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Any personal experiences with ESWT?

Posted by Walkingirl on 3/16/05 at 14:51 (171325)

Any personal experiences with ESWT? It appears to me that everyone responding on this board are the same people over and over again. I don't want to hear from the experts! I want to hear from people who have actually had ESWT and what is the outcome. I don't want any response from Victor, Dr. Z, Elvis, etc.

Re: Any personal experiences with ESWT?

Monte on 3/16/05 at 15:06 (171326)

Hi
I had ESWT performed on my left heel on Dec 17th 2004. I also had my own blood drawn and spun to isolate certain healing properties and then injected into my foot after the ESWT treatment.

Prior to this round of ESWT, my left heel felt like a big knot was under it. Now, the left foot feels a little better than before I had the tretment. It does not feel like I am standing on a marble anymore.

There is still pain there as well as in my arches...but the ESWT seems to have eased the knot feeling.

Maybe the tissue is become more healthy in that area or maybe scar tissue was broken up.

I need to return to DR Z for a follow up sonogram to measure the fascia's thickness.

I would do it again to get more pain relief, but I know that I still need to allow more time to possible heal further.

I hope this helps you

Monte

Re: Any personal experiences with ESWT?

Walkingirl on 3/16/05 at 15:48 (171328)

Can I receive a response from somebody that is not associated with Dr. Z? I am beginning to think this site is rigged!

Re: Any personal experiences with ESWT?

Moderator on 3/16/05 at 15:58 (171330)

This is a legitimate question, however, the site is not 'rigged'. The doctors and pedorthists that respond to questions do so during their own time and are not compensated.

Re: Any personal experiences with ESWT?

Walkingirl on 3/16/05 at 15:59 (171331)

Can I receive a response from somebody that is not associated with Dr. Z? I am beginning to think this site is rigged!

Re: Any personal experiences with ESWT?

Ralph on 3/16/05 at 17:21 (171343)

Hi,
My name is Ralph and I'm not associated with anyone on this site. I came here because I too have Plantar Fasciitis. I'm relatively new, but what I've been doing is using the 'Search' area on this site to read back posts from others that came here before I did. It's been very helpful and I'm learning more and have gotten a better feel for this site.

You too may find it helpful to use the search area and read earlier posts. I don't know about this site being rigged as you say, but by now I've come to realize that Dr. Z does use a specific ESWT machine which he no doubt favors and promotes. I don't consider that rigging anything because he lets everyone know how he feels on the subject of ESWT. I simply think of it as advertising. I believe that most of the other doctors that come here are part of Dr.Z's group. If that is correct then they use the same ESWT machine that he does.

Unfortunately I can't provide you with a personal account of ESWT because I've not had it. I'm still using all the conservative treatments described in Scott's P.F. book on this site. Will I have it in the future? I don't know because I'm not certain myself that it really works as well as reported here.

Apparently there have been lots of discussion about ESWT machines early on. Which machine was better or is better and about these percentages which are posted about success rates etc. Maybe I feel a bit like you. Numbers are great and so is having doctors on the site that use ESWT but you just can't beat hearing first hand information from patients that have gone before you and to find out how they faired.

My take and only my take right now is people seem willing to pay the money for this treatment and take their chance that it will provide relief, but
like anything else in life accept for paying taxes and death there isn't any guarantee.

Re: Any personal experiences with ESWT?

SteveG on 3/16/05 at 17:51 (171348)

Walkingirl - I have had ESWT 3 times (one low energy and two high) (and not by the good Dr.Z). I am about 80% better than I was 2 years ago, and I attribute much of the improvement to ESWT. Is there anything else you would like to know?

Re: Any personal experiences with ESWT?

monte on 3/16/05 at 18:13 (171349)

What is wrong with my response. You wanted to hear from someone that is not a doctor and has had experience with ESWT treatment. I meet that criteria.

So what if Dr Z performed the treatment. I am not him and would not tell you that I feel better if I didn't.

