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

shock wave therpy

Posted by David B on 8/22/03 at 21:24 (127735)

I had shock wave therpy 2 months ago and I believe my heel hurts worse now than before. My doctor said im the 1st patient that has not seen any results, most patients see results just after 3 weeks. I wish he would just go ahead and re-do it now that is if the insurance company will pay for it the 2nd time. I hope I don't have to do these stretching exercises the rest of my life, if the shock wave therpy works is it perminate or will I have to keep doing exercises? I saw on the internet this vitamen that has calcium suppose to help has anyone tried it?

Re: shock wave therpy

Dr. Z on 8/22/03 at 22:49 (127740)

Most insurance companies if they do pay will only pay after 12 weeks . ESWT is a curative treatment with very little side effects.
It can take up to sixteen weeks for the result to take. Some patients have pain up to 12 weeks before pain resolution.
In the waiting period, taping, elastic supports for ankle sprains can be helpful. Sometimmes you do need to take pain pills. What treatment has you doctor suggested beside waiting. What kind of stretching are you doing?

Re: shock wave therpy

David B on 8/23/03 at 05:36 (127745)

I will see my doctor on wed got another checkup, I have some pain pills Tylenol 3 but don't take them when Im working cause they make me tired, regular tylenol does not give me any relief. The stretching I am doing is where I pull my foot towards me hold it then away from me, also I stand on a step with just my toes then push the weigh of my body down (hard to explain). When I had the treatment the doctor told me I could except my foot to be a little sorer than when I would get a coritoze shot, after the numbness went out I had ZERO pain, and no swelling. The doctor told me all of his patients have improved 50% just after 3 weeks, it has been 8 weeks and im 0% better.

Re: shock wave therpy

Kristie R. on 8/23/03 at 08:46 (127747)

I'm so sorry to read about your experience with ESWT. I two have just had ESWT done, four weeks ago, and have had terrible pain. The pain I get is were the heel meets my arch up the back of my leg to my right butt cheek. Is that similar to yours? I think the ESWT caused some nerve damage? I thought ESWT was the miracle cure. Please let me know what your doctor says. Your right about the pain medication. I feel like I'm sleeping all the time

Re: shock wave therpy

Dr. Z on 8/23/03 at 09:17 (127748)

Stop the stretching if you are putting all of your weight on your toes with your foot either hanging off the step or you are raising your heel and placing all your weight on the front. This could be why you are in alot of pain.
ESWT can take time. If you are still in pain after 12-16, then a second treatment is in order. It is my opinion that you need to stop this step
stretching

Re: shock wave therpy

Dr. Z on 8/23/03 at 09:20 (127749)

Have you doctor examine this and see why you are having this type of pain.
I find alot of pain post-eswt is from too much activity, improper stretching, local anesthesia effects, other tendon problem from compensation.
Your doctor should be seeing you and addressing your pain . There are treatment to make you improve and feel better during the ESWT process

Re: shock wave therpy

Aly R on 8/23/03 at 11:55 (127755)

Hi David,

Re. your stair stretching, I'd avoid that one - I used to do it too (and for a while it felt good) but then I developed achilles tendonitis as a result. It's too hard to know how far is 'too far' when you're stretching that way. I read somewhere else that the stair stretch can cause knee problems too...

Good luck...

Aly

Re: shock wave therpy

David B on 8/23/03 at 14:48 (127762)

The pain I have is in my heel, it hurts so bad when I get out of bed in the morning it almost brings tears to my eyes, or after a long day at work. Seems like im always limping cause my heel hurts. What kind of stretching exericises should I be doing? Also, IF shock wave therpy works for me the 2nd time will I have to keep doing stetching exercises? If I could afford to be off work for 6 weeks I would just have surgery on it.

Re: shock wave therpy

Ed Davis, DPM on 8/23/03 at 15:43 (127764)

David:
Your doctor's claim is very unusual. It takes about 12 weeks to see the effect of ESWT.

Paitents often get a temporary analgesic effect causing the area to feel better the fist week after ESWT. Generally by the second week the area feels the same as it did before treatment. Patients generally start to feel something happening by week 6 with potential resolution by week 12.

Keei in mind the treatment triad I have often discussed on this site so make sure that you are treating the problem in a coprehensive manner.
Ed

Re: shock wave therpy

Ed Davis, DPM on 8/23/03 at 15:51 (127765)

David:
Why would you want to have a treatment which is more painful and with a lower success rate than ESWT?

