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Heel Spur Shock Wave Treatment

Posted by Janet W. on 7/08/03 at 09:34 (123744)

May of 2003 I had the Shock Wave Treatment on both feet. It seemed to work on one foot that was not as painful as the other. Today, July 2003, I am wearing a 'temporary walking cast' something like an immobilizer that can be removed when I'm not walking or standing. This is because the more painful foot doesn't seem to be any better than before the proceure. I'm to wear this for approximately one week and then return to the Podiatrist to see if there is any improvement. Right now, I don't think there is. I was so excited when I heard of this new procedure. I was told I would have the procedure and walk out of there pain free. I was pain free for a short time because both feet had been injected and I was still feeling the numbness of the injection which was given after I received the anesthesia. When the numbness wore off I still felt pretty good and a little better than before. But, after a week or so, things weren't much better. Over the past three years I have had every treatment available from Orthopedic doctors and Podiatrists as well as every devise available in the shoe, inserts, medication, etc. line. So far, nothing has helped very much. I do not want to have the surgery. My Podiatrist now tells me it could take from 6 to 9 months for me to notice any relief from the Shock Wave Procedure because it is a 'healing process'. This isn't what I was lead to believe. I have been returning to the Podiatrist weekly since the procedure. He has given me two UltraSound treatments and the cast. I don't see any improvement. This is becoming an expensive problem and I'm not sure what to think. So far, I don't see any positive results. I intent to wait the entire 9 months before I make any decision about having surgery. I did say one foot seems better, but it was getting better before the procedure. It still isn't totally pain free, but I can tolerate it.

Re: Heel Spur Shock Wave Treatment

BrianJ on 7/08/03 at 14:34 (123764)

Hi Janet --

Several people here on this Board have had a similar experience (tried everything including ESWT with little or no success). The only other treatment I'm aware of (besides surgery) is a process called RFL. You may want to use 'RFL' as a search term on this Board, so you can learn more about it.

Hope this helps.

Re: Heel Spur Shock Wave Treatment

BrianG on 7/08/03 at 18:23 (123780)

Hi Janet,

I couldn't help but notice that you fall into the 3 to 5 year PF suffer's group. I have noticed that the group most likely to benefit from ESWT is the folks who have had PF a year, or less. This just happens to be the same group (6 to 12 months) the FDA used when performing their trials. Unfortunatly they (FDA) did not use patients like the majority of us. When the FDA approved the ESWT machines, they did not suggest they may be better for one group, or another.

The doc's who are using the machines will tell you all about the trials, where a big percentage of the patients were helped by the ESWT machines. Unfortunatly they will not tell you who these patients were, that they only had PF for 6-12 months, and had no previous surgery. Personally, I think the FDA should complete more trials, this time using a group of people who are most apt to seek treatment. People who have had bad PF for 3 - 5 years, and more!!! You just won't see too many 6 month PF suffer's seeking out ESWT, as they are still in denial, and trying conventional treatments.

I also hate to tell you this, but you may run into the same problem with surgery. There are no guarantees that you will be helped, and there is a chance that you may end up in much worse pain than you are currently in. If you really do consider surgery, try to find a doc with a good track record, who is also compassionate.

Good luck
BrianG

Re: Heel Spur Shock Wave Treatment

Dr. Z on 7/08/03 at 18:36 (123782)

Hi
I agree that more and more long term studies should be on going. The Dornier fda AVERAGE length of pf was 22 months with all patients having the pf disease for at least six months.
I will always remember that number because before the study was printed I was told it was 24 months. Elliott found the article and pointed out that it was an AVERAGE of 22 months. That is still a pretty impressive time frame.
I had a conversation with a major insurance carrier and they told me that they are waiting for a three year long term study. This doesn't exist as far as I know but probaby will be shortly approached
I have some Orbie patients that are approaching four years of pain free plantar Fasciitis some with a duration of eight years

Re: Heel Spur Shock Wave Treatment

BrianG on 7/09/03 at 07:52 (123818)

I'd like to see am 3 year study myself, as long as they used patients that have had PF for longer amounts of time. I don't think a 3 year study of the original trial patients would be too valid. Have you heard any rumblings on who may be performing this 3 year study?

