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pain much worse after ESWT

Posted by supertwin on 9/15/04 at 17:19 (159959)

I just had ESWT on both feet with the ossatron. I was put totally under anesthesia, as my doctor said it is too painful to not be. I'm a week post-op, and I have extreme pain. My doctor and nurses at the facility are very surprised I have such pain - which doesn't sit well with me. I have bruising on one of my heels, and it feels so painful, I can't stand up. I don't want to get ahead of myself, but, is this a really bad sign? Put it this way - I never had this type of pain in the 13 months I've had PF. I hope it wasn't a mistake. I've heard so many stories of people going back to work within a week and feeling great. Not that I expect to be all better in a week, but, I didn't think it would be such sharp pain. I can't imagine even standing up right now. Anyone else had this with ESWT and are now better?

Re: pain much worse after ESWT

Tina H on 9/15/04 at 19:49 (159963)

Supertwin, Hang in there. I too had pain much worse after ESWT. In fact it was searching for more answers post ESWT that I found this site. Sure wish I had found it sooner. The machine used on my foot was not the ossatron but the Dornier. Anyway my foot was definately much worse for about 2 weeks after. From about 2-7 weeks after the pain was just at the level as before ESWT. Now at 8 weeks post-ESWT I am showing some improvement finally, but I am also having physical therapy 3X/week so I'm not sure if the improvement is due to ESWT or PT, maybe both. One thing I think contributed to the increase in pain was the sudden cessation of anti-inflammatories. I was taking a lot pre EWST and to just stop everything made it very painful. At 6 weeks post EWST I started taking Bextra again. You have to just take it easy now for a few weeks. Personally I think the stories about feeling great one week later are a bit farfetched. This is not a quick fix. In fact I have a friend who is a doctor in France where this technology has been used longer. I contacted him with my situation and he said it wasn't that unusual to have more pain after and in France they tell people not to expect much improvment until 8 weeks post. I'm not a doctor but I think there is hope. Just take it easy, and let those new blood vessels form, get lots of sleep, eat properly, take vitamens and hopefully you'll improve soon. Keep the faith! Take Care, Tina

Re: pain much worse after ESWT

supertwin on 9/15/04 at 20:17 (159965)

Thanks for the reply, Tina. Did you have bruising like I do? That's what I'm really concerned about. The doctor treated some areas on my heel that didn't hurt before - and now I worry I'll be much worse off than before. I went off Vioxx several weeks before, and actually didn't notice that much difference in my pain right before ESWT. I actually had second thoughts while sitting there in the hospital - like, could I possibly be getting better finally, and, is it worth it.

Re: pain much worse after ESWT

Dr. Z on 9/16/04 at 17:47 (159994)

Supertwin,

Why do you think that you have areas treated that didn't hurt. The treatment was directed at the insertion of your plantar fascia that was painful when they pressed on this area.

Re: pain much worse after ESWT

Tina H on 9/16/04 at 18:27 (159998)

For what it's worth I did have some bruising. I never mentioned it to the doctor, quess I thought it was normal. Maybe it's not. I know that the doctor told me she was able to give me the maximum power for the full time since I was able to tolerate it. Again, I'm not a doctor, but I think in your case it's too soon to tell if it will work. I think in my case now post 8 weeks, I'm a bit concerned that it's not going to work completely. If I'm on my feet longer that 2 hours at a time I still have excrutiating pain. So I'm a long way from healed although being able to stand even for an hour is certainly an improvement. Keep us up to date with how you are doing.

Re: pain much worse after ESWT

Dr. Z on 9/16/04 at 18:31 (159999)

There is a group of ESWT patients that won't start to feel any relief for at least eight to twelve weeks. What kind of work do you do ?

Re: pain much worse after ESWT

supertwin on 9/16/04 at 19:40 (160005)

Dr. Z.
My pain was on the outside edge of my left heel, with no inside pain. But on my right foot, it was definately on the inside, I believe where you say is the insertional point. The doctor marked those areas with a pen. On my right foot I felt excruciating burning pain the minute I became consious from the anesthesia. Now, that area feels like it was cut with a knife, and is bruised red, not even blue. I can't press on it even with my hand. The left foot has similiar pain at the insertional point, as well as the area the doctor marked with pen. Basically, on my left foot I have pain where I never did before. Does the Ossatron have a set amount of shock wave it sends out for all patients? I'm so worried something went really wrong - because I can't stand on my feet without feeling like passing out from pain. The weekend before my procedure, I walked farther than I ever had in over a year - and I was in pain, but I was able to tolerate it. Now I worry I'm torn to pieces inside my heels.

Re: pain much worse after ESWT

supertwin on 9/16/04 at 19:43 (160006)

Dr. Z.
My pain was on the outside edge of my left heel, with no inside pain. But on my right foot, it was definately on the inside, I believe where you say is the insertional point. The doctor marked those areas with a pen. On my right foot I felt excruciating burning pain the minute I became consious from the anesthesia. Now, that area feels like it was cut with a knife, and is bruised red, not even blue. I can't press on it even with my hand. The left foot has similiar pain at the insertional point, as well as the area the doctor marked with pen. Basically, on my left foot I have pain where I never did before. Does the Ossatron have a set amount of shock wave it sends out for all patients? I'm so worried something went really wrong - because I can't stand on my feet without feeling like passing out from pain. The weekend before my procedure, I walked farther than I ever had in over a year - and I was in pain, but I was able to tolerate it. Now I worry I'm torn to pieces inside my heels.
I'm a first grade teacher, and have taken 2 weeks off. I can't imagine being ready to go back in a week. But that's not my concern right now, I just want to be able to walk, even to the point I could before the procedure.

