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ESWT only for proximal plantar fasciitis?

Posted by Jennifer M. on 6/13/04 at 19:43 (152904)

I was reading the brochure my doc gave me on eswt, and it talks about the doctor palpitating the heel to find the sore spot before the procedure. My problem is my exact point of pain is hard to find, it's more of a weight bearing pain, and is on the outer edge of both my heels. Sometimes my toes even have the burning pain. Has anyone had eswt with these types of symptoms?

Re: ESWT only for proximal plantar fasciitis?

Steve G on 6/13/04 at 23:21 (152918)

Jennifer - Since they treat the insertion point (the heel), that is where you will notice the pain relief, if any. Is most of your pain in your heels? Has the doctor palpitated your heels?

I would certainly consider going for the treatment. Many of us with atypical PF benefited from the treatment, although, I don't know of anyone with atypical PF that was cured by it.

Re: ESWT only for proximal plantar fasciitis?

john king on 6/14/04 at 13:24 (152965)

Has anyone here been cured of atypical PF by an open procedure and cutting PF? I am seeing my podiatrist under workers compensation. Work comp will pay for anything but I want results. The main thing is not to be worse off than before. It seems there is no cure for atypical PF. I have been wearing orthotics for years. What is the treatment for atypical PF?

Re: ESWT only for proximal plantar fasciitis?

Dr. Z on 6/14/04 at 14:05 (152969)

This is a very good question. VERY rare. I would try ESWT well before I would consider pf release. There are too many cases where the foot become became much worse off with a pf release. There are many posting for atypical pf that you can review Try to get a diagnosis first if possible. Rule out nerve entrapments, lower back dis/spine involvement and any systemic related diseases

Re: ESWT only for proximal plantar fasciitis?

Jennifer M. on 6/14/04 at 16:52 (152975)

Thanks for the replies. My pain is on the outer and inner edges of my heels. When my pain first began a year ago, I had the typical fascia tug, pain under my arches, and pain in specific points on my heels. Now, I have pain all over. My doctors have looked at lupus, rheumatoid arthritis, and nerve damage. ALL tests were negative, but, my rheumatologists says he doesn't put much clout in the tests, and thinks its possible I could have arthritis, but is just watching me at this point. I have some little bumps or cysts on a tendon on the outside of my ankle, not achilles, and when I touch it, it sends pain down to the underside of my heel. My podiatrist doesn't seem to think it's related - and suggested cortisone. But I've already had cortisone on the top of my ankle for some arthritis I have there. I kinda feel like I may have several things going on with my feet - hence my concern about eswt.

Re: ESWT only for proximal plantar fasciitis?

Dr. Z on 6/15/04 at 02:12 (153007)

The doctor must beable to palpate the area that is painful or ESWT isn't such a great idea. You could have nerve entrapmenet of your lateral plantar nerve branches or lateral plantar fasciitis. Tough to determine without an examination.

Re: ESWT only for proximal plantar fasciitis?

Jennifer M. on 6/15/04 at 22:50 (153143)

Dr. Z.,
How does one find out if it's nerve entrapment? I've had nerve, eeg tests for TTS and nerve damage. Both were negative. My pod. doesn't seem concerned with the nodules, or bumps on my tendon, and I only have it on the left foot, not the right. He doesn't think it's nerve related, but it sure feels like it. Why else would the pain travel down to the bottom lateral side of my heel when I press on it? That pain started several months AFTER I was diagnosed with PF, and after wearing my orthotics every single day. My pod. says sometimes people get that type of pain from compensating for pain in the arch, like, walk on the outside of their heels. I've never done that, really, since my orthotics actually roll me over so much so that I don't pronate, and I've had them from the first month I felt pain last July. I've often wondered if they roll me over too much, and that's why I feel the pain on the lateral sides of my heels. Also, does ESWT work for Lateral PF?

Re: ESWT only for proximal plantar fasciitis?

Dr. Z on 6/16/04 at 08:31 (153158)


That is a good question. Beside testing, clinical examination, the physician should have a feeling that that is the problem. It is possible that you are compensation from the medial band plantar fascia. If you are rolling over to the OUTSIDE of the foot this could be from the orthosis.
ESWT does work for insertional medial and lateral band plantar fasciitis. It is my gut feeling that your orthosis could be contributing to your outside pain.