First of all...I owe finding out about ESWT from this website and Dr Z!!!

So I pretty much wasted my time reponding to you.

Re: Any personal experiences with ESWT?

elvis on 3/16/05 at 18:45 (171352)

I guess she's looking for the 'full monte'!! LOL Couldn't pass that one up. But I'll shut up for now since she doesn't want to hear from me. Well, maybe not. My current docotr who is a woman told me it didn't matter what kind of machine is used for ESWT as long as it was a high energy machine. Take that for what it's worth. She is an orthopedic foot specialist.

Re: Any personal experiences with ESWT?

Fed Up Also on 3/17/05 at 08:43 (171378)

Walking girl, ESWT carries a lot of controversy, success rate range from 50% to 94% depending on which site, which doctor, which machine.

I had ESWT over a year ago from a doctor claiming a 94% success rate, it didn't help, I did everything the doctor told me to do, follow the regiment, no improvement.

The FDA approval was optained as safe only (the FDA as approved Vioxx).

The following link, from the Journal of American Medical Association, dated September 18, 2002 cast a doubt to it's effectiveness: http://jama.ama-assn.org/cgi/content/abstract/288/11/1364

Also the following link from the Physician and Sports Medicine, states most of these studies are flawed, and some were funded by ESWT manufacturers and no standardized treatment protocol is used http://www.physsportsmed.com/issues/2004/1104/glazer.htm

The FDA PreMarket Approval (attached link) showed at conclusion of test, 56.2% of the Active group demonstrated 60% improvement from baseline in their VAS scores compared to 45.2% of the patients in the Sham
group. Only 11% of active group did better using the real thing. http://www.fda.gov/cdrh/pdf/P000048b.pdf

In my conclusion: I would not recommend spending the money on ESWT

..

Re: Moderator

Fed Up Also on 3/17/05 at 09:03 (171382)

One of the drawbacks to public message boards in that most are one sided to the opinion of the moderator and frequent posters. When you post links to particular participants at the top it further lends it's self to appear as if rigged. To balance controversy, in addition to links for Doctors, how about links to the AMA studies on ESWT, Medicare/Medicaid findings on ESWT, FDA PMA on ESWT, etc. This way, individuals seeking knowledge on ESWT get a balance view and can make an informed choice.

Re: Any personal experiences with ESWT?

vince on 3/17/05 at 09:11 (171384)

Hey Fed-UP-I guess you would rather pay the cost of surgery, have about the same or less of a chance of having a good response, having to take the risk of anesthsia and infection and possible permanent damage to the structure of your foot and experiencing a long recovery time that could subject you to a significant negative economic impact.

Re: Moderator

Dr. Zuckerman on 3/17/05 at 10:06 (171393)

That is an excellent idea.

Re: Moderator

Moderator on 3/17/05 at 13:00 (171414)

Links to particular participants is a 'thank you' for their time and effort to answer questions.

The links you suggest could be very helpful to keep redundant questions at a minimum.

Re: Vince

Fed Up Also on 3/17/05 at 13:56 (171423)

First off, as a public message board we are entitled to our own opinions (unless this is forbidden, and that would really make this a one sided (rigged) board).

Second, I had ESWT over a year ago, followed the regiment from the doctor and did not have success. Insurance did not cover this treatment so I paid out of pocket (in addition to orthotics out of pocket, co-pays, etc.). I was treated at the advise of my doctor. Had I done the research then that I've done since the treatment I would not have done it. Because of the delay in proper treatment (ESWT is still considered investigational by many including the AMA and most insurances) I now have ankle, knee and hip problems which are all link to the delay. These problems are er-reversable, so yes, I will be lame the rest of my life because of ESWT.

Third, all procedures, be it ESWT, surgery, accupuncture, PT, etc. carry some sort of risk. Just wondering, did the doctor explain all the possible side effects of ESWT with you? Mine didn't.....

