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

2nd ESWT treatment on 11-05-03

Posted by Molly H on 11/03/03 at 00:01 (136237)

I had my 1st treatment with the Dornier back in May. It almost cured my right foot and my left was @ 50%improved. Then one day @ 1 and 1/2 months ago my right foot got bad again and slowly but surely is now WORSE than my left. My left is feeling much better but, I still have some pain. Would I be setting myself back by having ESWT on my left? Or will the 2nd treatment speed the healing? If anyone could answer these questions, I would greatly appreciate it!



Re: 2nd ESWT treatment on 11-05-03

Pauline on 11/03/03 at 11:20 (136253)

I'm not a doctor, but I think most of the doctors that provide ESWT would say 'no you would not be setting yourself back by having another treatment'. Many other posters have gone ahead with a second, third and sometimes even more ESWT treatments. Some selected the same machine and others swithed to a different one.

I'd suggest you talk to your doctor and see what length of waiting time he suggests between treatments. As I understand ESWT, healing can continue to occurs over several weeks and months. Some doctors may suggest a longer waiting period. Your treating doctor can help you decide. Brian G. who posts on this site waited a year I think before having his second Dornier treatment, we've heard from others who returned sooner.

I think the question you really would like to have a definite answer to is will it help and I don't think anyone can provide you with a definate quarantee on that one.

Brian will tell you he was not helped, others responded in a positive fashion. Many variables play a part in treating P.F.

ESWT is a great treatment to try, but whether it's the cure all everyone is searching for is a question still waiting for a definate answer.

Re: 2nd ESWT treatment on 11-05-03

SteveG on 11/03/03 at 13:15 (136266)

Molly - sorry to hear about your setback. I would go for the second treatment.
I had about a 4 month break between 1st and second. Since you responded to the first treatment (50%) that suggests you would benefit from a second. I was about 50% improved after the first. Then you can see where you are at in a few months and think about getting the right zapped again.

Don't be too discouraged. I have had a couple of setbacks since my first treatment.

Re: 2nd ESWT treatment on 11-05-03

BrianG on 11/03/03 at 21:18 (136301)

Hi Molly,

To be truthful, I think it is still to early in the world of ESWT to say exactly how long one should wait before a second, or more treatment. In this country (USA) most of the doctors seem to be using the 6 month mark, before offering another treatment. In Europe, where ESWT is much more common, I talked with a couple doctors who suggested I wait a full year, as healing could take that long to happen.

Since this is a fairly new treatment, not enough studies have been done to say if one should wait 6, or 12 months. I think any time after 6 months is most likely OK, but if you really want to be sure, then wait the 12 months. What I think is more important though, is how long a person waits before they have their initial ESWT treatment. I would suggest between 6-12 months, provided a good amount of conservative treatents are done first. I'm talking night splint, icing, taping, exercises, and most important, REST !!! If you continue to do the same things that initially brought on your PF, it will be difficult to cure, no matter what you try!!

Good luck

Re: 2nd ESWT treatment on 11-05-03

Sunny Jacob on 11/04/03 at 10:23 (136343)

From my experience (mainly with low energy ESWT using 3-session treatment), almost all patients experience a gradual improvement from the original condition within 12 weeks. Of course, the rate of improvement during this period varies among the individuals. If there is no improvement at all, it is advisable to review the original diagnosis.
If there is a significant improvement in 12 weeks, then a 6-month period is adequate to monitor further improvement.
After ESWT, reasonable rest and light physiotherapy are highly recommended. As you have stated, if the patient does not follow that, recurrence of the original painful condition can be expected. We have experienced this with professional athletes who can't afford to take the time for the required resting period.

Re: light physiotherapy -12 wks post ESWT

Jen L on 11/04/03 at 13:51 (136360)

Hi Sunny Jacob,
would you please give us more detailed info. on the light physiotherapy you mentioned, which may help patients with further improvement after 12 weeks post ESWT?


Re: 2nd ESWT treatment on 11-05-03

BrianG on 11/04/03 at 18:32 (136384)

Hi Sunny,

I know that you have treated your share of professional athletes. I'd have to believe that they are in a whole different class, then the rest of us. Their healing, and our healing, are two different animals. We shouldn't even be mentioned in the same sentence as them, hahahaaaa.


Re: light physiotherapy -12 wks post ESWT

Sunny Jacob on 11/04/03 at 19:38 (136388)

Jen L.,
Sorry for not expressing myself clearly.
1. Light physiotherapy is recommended, starting soon after the ESWT sessions.
2. Light physiotherapy is recommended for all joint tendonitis and plantar fasciitis.
Such a procedure should be consulted with a physiotherapist and can be done at home.
What one has to avoid after the ESWT for at least 12 weeks is repetitive stress to the same joint.
Example: A jogger with PF after ESWT treatment should not start jogging as soon as a pain relief has been achieved,say in 4 weeks, one should wait for at least 12 weeks but continue light movement of the joint, short walks, etc.
Also, refer to the experiences of Chris b, message No. 136 365 and Steve G., message No. 136 372, doing leg press after ESWT.

Re: light physiotherapy -12 wks post ESWT

Molly H on 11/04/03 at 22:41 (136407)

Hi all!

Thanks for your imput everyone! I will be at the 6 month mark and I am going to have ESWT tomorrow! Wish me luck!!!!!!!!!!!
I know that you should not take any NSAID's but, I am wondering about Gloucosamine and MSM???



Re: 2nd ESWT treatment on 11-05-03

Pauline on 11/05/03 at 22:12 (136512)

Good luck Molly. Let's hope this does the trick.

Re: 2nd ESWT treatment on 11-05-03

Molly H on 11/05/03 at 22:25 (136514)

Thanks Pauline!

I appreciate your good thoughts! :)


Re: Should not take any NSAID's?

Rick B on 11/22/03 at 22:27 (138414)


Hope your 2nd ESWT went well. Just curious about the line 'I know you shouldn't take NSAIDs.' That's news to me. Do you mean in conjunction with ESWT, or in general? Can anyone enlighten me?
Rick B

Re: Should not take any NSAID's?

Julie on 11/23/03 at 09:37 (138457)


The doctors here have explained in the past that because ESWT works by causing an inflammatory reaction (thus stimulating circulation to the affected area) NSAIDs, being anti-inflammatory, shouldn't be taken because they interfere with that process.

It isn't a general prohibition against NSAIDs, only post ESWT, and if my recollection is right I think Dr Z has said 'don't take them for six weeks after ESWT'. He'll correct me if I am wrong.