ESWT at Bayshore in TorontoPosted by Kamal S. on 3/12/03 at 14:48 (112672)
I have been suffering from PF for over a year and a half. After trying several conservative treatments (orthotics, stretching, icing, cortisone shots), I am now looking into ESWT. Many people have reported good results with this treatment. Has anyone every gotten worse because of this treatment?
I also want to know if anyone had it done at Bayshore in Toronto and how their experience has been.
I live in Dallas, TX and if anyone knows of a good option closeby, would appreciate knowing about it.
Thanks in advance,
Re: ESWT at Bayshore in TorontoDrMan on 3/12/03 at 16:13 (112677)
It is very, very rare for a patient to be worse after ESWT, either high power or low power, however, there have been reports of a select few experiencing this unfortunate incident. Keep in mind, ESWT is a medical treatment that should be utilized by a physician, either orthoped..ic or podiatric. There are always risks, however, my experience, those of doctors I know and those of the International Society of Musculoskeletal Shock Wave Therapy would be that the risk is very, very slight. Keep in mind that the diagnosis must be correct in order to utilize this technology within its scope. The doctor must also have experience with the application of this technology.
As for an ESWT doctor near you, I'm sure there must be someone nearby. You could search this site or contact the International Society of Musculoskeletal Shock Wave Therapy or American Society of Musculoskeletal Shock Wave Therapy websites. We are in New York City, and have access to HIgh power and low power devices. WE are also conducting an approved FDA study on a newer HIgh Power ESWT device. If money is an issue you may consider participating in this study. It is a prospective, double-blinded , placebo study with follow up for 12 weeks. We actually have had a patient come from Texas for the study because her insurance did not cover ESWT. Feel free to contact me if you have any questions: (email removed)
Re: ESWT at Bayshore in TorontoDr. A on 3/12/03 at 21:34 (112706)
The chances of making your condition worse is very small. I have not heard of any malpractice lawsuits originating from eswt in my area (St. Louis). Patients have traveled from as far as Alaska and California to have eswt performed in my office. You can find more info at podiatryinfo.com or heelpaincenter.com. I charge $1600 for one foot and $2800 for two feet.
Repeat treatments, if needed are $600.
Re: Yes, I went to TorontoMolly on 3/13/03 at 08:11 (112727)
Kamal: Yes, I had treatment done in Toronto on January 30, 2003. I am currently at 6 weeks post-treatment and I'm doing very well, occasional soreness if I walk too much, but definitely NOT worse, I am better! Check my posts just below for more details '5 weeks post-op' thread. I'd be happy to give you any information on going to Toronto if you are interested. They were very nice there. I had the 'high intensity' treatment which was only one day as opposed to the 'low intensity' which means you'd have to be up there for a week. Let me know if I can answer any questions.
Re: ESWT at Bayshore in TorontoKamal S. on 3/13/03 at 08:47 (112731)
Thanks to Dr A., DrMan, and Molly for sharing their information. I will respond via e-mail to you all. I had one important question at this stage: I do not have that much morning pain -- is ESWT still an option for me or not? Several people seem to have suggested that morning pain is a necessary requirement for ESWT to work.
The hardest thing for me is to stand in one place -- starts to hurt within minutes. Walking is a bit better but only for short distances. In general, my feet feel worse at the end of the day than they do in the morning. However, I do take precautions like rolling my foot on a bottle and stretching my calves before getting out of bed. So could be that I would have worse morning pain if I did not do that.
Re: Yes, I went to TorontoMolly on 3/13/03 at 09:02 (112736)
Kamal: I had friends up in Toronto and that was a great help, so yes, having family up there would be a definite plus. It helps having someone there that knows the lay of the land and you're not in this strange city 'all alone.' It's hard to say which treatment is actually better, low or high, I chose high because I didn't have a week to stay up there. With 'high' you have to be put out with an IV, with low you do not, but you have to go for three treatments, every other day. So maybe it's a personal choice. Also the 'high' was more expensive because of the anestheia, but so far I have not regretted my choice.