Forth, surgery IS covered be insurance, my cost $100 which is almost 10X less than the ESWT cost me.

Fifth, how do you know my financial condition, I have 125 DAYS (not hours) of sick leave on the books and always insure that I have at minimum 3 months of salary banked. RESPONSIBILITY is the key. Additionally, I pay disability insurance on my mortgage to cover in the event of long term disability.

What I posted was my opinion only, I am not a doctor nor do I claim to be one, I've had a bad experience with ESWT and don't believe it is for everyone and I do believe that the number were manipulated. Everyone needs to be informed and make a decision on their own, not on just information from a one side message board.

..

Re: Any personal experiences with ESWT?

elliott on 3/17/05 at 15:42 (171434)

Fed Up Also:

Just one comment. I noticed you keep linking to Buchbinder's study as evidence that ESWT doesn't work. Buchbinder set the Dornier on a low-energy setting and had a minimum PF requirement of only 6 weeks. Rather than reject all of ESWT based on that study, I would say her study offers evidence that Dornier low energy on newer patients doesn't work. I am not trashing her study as some have, but her own conclusion that all of ESWT doesn't work based on her study was IMO too far-reaching.

Re: Any personal experiences with ESWT?

elliott on 3/17/05 at 15:58 (171437)

Vince,

No one wants to risk getting their plantar fascia cut for nothing. The question is whether they're getting something for their money when they shell out thousands for ESWT. With the alternative possibly being getting their PF cut, I think many believe simply because they want to believe, price be damned. But if ESWT really doesn't work, then the decision process is back where it was before ESWT appeared.

Re: Any personal experiences with ESWT?

Dr. Zuckerman on 3/17/05 at 16:25 (171438)

What I found out is patients that gave up on the tradional treatments come out again for help. Less then 20% of all plantar fascia patients ever seek treatment form an MD, DO. DPM.
So if you look at the stats, the 90% is 90% of the less then 20% of patietns that ever seek care from an MD, DO, or DPM. I don't think that conservative treatment would ever get FDA approval if we just looked at the stats.
I believe in conservative treatment 100%. I just don't believe that it is as effective as the literature states

Re: Any personal experiences with ESWT?

BrianG on 3/17/05 at 20:52 (171453)

Hi Walkingirl,

I had 2 ESWT treatments, both heels, one year apart, in 2002 and 2003. I also had an EPF surgery on one heel, in 1999. None were any help at all. It's my opinion that my HMO Pod only recommended typical early treatments: ice, rest, taping, cortisone shots, walking boot, orthotics, etc, etc. I finally went out on my own to get the surgery, and then the ESWT treatments. By this time, I had already been in severe, chronic pain, 7x24, for a number of years (12 at this point). Aagain, it's my opinion that if I had received either of these treatments in the first 6-12 months of first having heel pain, my chances for healing would have been much better. At this point, I don't see any cure in my future. I take daily pain meds, to keep from loosing my mind. Without them, I may have already checked out !! Who would have ever believed that a simple pain in the heel, could be so life altering!!!

Good luck with your choices,
BrianG

Re: Any personal experiences with ESWT?

Tina H on 3/17/05 at 21:24 (171458)

Had ESWT after being almost debilitated by pf. Kept crutches by my bed for nightime bathroom visits, some nights I literally crawled up the stairs, now I barely think about my feet 9months after ESWT but I'm so scared the pf could come back that I still obsess about it and try to stay current. I'm not associated with anyone on this site, although I've gotten some very helpful, and FREE advice here. People on this site have listened when no one else cared and for that I feel very fortunate.
Tina H

Re: Any personal experiences with ESWT?

CherylS on 3/18/05 at 08:33 (171479)

While I haven't had this procedure, I too am thinking about it. I think that on this website, which MOSTLY consists of people who have a current case of PF and are obsessed with getting relief, people who have had a successful outcome with ESWT probably are no longer lurking and posting on this board. Probably only the people whose treatments have failed, and are still looking for relief, would continue reading this board every day.