Re: pain much worse after ESWT

supertwin on 9/16/04 at 20:00 (160008)

Tina. My concern now is not that it will work on the pain I had before, it's that I feel soooo much worse and cannot stand on my feet at all. Do you now feel like your pain is back to where it was pre , or still a bit worse?

Re: pain much worse after ESWT

Dr. Z on 9/16/04 at 20:20 (160010)

Hi
The ossatron has a set amount of energy that it sends out for all patients. I am not sure why. What did you doctor say was going on. There are some people that have increased pain before some resolution of the orginal pain. Call you doctor and see him or her. Having so much pain that you feel like passing out needs to be checked asap

Re: pain much worse after ESWT

Ed Davis, DPM on 9/16/04 at 21:19 (160013)

supertwin:

Keep in mind that it takes 12 weeks to see the effects of ESWT so now is not the time to get discouraged. Also, consider the fact that ESWT is not a stand alone treatment so there is no reason that you must suffer. You need to avoid anti-inflammatories at this stage but you can take pain medication. Addditionally, you can be getting physical therapy including those modalities that tend ot offer pain relief.

Be sure you are getting the 'total package' along with the ESWT -- please read Scott's Heel Pain Book if you have not done so already. Hopefully, you have been guided to the best shoes, orthotics, stretching exercises, etc.
Ed

Re: pain much worse after ESWT

supertwin on 9/16/04 at 21:39 (160016)

Dr. Z, Dr. Davis. I did see my Dr. 3 days after the procedure. His nurse was very surprised at my intense and increased pain. The doctor was not - or at least he didn't say he was. He said it was like having surgery, without being cut on. He saw the bruising, taped both my feet, told me to stay off them, and to ice. I did ice for a few days, but then stopped, thinking it may not be a good idea. I've had months of physical therapy prior to the procedure, so I do know how to stretch. I also have night splints, which I'm wearing during the day, since I'm off my feet, and couldn't really tolerate them at night - they hurt. I go back Monday to see my Dr. again - I'm just afraid he'll expect me to be better than I am. Is ultrasound a good thing for after ESWT? I had so much of it when I first had my pain over year ago, and it never did any good. Can scar tissue form to the point that it is painful? I know the procedure does produce some small scar tissue, but, with the bruising and intense sharp pain - it feels like a deep wound.

Re: pain much worse after ESWT

Tina H on 9/16/04 at 21:59 (160018)

Not sure if you were asking me or supertwin. I'm a science teacher and a field hockey coach, obviously my days of demonstrating anything on the hockey field are long gone, but as much as I try to sit, I still need to stand a lot coaching. It's hard because there is this trade off between mental and physical health. I know I should stop coaching but I love it and pf is so depressing... I have made what I think is a huge improvement, I can now walk without limping!!!! I still have so much pain but for some reason I walk normally now and before I was limping all day long, so that's something right?, even though I still have a lot of pain.

Re: pain much worse after ESWT

Tina H on 9/16/04 at 22:02 (160019)

My pain at 8 weeks later is less than pre ESWT but I still have so much, but it is less. I was really worse off those first couple of weeks after but then starting at about 2 weeks maybe, most days would be just a fraction better than the day before, with some backsliding from time to time. It's slow progress...

Re: pain much worse after ESWT

Tina H on 9/16/04 at 22:10 (160020)

Dr. Davis, I thought I could start taking anti-inflammatories at 6 weeks. Not sure where I got that, my doctor or this site, don't remember. So do you think if I'm now 8 weeks I should stop taking the anti-inflammatories? Pain killers do nothing for me except the really strong ones and they have too many side effects to function properly. Thanks for your help. You have no idea (well maybe you do), what a tremendous comfort this site is. Thanks to you, Dr Z, and all the regulars who provide support. Tina

Re: pain much worse after ESWT

Ed Davis,DPM on 9/17/04 at 00:33 (160024)

Tina:

Opinions vary and thereisnot a lot of data to back things up. I generally allow patients to return to anti-inflammatories 6 weeks after ESWT. others beleive that it should be 12.

Irrrespective of that one issue, make sure you are doing everything else-- the right shoes, orthotics if indicated, stretches, massage, physical therapy -- they may all compliment the effects of ESWT.
Ed

Re: pain much worse after ESWT

shirley j on 9/21/04 at 06:40 (160244)

I HAD MY FIRST ESWT SYDNEY AUST YESTERDAY COULD NOT WALK MUCH TODAY AT ALL SO HOPE TO IMPROVE OVER 3 WEEKS GET IT DONE EACH WEEK FOR THREE WEEKS EXPENSIVE BUT PAIN IS AWFUL

Re: pain much worse after ESWT

supertwin on 9/21/04 at 12:58 (160261)

Tina. I just saw my doctor, and asked him about physical therapy. He said all they would do there would be ultrasound, and he didn't want to break up the inflammation yet. At what point did you start PT, and what did they do for you?