Re: ESWT at Bayshore in TorontoDr. Z on 3/13/03 at 11:43 (112752)
Do you limp or have pain after being on your feet for any length of time.? If you sit after being on your feet and get up such as going to the bathroom in the middle of the nite. Have you had an ultra-sound and or mri evalution. Just as in Canada we perform an ultrasound and or mri before performing high energy ESWT. The hands on examination is very important. Do you have alot of pain in one specific area where the plantar fascia attaches to the bottom of the heel . This is called the inserional point.
Re: ESWT at Bayshore in TorontoKamal S. on 3/13/03 at 13:10 (112765)
Thanks for taking the time.
I have pain if I have been on my feet for some time. If I stand in one palce, the pain starts rather quickly. In a matter of minutes. If I move around, it still hurts but less than standing in one place. Most of my pain is in the heel and its of a stinging , burning type. If I have been resting and get up and night to go to the bathroom say, I don't have the sharp pain that many describe. But I almost never get out of bed before wiggling my toes, stetching my calves, and rolling my feet on a glass bottle for a minute or so.
Right now, I am using custom made orthotics that were made from a cast and I have had a rather unpredictable time with them (started using them 4 weeks ago). Sometimes they feel fine, other times I can only wear them for an hour or so before pain starts. The weird thing is that even if I am sitting while wearing them, they can start to bother me.
I have not had an MRI or ultrasound evaluation done.
I look forward to your response.
Re: ESWT at Bayshore in TorontoJean P. on 3/13/03 at 14:04 (112773)
Cori at Bayshore did my procedure - she rocks. I went to Canada as a last chance to avoid surgery on both my feet. I was in significant pain - limping and sometimes waking up at night because my feet hurt so much. Insurance would not cover ESWT too experimental and it was a big decision for me because I am cheap and the thought of spending all that $ on a crap shoot was scary. I had the procedure late August and felt better immediately - and I mean the minute I walked out of the office my limp was better and by the third time I wasn't limping at all. I still can't quite believe my good fortune - it seems too good to be true but as more time passes with no return of pain I am beginning to hope that it is a long term fix. I do still have some pain in one foot but I am no longer arranging my life around my feet.
Re: ESWT at Bayshore in TorontoDr. Z on 3/13/03 at 14:27 (112777)
I prefer to use ESWT for only what is called first step pain after sitting for any length of time. I have treated patients with your exact condition with good relief but much better with the classic first step pain. Don't place your full weight on the can it can injury the pf more
Re: ESWT at Bayshore in TorontoKamal S. on 3/13/03 at 14:46 (112779)
Thanks for the info Dr. Z. I will be careful with that can. Sounds like bad news -- ESWT will not be such a good option for me then? I suppose it can still help me but not as much as it would if I did have first step pain.
Re: ESWT at Bayshore in TorontoKamal S. on 3/13/03 at 14:58 (112786)
Did you have first step pain in the morning? Dr. Z has indicated that ESWT works better when this is the case. I don't have to much pain in the morning and am now wondering whether to pursue ESWT at all. If anyone else has had ESWT with my symptoms then please let me know how it went for you.
Re: ESWT at Bayshore in TorontoMolly on 3/13/03 at 15:52 (112796)
Kamal: I did not have the morning pain either, I used to in the very early stages, but it excalated to pain 'all the time' and grew worse with any walking or standing still. PF can be so mysterious!
Re: ESWT at Bayshore in TorontoJean P. on 3/13/03 at 15:56 (112800)
I did have first step pain.
Re: ESWT at Bayshore in TorontoSteveG on 3/14/03 at 10:53 (112949)
Kamal - I did not have the first step pain and my symptoms were pretty much identical to yours. Althought I am not 'cured' the ESWT definitely made an improvement. The pain in the heels is much better and I can stand in line and walk for longer periods of time. I think it would be worth looking into for you. I am glad I had it done.
Re: Yes, I went to TorontoDr. A on 3/14/03 at 17:29 (113003)
Dornier epos ultra ESWT is high energy ( one treatment) and is done under local anesthesia so no IV is needed.