Take some time to study this site because it sounds like you are speaking with a significant lack of information concerning your problem. Study Scott's Heel Pain Book on this site. What else is your doctor doing for you? I have to wonder, considering some of your statements here, what information you are getting or not getting from your doctor. 50% improvement 3 weeks after ESWT is unheard of.
Ed

Re: shock wave therpy

DR BEN PEARL on 8/23/03 at 17:12 (127766)

My experience with ESWT recovery has been on par with Dr. Davis.
DRBP

Re: shock wave therpy

Dr. Z on 8/23/03 at 17:24 (127767)

As Dr. Ben and Dr. Ed have stated ESWT pain resolution takes time, however the pain that you now have has to be addressed. This can be done with taping, nsaid, and possible local steriod injection as a last resort. Alot of times taping and or elastic support can help you alot. I like th plantar fascia stretch. I just described it in one of the last posting.
If the foot is throbbing use ice if the foot is sore then use heat.

Re: shock wave therpy

HilaryG on 8/23/03 at 17:56 (127768)

Hi- i don't really understand why more of you don't try Active Release Techniques. I had PF for 20 yrs and was cured in once a wekk treatments. Please, please, please look at the website activerelease.com .
I would just like to see more people get the relief I got. Ican walk more now thatn I have in 20 yrs. I know it sounds unbelivevable. i'm still in shock (but thrilled)! Hilary

Re: shock wave therpy

Peter R on 8/24/03 at 08:05 (127798)

Dr Ed- I think it may be of value if you restated your treatment triad once again for those who might have missed it.

Re: shock wave therapy, ScottR

Ed Davis,DPM on 8/25/03 at 09:30 (127897)

Peter:
I wish I could get ScottR to incorporate this into his Heel Pain Book or somewher in the site.

Plantar fasciitis has 3 components: inflammation, biomechanics and tissue quality. Effective treatment must often address all 3 components -- the 3 legs of PF treatment:

1)inflammation -- a larger component earlier in the process - may be treated via oral or injectable anti-inflammatories

2)biomechanics--tension on the plantar fascia, if increased on a chronic basis cancause the fascia to become painful. Tension on the plantar fascia is increased by subtalar joint overpronation and midtarsal joint oversupination. Orthotics designed to reduce subtalar joint pronation and midtarsal joint supination effectively reduce plantar fascial tension.
A tight gastrosoleus-achilles complex can indirectly increase plantar fascial tension. Failure to address a tight gastrosoleus achilles complex is a major reason for 'difficult' cases. This can be treated via night splints and manual therapy.

3)tissue quality -- indirectly addressed via treatment of #1 and #2 but now directly addressed via ESWT.

Ed Davis, DPM

Re: shock wave therpy

Ed Davis,DPM on 8/25/03 at 16:53 (127949)

Hilary:

I am sure that readers ae very happy to see your results with the technique.

Unfortunately, it is a difficult thing to assess since very little specific information as to what this technique involves is presented on their website. There is not much written about it and no listed studies.
The website relies mainly on testimonials which praise the technique but, again, provide few specifics.

There have been a number of treatments suggested throughout the years, eg. jade 168 cream. Some of those treatments have had enthusiastic followers who, like yourself, expressed surprise at why other practitioners and posters did not wholeheartedly embrace those concepts.

We do need somewhat more substantial information before new ideas can be accepted. We approach new concepts with an open mind but feel that the burden of proof must lie with those proposing such concepts.
Ed

Re: shock wave therpy

JerryT on 9/25/03 at 21:26 (131077)

HillaryG, please tell us how many treatments did it take for success with ART, and how much did each treatment cost. I have read of many successes with ART but no one states the time frame and cost.

Thanks,
Jerry

Re: shock wave therpy

HilaryG on 9/25/03 at 22:27 (131091)

Jerry- It took 10 ART sessions for me to feel cured. I felt some improvement after the 6th or 7th. Luckily my insurance pays for chiropractic treatment, so all I pay each time is a copay of $15. But if it wasn't covered by insurance I think it would have cost me $90 per appt. But i think the pricing varies alot from chiropractor to chiropractor. So maybe you should go to the ART webside,find a provider near you and call them and ask how much it costs. If there is more than one near you maybe you can compare prices. Like I've said before, ART has given me back my life. I hope you pursue it. Hilary