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Question for Dr. Z.

Posted by Dan D. on 2/11/04 at 21:55 (144139)

Dr. Z,
Awhile back you mentioned in a post to me that ESWT should never be done on non-insertional plantar fascia pain. Could you tell me why?
I'm still not exactly clear what non-insertional means. Is the insertional area the area a little in front of the heel where the plantar fascial connects to the bone? And are you saying that any other area other than that one should not be treated by ESWT? Please let me know if I am understanding this correctly and if so, why other areas should not be treated by ESWT.

Re: Question for Dr. Z.

Steve G on 2/11/04 at 22:04 (144141)

Though not the good doctor, I think I can answer your question(s). It is only authorized (has FDA approval) for pain at the insertion. If you open the heel pain book you will see some pictures that show the insertion point - they are marked 'pain often here' 'most common area of pain' - The area is in and toward the front of the heel. 'Non-insertional' pain just refers to pain in other areas of the fascia - the arch, the metatarsals. The fascia extends from the heel to the base of the toes. Pain in any area other than the heel is, therefore, 'non-insertional'