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Pain less after ESWT? / A second one?

Posted by Janice N on 7/22/04 at 07:24 (156035)

Sometimes I just can't tell how much good the ESWT did with all the other foot problems I have. The pain is in other areas of the foot. I was on my feet a whole lot yesterday. I was not limping or walking slow or anything. My foot is very sore today but still I am able to do alot more walking without severe pain than I was three months ago. Yes it hurts on the bottom of my heel today so I know what most of the pain source is from. But I am not awake all night every night anymore either. I have hours with greatly decreased pain in my heel.
I really don't know what to do as far as having a second ESWT. Will a second one really make a bigger improvement? As far as the back of the heel it was a bust. I am just as sore and having as much pain. I had to to the bottom of my heel and the back.
How much improvement should I have gotten to consider a second ESWT? And if I do should I even bother with the back of my heel since I didnt get any results?

Re: Pain less after ESWT? / A second one?

Ed Davis, DPM on 7/22/04 at 19:37 (156083)

Janice:
Both Dr. Z and I have noted that the success or failure of one treatment is not a very good predictor of what happens on the second treatment. I prefer that low energy ESWT be used on the back of the heel. Also, many problems at the back of the heel occur at the area in which the achilles tendon attaches to the back of the heel. The achilles has good tensile (pulling) strength but seems to get into trouble when twisted. A heel bone that moves side to side too much in gait is often a culprit so hopefully you have had a good biomechanical evaluation.
Ed

Re: Pain less after ESWT? / A second one?

Janice N on 7/23/04 at 06:20 (156101)

I have Achillies Tendonitis in that foot. Plus the overgrowth of bone. That is why I cant tell what is what. The reason why I don't know if I should do a second treatment or not. If I do the bottom again I guess maybe I should go ahead and do the back again too.

Re: Pain less after ESWT? / A second one?

Ed Davis, DPM on 7/23/04 at 10:08 (156114)

Janice:
An overgrowth of bone in back of the heel is often the body's way of trying to reduce the excess motion between the achilles and back of the heel bone.
Ed

Re: Pain less after ESWT? / A second one?

Vern S. on 7/23/04 at 18:22 (156155)

Dr. Davis-
Could you expand on your comment about..excess motion between the achilles and back of the heel bone? What would cause that and how would one try to prevent it? Thanks.

Re: Pain less after ESWT? / A second one?

Anna H on 7/26/04 at 10:25 (156266)

Janice, just came in on these emails. I had ESWT in May and so far I think that I have more pain now than I did before the treatment. I've even doubted that my podiatrist was as thorough as he needed to be but then I feel like I need to blame someone or something. I have altered my life to accommodate this problem. Stopped a lot of day long shopping, etc. I walk, rest, walk, rest. It's the only way to get through a walking excursion. My pain runs up the back of my ankle so, of course, I'm wondering if I have a problem with the Achilles tendon. I paid out of pocket for the ESWT and am very disappointed in the results. My podiatrist suggested the 'old' way of treatment...invasive surgery. I don't even know if that is an answer. Nice to have someone to talk to that has an understanding of how I feel. Thanks for listening, Anna

Re: Pain less after ESWT? / A second one?

Janice N on 7/26/04 at 20:03 (156310)

When your feet hurt as bad as ours it affects your whole body. Not to mentin your mood. Then I go and smash my toes and foot in the elevator. So now my left foot feels almost as bad as my right one.
I am tired of all the pain. Need a nice relaxing massage and whirlpool and a foot transplant. Not expecting any of it.
I hope you find some relief soon.

Re: Pain less after ESWT? / A second one?

Ed Davis, DPM on 8/02/04 at 18:44 (156779)

Vern:
Excess motion can be caused by a variety of factors but the most common cause is overpronation which is excess inward roll of the foot. That would be controlled by use of an orthotic designed to reduce that motion.
Ed