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Posted by R.R. on 11/14/03 at 22:31 (137561)

Dr. Z,
Just curious if you use the ESWT in your practice for insertional achilles tendonitis. Also, Can ESWT be used for the plantar fasciitis on the ball of the foot. Any response would be appreciated. Thanks

Re: ESWT: Dr. Z

Dr. Z on 11/15/03 at 01:01 (137570)

Yes we use ESWT for insertional achilles tendonitis. No it can't be used for pf in the ball of your feet.

Re: ESWT: Dr. Z

Pauline on 11/17/03 at 15:52 (137750)

Dr. Z,
Can you clarify for us what ESWT can or cannot be used for in a doctors office.

I understand the necessity not to advertise off label uses, however, a while back you posted that Dr. Weil was using it with a good amount of success to treat neruomas.

How is it possible to treat neruomas, yet it cannot be used to treat pf
in the ball of ones foot. Wouldn't they both be considered off label treatment of sorts?

What is the sliding scale of treatment allowed for ESWT once in a doctors office. I'm speaking to what it can or cannot be used for when I use the term 'sliding scale' not cost of treatment.

Re: ESWT: Dr. Z

Dr. Z on 11/17/03 at 17:46 (137778)

The place of service such as the offfice has nothing to do with indications for ESWT. ESWT can be performed in the office, mobile treatment center and or ASC depending upon the physicians choice
ESWT can used for almost any type of insertional tendonopathy and or chronic fasciosis. For example: Achilles tendonitis, Peronal Brevis, posterior tibial tendonitis.
The reason that it can be used for distal plantar fasciitis is due to the need for the tendon and or fascia to be used at an insertional area.
The neuroma treatment is used due to the destruction of a nerve that is
placed into direct field of focus with a shockwave. So direct focus in a neuroma should destroy the nerve much like surgical excision does.