why would you not want to have ESWT before even considering surgery. There seems to be a very strong family history of pain in this part of the anatomy, the first question should be; are they sure the working diagnosis is plantar fasciitis. Especially since you said your sister had unsuccessful surgery. I also perfer podiatry over orthopedics, however the doctor's qualifications and experience should be the next question. The next question is that of high power or low power ESWT machines. Those of us with experience tend to prefer high power since most of the liturature supports this. The only FDA approved devices for plantar fasciitis are the high power ones. There is a low power device used for the heel, however it is only FDA approved for the elbow, and it requires multiple treatments when used on the heel. I personally am involved in an FDA study on a new ESWT device for the heel, it too is a high power ESWT device. You should run if the doctor either doesn't have any experience with ESWT or he/she gives you too high expectations or bad mouths ESWT. ESWT does work, the science is behind it and the research does document it. Good Luck