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Posted by jeannie c on 9/07/03 at 23:25 (129092)

I just had the EWST done just 2 weeks ago. I was expecting some relief and am concerned that it feels the same. I did Ice, massage, mild stretching and mostly rest. I still have Pain more medially, as always, but the treatment was targeted at the calcaneous insertion just as the MRI and the machine showed where the inflamation was
Is this pain or result normal? I wear sneakers and have not done any walking for more than 1/2 hour or so, just normal food shopping. Please let me know if I'm jumping the gun on this and can hope for a better outcome in the future. Thanks so much

Re: post eswt

BrianJ on 9/08/03 at 11:01 (129122)

Hi Jeannie --

ESWT takes up to 12 weeks to provide full benefits. Many people don't notice any improvement at all for 6-8 weeks. If you have no relief at 12 weeks, talk with your doctor, as he may give you a second treatment at reduced charge.

It is true that a significant percentage of people will not find relief with ESWT, but you have to give it more time.

Re: post eswt

Peter R on 9/08/03 at 15:16 (129164)

Brian; Would you care to place a number in front of that % that will replace 'significant' and substantiate it.

Re: post eswt

BrianJ on 9/08/03 at 16:22 (129177)

Peter --

You raise a good question. I am not a doctor, and I do not know how many people receive 'unsuccessful' ESWT treatments. I have had a total of 5 ESWT treatments with no improvement. John H, Brian G and Monte on this board have also had multiple ESWT treatments without significant improvement (they can please correct me if this is a mischaracterization). Perhaps people with atypical PF (no first-step pain)are not good candidates for ESWT.

Medical studies are conflicting as to ESWT's efficacy, and of course there is debate as to which machines are better and whether 'high energy' or 'low energy' treatments are more effective. You can do a search on this site and read the studies yourself. However, ESWT definitely works for some people (perhaps a majority), and it's certainly worth trying before considering surgery.

Re: post eswt

BrianG on 9/08/03 at 18:12 (129192)

I have no doubt that ESWT works, for some people. Those people would fall into the same group that the FDA tested while conducting their trials. They took patients who had PF between 6-12 months, had at least 2 types of failed treatment, and did not have surgery. Hmmmm, that sounds just like the same group that could be cured with conservative methods. It's true, I had 2 high energy Dornier treatments, a year apart, with no healing, yet.

Some people would tell you that the hard core, chronic cases, like mine, can be cured with ESWT. Maybe so, but I haven't seen it on this message board.

Good luck
BrianG

Re: post eswt

Peter R on 9/09/03 at 08:56 (129260)

The future success of ESWT for any type of insertional tendonitis, be it PF or Lateral Epicondylitis or any of the other types, depends significantly on the skill of the practioner in determining which cases are right for this modality. This holds true for any treatment or medication that is used. Diagnose the problem correctly, determine which treatment is most effective, apply it expertly and you will have the best chance of reversing the ailment. If a doctor prescribes a particular antibiotic that doesn't aleviate the illness it's accepted that another one is tried. We simply do not throw the one that didn't work away or claim that it is no good.
If your auto mechanic tries to fix the missfire in you engine with the best spark plug made and installs it in the most expert manner it won't solve the problem is the orginainal faults was a defective ignition wire or a bad valve.
ESWT works, it works very well, it is a definite and valuable alternative to surgery. The % of cures is not important, ESWT is just another tool. I don't know who said this but it's quite true that 'If all you have is a hammer than everthing begins to look like nail'

Re: post eswt

BrianJ on 9/09/03 at 10:02 (129268)

No disrespect intended, but for me as a patient paying out of my own pocket, the % of cures most definitely matters.

Re: post eswt

Peter R on 9/09/03 at 10:45 (129270)

Would you let your pocket dictate if you had to choose any other type of medical treatment that doesn't have a 100% cure rate or even a much lesser chance of cure.? If you truly are so indigent that you are forced into those decisions then I have empathy for you. If it is just a case of being overly frugal, well, that's your choice.

Re: post eswt

Pete R on 9/09/03 at 15:14 (129309)

I'll call myself Pete R so as not to confuse with Peter R. I think I got here first anyway !

I'm in the UK and had 2 eswt treatments both of which failed to respond. The first was a total rip off and the second practitioner was suspicious that I have typical PF symptoms.......no 1st morning pain. I still have arch pain though but get v frustrated over just how successful ESWT is. Seems to me that there is a high failure rate ??

All the best to you all

Pete R