Re: Any personal experiences with ESWT?

elliott on 3/18/05 at 13:25 (171504)

CherylS:

Good point, but there also were many regulars on these boards who announced in advance they were going for ESWT treatment and did not get better. If success really were around 94%, I'd think we should've seen just a few failures at most. What I'm saying is, the observed prospective experience of heelspurs was nowhere close to the advertised success rates. Which brings me to another point: many docs here have claimed they achieve the same 94% success rate as in the FDA study (not 93% or 95%, but exactly 94%. :-)) Well, the FDA study was performed on a very pristine population--no previous surgery, no diabetes, no bilateral symptoms, etc. Appropriate for a study, but in real life, lots of patients have these things and seek and get treatment, including ESWT. They generally are considered to be harder to successfully treat, whatever the treatment. So I would think just due to that, success rates would be somewhat lower than the FDA, not the same.

Re: Any personal experiences with ESWT?

Dr. Z on 3/18/05 at 14:46 (171514)

In reality there should be more of a chance to help chronic pf's with ESWT. The treating doctor can use other treatment modalities in conjunction with ESWT. There were no other treatment modialities within the 12 week FDA study

Re: Any personal experiences with ESWT?

DavidW on 3/19/05 at 13:51 (171580)

WalkingGirl,

I have suffered with PF in both feet for a little over 3 years. My left foot has always been worse than the right. Walking or standing for any length of time over 15 minutes has been dreadfully painful. For the past 3 years, I kneel and sit most of the time.

In January 2005, I had ESWT on my left foot. For several weeks post ESWT, things were pretty bad. Around 6 weeks or so, my left foot started feeling pretty good. I can make it through a typical day now with maybe 30% of the pain that I had last year (hard to say). I am an IT guy, so I really don't spend alot of the day on my feet (thank god), and I have been extremely carefull not to push my feet to hard at this point.

I am very weary of the results so far, although they have been positive. I guess that 3 years of pain is hard to shake off. I do try to get off my feet at the first sign of pain in an effort to assist with the healing process. I am going to wait until this summer before I start testing out the feet for real (like walking or going to the mall). If all goes well, I will consider ESWT on my right foot.

By the way, I had ESWT done in NY and it cost me nothing other than doctor visit co-pays. I am insured by UHC.

Hope this helps a little.....

Re: Any personal experiences with ESWT?

Terri on 3/22/05 at 11:27 (171763)

I had it in Oct. 2003 and am still recovering from it. I think I had some sort of strange reaction to it. I have not wore dress shoes since then. I live in New Balance atheltic shoes even to work.

Re: Any personal experiences with ESWT?

elliott on 3/29/05 at 15:18 (172117)

test

Re: Any personal experiences with ESWT?

elliott on 3/29/05 at 15:32 (172119)

BrianG,
I can understand your frustration after dealing with PF for 12+ years, but the Ossatron researchers claim duration of symptoms has little to do with one's chances of success. While the highest category on which they base their conclusion is only 2+ years (I wish they would have broken the data down into smaller brackets for the longer durations), they also say that the two patients with the longest durations, 15 and 18 years, had complete resolution of symptoms--not in one year, but in 3 months! Maybe the Ossatron is more effective than other machines for those with longer duration of symptoms (no harm in hopeful speculation). Have you tried the Ossatron yet?

elliott

Re: Any personal experiences with ESWT?

Lynn F. on 3/29/05 at 18:50 (172129)

I had ESWT 6 months ago. It's been a very long (and bumpy) road butI can honestly say I am 85-90% improved since having it and I definitely have more good days than bad. I have babied my feet ever since and avoid setbacks by using the electric cart when grocery shopping, wear a night splint when sitting for extended periods (though I no longer have to sleep with it), and whenever I feel the slightest pain coming on I roll a frozen water bottle under my foot. I also went for 6 wks of physical therapy post ESWT which helped tremendously. Hope this is helpful. Good luck!

