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Considering ESWT

Posted by Ginny on 8/15/04 at 22:08 (158040)

My husband has suffered for nearly 3 years with PF (with a heel spur). We are considering ESWT, but are not sure what to think. Sounds like it takes months to feel relief. Is this procedure worth the time and effort? My husband works on cement all day -- how long will he have to be off work? Is there a difference in the type of machines they use for ESWT? How do I choose?

Thanks for your help. This is uncharted territory for us!

Re: Considering ESWT

Heather on 8/15/04 at 22:31 (158044)

I am no doctor, but I recently tried the Ossatron before I found this site. After reading this site, I think that the Dormier would have been better since it is more selective and seems to have a faster recovery rate.

Re: Considering ESWT

Ed Davis, DPM on 8/16/04 at 11:13 (158082)

Ginny:
I am of the opinion that the type of machine used does not offer greatly differing results. Everyone will give you reasons why 'their' machine is the best. I think that Ossatron works but Healthtronics has a treatment model that is a bit too expensive for todays healthcare environment.
Dornier, a high energy machine, is often office based, used under local anesthesia and the shockwave is aimed 'tangentially' (from the side) through the fascia thus making the heel bone less sore. Sonorex/Sonocur by Siemen's is a low energy machine, used first in Europe and Canada but available in the US. No anesthesia is used for that as 3 low energy shockwave treatments equals one high energy one. I have found it to work very well and feel it offers a lot of 'bang for the buck.' Some resources include: http://www.sonorex.com , http://www.unitedshockwave.com and http://www.ismst.com (for scientific info.).
Ed

Re: Considering ESWT

Pauline on 8/16/04 at 11:41 (158085)

Ed,
This is what United says on it's website, but it doesn't provide a search link for Orthopedic Surgeons M.D. only Podiatrist and Urologist, yet they talk about being able to find orthopedists.

'Our participating podiatrists and orthopedists utilize our Extracorporeal Shockwave Therapy (ESWT) services for a variety of podiatric and orthopedic ailments, including plantar fasciitis. In our first year of providing this service, we treated 2,500 patients in 29 states'.

Re: Considering ESWT

Ed Davis, DPM on 8/16/04 at 13:26 (158103)

Pauline:
When you bring up the home page, look at the links on top, 3rd link from the left brings up the podiatrist 'find' feature.
Ed

Re: Considering ESWT

Pauline on 8/16/04 at 14:06 (158118)

Correct. That's what I'm saying it say's Podiatrist. You're not in charge of their website but why don't they just say 'physicians' which would mean any and all types of doctors able to use the equipment.

My guess is that they have many more Pods signed up than Orthos.

Re: Considering ESWT

Dr. Z on 8/16/04 at 14:54 (158128)

Pauline,
Of course they will have more podiatrist using ESWT for pf. 20% of our doctors are orthopedic physicians. They use ESWT for elbows, shoulders and then pf. Not sure why podiatrists see more pf. From my conversations with the orthopedic group that I see they just see much pf. Even our foot and ankle orthopedic docs don't see as much pf as the podiatrist.
Most pf is not even seen by any type of doctor

Re: Considering ESWT

Bill, jr on 8/16/04 at 14:56 (158129)

Pauline,

It is my understanding that United refuses to allow Orthopods to invest in its company so they have no Orthopod owners/investors. It seems that the site mostly refers to investors in United.

United cannot use physicians to describe podiatrists because in many states, podiatrists are not legally considered physicians.

Re: Considering ESWT

Ginny on 8/16/04 at 19:51 (158180)

Thanks for the info. I'm a little worried about the long recovery time before results are noticed with the shock therapy. I also read that some patients never even notice results. We're debating whether to do the shock wave therapy or the partial severing of the tendon. Do you have any feedback on this?

Re: Considering ESWT

Dr. Z on 8/17/04 at 07:52 (158209)

Hi

ESWT has none of the serious complications that go along with Pf release. Once the fascia is cut it can cause long term pain in other areas of the foot that never go away, not to mention infection, scar tissue and nerve complications.
Here are some of the FDA stats that may help you with ESWT recovery time. In the Dornier Epos study 62% of the patients at 12 weeks had excellence and or very good pain relief. At six months it was over 80%. PF release can take up to six month to one year for recovery. Remember once the fascia is cut there is no turning back . I hope that this helps with your decision.