Thanks
BrianG

Re: Heel Spur Shock Wave Treatment

Dr. Z on 7/09/03 at 14:44 (123871)

Hi Brian

I haven't heard of any three year studies. I would be very willing to follow up the people who did the Dornier FDA study. I think I will give Dornier a call and see if they would agree.

Re: Heel Spur Shock Wave Treatment

Karin L on 7/20/03 at 11:06 (124830)

Hi all,
I suffered with severe PF for 21 months and also went through EVERY treatment except release surgery. I finally found a pod in a city an hour away that could do the treatment, covered by insurance--YEAH!--WHOO--.
My first treatment was beneficial, I was not terribly painful after the block wore off. However, the pain was only reduced to about 50%. So, we did another osatron 6 months later and could not walk for 3 days because of the pain (both feet). I have had a much better response since the second treatment, my pain is in a range, depending on activity, anywhere from 15-30%, which compared to where I was, is amazing.

I will say that, indeed for me, it took a FULL 3 months to notice the majority of benefit, maybe even 4 months. There was some pain relief at about 8 weeks and it kept getting better up to the 4 month mark and then it stopped. I'm wondering if Janet, your body may be a little slower to respond or maybe you need another treatment? Will they do that for you?

Dr. Z, question for you--with all of the above in mind, do you think that I ever stand a chance of being totally pain free? I do have 20 pounds to lose and I'm hoping that is going to be more relief, do you think it will finish going away on it's own if I do good stretching with the Prostretch?
Also, they told me I could do 3 treatments. Does that mean I could go back for one more and do you think it would be beneficial if I got a good response to begin with?

I know my Pod told me that usually if you don't get a response with the first treatment you won't with further, but if you do get a positive response they are more likely to let you continue to the 2nd and 3rd?

Any feedback most appreciated. Thanks, Karin

Re: Heel Spur Shock Wave Treatment

Dr. Z on 7/20/03 at 16:00 (124843)

Yes. I do think you can improve. A third treatment and or time is very important with ESWT. Only stretch if you are having AM pain or it you range of motion at your ankle is tight. Do you have a tigh Achilles? In addition the personal foot trainer can help you alot. Make sure you know how to use it

Re: Heel Spur Shock Wave Treatment

Lynn S on 7/23/03 at 11:48 (125041)

Dr. Z
What is the 'personal foot trainer'? Thanks, Lynn

Re: Heel Spur Shock Wave Treatment

Pat on 8/20/03 at 19:56 (127472)

It sounds like you've tried everything possible but I wanted to tell you if you do decide to get the Surgery PLEASE have an Orthopedic Surgeon do it instead of a Podiatrist. I had the surgery back in 1994 and was in so much pain afterwards (foot numbing etc) that I went through a year of HELL with nerve conduction studies, casts, foot baths, physical therapy etc. to see why I was still having so much pain. Turns out the Podiatrist cut a nerve during the surgery. Since that time my foot has gained about 75% of it's use back - two toes are permanently bent and I can't always feel the floor when I step down so I'm forever falling and spend my time with lots of black and blues. I feel like an old lady now! I walk slow because I'm afraid of falling and because of the way I walk (a little lopsided because of the foot) I ended up getting a heel spur in my other foot I will never have the surgery again! Just wanted to tell you if you go this route don't have a Podiatrist do it.

Re: Heel Spur Shock Wave Treatment

Dr. Z on 8/20/03 at 20:04 (127474)

I am a podiatrist are you picking on me.? Seriously heel spur/plantar fascia release can cause the exact problems you have experienced whether it is a podiatrist or an orthopedic surgeon. It is my opinon that the operation itself can cause these problems even if the surgeon did a perfect job. Nerve damage happens due to the difficulty of the area that is being cut to be visualized. I see alot of patients that have difficulty with bending 4th and 5th toes post pf release. The only way to avoid these problems is to have ESWT or jut avoid surgery. Surgey can cure alot of patients but it has some bad complications