PS. I have no association with Dr. Z but I can tell you that his input and support while I was going thru my roughest period was invaluable to me!

Re: Any personal experiences with ESWT?

elliott on 3/29/05 at 19:22 (172135)

Lynn F:

Given all the self-treatments you did and post-ESWT PT which you say helped tremendously, is there any way you can tell for sure that it was the ESWT and not all those treatments that got you to 85-90% in 6 months?

Re: Any personal experiences with ESWT?

Ralph on 3/29/05 at 21:54 (172145)

I think it's interesting that your doctor sent you for P.T. following your ESWT treatment. I wonder how P.T. following ESWT comes into play and if it should be made part of the after care treatment for ESWT.

Earlier posts from others indicate that not all patients get the same after care orders from their doctors. I think you may be the first that I've read that followed up ESWT with P.T. so I think this combination is an interesting one and wonder why other doctors don't seem to RX this for their patients.

It certainly seemed to be a turning point for you and possibly could help others as well. Maybe more doctors should be ordering P.T. for their patients following ESWT. Perhaps it enhances ESWT treatments.

Re: Any personal experiences with ESWT?

Dr. Z on 3/30/05 at 19:47 (172220)

Glad I could help you. It is posts like this one that make everything worth it !!

Re: Any personal experiences with ESWT?

Lynn F. on 4/03/05 at 20:24 (172517)

Elliot - I can't say for sure if it was the ESWT (high energy Dorsier) or just time, but after sufferering for 7 months, exhausting every available treatment, I decided to have it done. And believe me, it got worse before it got better. In fact, at 8 weeks, I was in so much pain, my pod suggested surgery -- which I was dead-set against. I opted for PT instead. My dr. wasn't overly optimistic, nor was the Physical Therapist, for that matter, but for some reason it was the turning point for me. I went 3 x a week, doing only NON-weight bearing exercises (NO weight on the heel EVER).

Now at 6 months, I can say a bad day for me is a pain level 2-3 -- and that's only if I overdo it. I recover much more rapidly and feel I have my life back. As such, I have just booked a vacation! :o)

Re: Any personal experiences with ESWT?

Lynn F. on 4/03/05 at 21:06 (172522)

Ralph - At 2 months post treatment, I returned to my POD in alot of pain and he suggested surgery, which I was unwilling to do. I asked him about PT instead and he agreed. I went 3 x a week for 6 wks and did NON weight bearing exercises only. I began to notice improvement almost immediately. I don't see that PT can hurt, provided the therapists know exactly what they are doing.

Re: Any personal experiences with ESWT?

Dr. Z on 4/03/05 at 21:21 (172524)

Lynn

What kind of pt do you have?

Re: Any personal experiences with ESWT?

Dr. Z on 4/04/05 at 21:43 (172593)

Lynn.
Did you have a lack of motion at the ankle joint

Re: Any personal experiences with ESWT?

Lori S on 4/05/05 at 00:43 (172616)

I just posted about my ESWT outcome ...... check it out......

Best wishes,
Lorinda

Re: Any personal experiences with ESWT?

Lynn F. on 4/06/05 at 22:24 (172735)

Dr. Z - My therapy incorporated massage and very basic toe & arch strengthening exercises, such as:

- Spreading toes and placing them back down while spread

- Lifting arches (while keeping toes & heels on ground)
(these 2 seemed impossible at first, but became quite easy with practice)

- Towel scrunches, picking up marbles, rolling a ball, etc

- Standing 2 feet from the wall, extend one leg forward, placing ball of foot on base of wall while keeping heel on ground. Extend the other leg straight back. Pull hips inward and hold for 30 seconds. Switch legs. Do 3 sets (I do this straight out of bed every morning, does wonders for first step pain)

That's about it.

Re: Any personal experiences with ESWT?

Lynn F. on 4/06/05 at 22:24 (172736)

No