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ESWT and spurs on the back of the heal

Posted by Richard G on 5/15/04 at 01:31 (150619)

1. Can ESWT be helpful with large spurs on the back of the heal?
2. What doctors can you recommend using ESWT in Orange or Riverside Counties of Southern California?
3. Is there a difference between the ESWT machines being used and do you have a preference?

I have had my first consultation with a Dr. Richard Haas. He wants to use cortisone as a first treatment. Since it does not address the continued growth of my rear heal spurs; I am dubious as to its benefit there. My heal pain on the bottom of my foot could be helped short term by the cortisone. Any comments?

How can I find out about the educational and practical background of Dr. Richard B. Haas DPM in Temecula, CA. I could not find anything on the internet.


Re: ESWT and spurs on the back of the heal

Dr. Z on 5/15/04 at 09:05 (150628)

Hi Richard,

Most of the time the 'spurring' on the back of the heel bone is really calfication due to micro tearing of the achilles tendon where they attach. The body is trying to heal the area with bone and it has failed to do this

Local Steriod injection can and have caused rupture or tearing of the tendon if that is what is being inject into. AVOID injections into the tendon.

We have used ESWT very successfully for the past five years for this conditon. You are going to get alot of different views on which machine is better. I perfer the Dornier, because of its ultrasound abilities . We use high energy over multiple low energy treatment. With our machine we have a choice to use low, medium and or high.

Re: ESWT and spurs on the back of the heal

Dr. David S. Wander on 5/15/04 at 09:24 (150629)


There are several theories on the development of a spur on the back of the heel. Some believe that there is tearing, causing bleeding and resultant calcification. There is a theory in medicine called 'Wolf's law' that basically states that bone will grow in the direction it is stressed. Therefore, the Achilles attaches to the back of the heel, with constant pulling and tightness, the outer layer of the bone (periosteum) is pulled in the direction of the tendon, laying down new bone cells in that direction, and this causes the spur formation. As per Dr. Z., I would avoid injections if possible at the area of the Achilles tendon. If you do opt for an injection, I would limit it to one injection, and would immobilize the area for 1-2 weeks following the injection. I agree with Dr. Z regarding the preference for the Dornier unit. You must understand that the use of ESWT for your condition will NOT change the actual spur. ESWT does not dissolve or 'break up' the spur. If you do have relief following ESWT, the spur will still be present. If you have questions regarding your doctor's credentials, simply ask him for a copy of his curriculum vitae (resume). Hope this helps.

Re: ESWT and spurs on the back of the heal

diana p on 5/16/04 at 08:49 (150662)

my achille foot pain is located on the back of my foot above the heel and below the ankle. I am confused why the literature I read indicates under the heel. I have no pain there. Where my pain is I have a bump that if it touches a chair when sitting down it is very painful. I get shotting pain sometimes when I awake in the morning. If traveling in a car for a short distance and when getting out of the car I always have the pain and must walk limping to release it somewhat but I can't walk very far. This has interfered with me shopping or anything. I have gone to 2 doctors and they didn't recommend surgery but keep giving me arch support foams. They do not help and I have to climb steps like a child. Not one foot after the other. I am now 63 yrs old and I know I am overweight and exercising or walking (which I do) causes pain the day after but I won't stop because I am determined to lose at least 40 lbs. What is my condition called medically because the pain is not on the bottom of my foot. Thank You in advance for any info you can give me on my behalf. I have had the condition probably 4 years now.