to: Fed UPPosted by vince on 3/10/05 at 19:28 (170908)
First of all be assured that everybody on this board has empathy for you. We have all been or still are sufferers of foot pain from PF, TTS or whatever. Secondly, it is not very important if ESWT work 94% of the time or 50% of the time or what method of applying it is used. The important facts to consider is that it has neglible risk, and doesn't compromise the structure of the foot like surgery can and is effective.There are many on this board who have been helped. I think any doctor who has significant experience with it will say that they experience results at least comprable to surgery. The fact that you experienced poor results may not be the fault of the therapy. It is possible that you were not the best candidate for the procedure. Maybe you weren't copliant with what you were supposed to do following the procedure, or maybe you have a Baxters nerve involvement, or maybe you have poor vascularity. Sorry you weren't helped as much as you would have liked but now you should get another diagnosis of your problem and if it still turns out that you have typical PF, and have had some results, however slight, then I would try ESWT again. I wasn't helped until the second treatmnt. If you want virtualy 100% predicatable results then you are always going to be disappointed. I can think of very few things you can do to a human that would have 100% predicatble results except maybe a large caliber bullet between the eyes or jumping off the Golden Gate Bridge.
Re: to: Fed UPEddie Davis on 3/12/05 at 16:52 (171049)
You mentioned the one factor that is remarkable -- ESWT has fewer side effects (other than the price) than any modality or drug that has come to market since I have stared practicing in 1983.
Surgery has a list of side effects that have been rehashed on this site ad nauseum and is more expensive. Surgical success rates are less than that for ESWT. I have problems with anyone claiming any decent success rate with surgery because the procedure is not going to be done very differently from practitioner to practioner -- it is fairly simple. More variability exists in the post-op care. For example, I feel a cast is mandatory after surgery becaues the structures taking the job of the fascia need a reasonable time to adapt. Also, it is an area that likes to form scar tissue so physical therapy is needed when the cast comes off. The need for an orthotic actually increases after surgery because a primary lack of support for the foot has been sacrificed. When you add up the cost of surgery, anesthesia, cast, orthotics, PT , days lost from work surgical costs are very high.