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post ESWT - a year and a half

Posted by Dan D. on 5/24/05 at 15:44 (175638)

A year and a half ago, I had Shock Wave Therapy done on both my feet after having been on crutches for the most part of 7 years due to severe, chronic, and somewhat atypical plantar fasciitis. The pain in both my feet was in the classic pf location at the place where the plantar fascia connects at the rear of the foot. However, about 2 or 3 months prior to getting the treatment, I started getting additional pain in the very rear of my heels, about as far back as you can go before the heel starts sloping upward toward the ankle (just a hair bit further down than the upward slope). I received Shock Wave therapy on both spots of pain in both my feet using the Sonorex machine (3 separate treatments). The area of pain in the classic pf location that I had suffered with for 7 years was miraculously and almost instantly healed. However the new pain toward the rear of my feet did not respond. Doctors are puzzled by this new area of pain as they say there is not much tendon there. Mostly bone and very small strands of connective tissue and maybe some fat. I am wondering if I should try shock wave therapy again on this area. I am overall much improved after ESWT. I've been off crutches since the treatment. However I want to get rid of this pain in the far rear of my heals. Has anyone out there had pain in this area? Any thoughts on getting ESWT again?
A friend bought me some Earth Shoes which have helped out tremendously.
Any thoughts or suggestions would be helpful. Thanks!
Dan D.

Re: post ESWT - a year and a half

Ed Davis, DPM on 5/25/05 at 22:33 (175736)

The region you describe is part of the achilles attachment. Have you been measured for a tight achilles as that will potentiate PF and cause pain exactly where you describe. I would also look for calcaneal varus which is an inward bowing of the heel bone best seen by taking a specialty x-ray view called a calcaneal axial view. Calcaneal varus, treated non-surgically requires an orthotic with a deep heel cup, posted to effectively reduce the angulation. Glad to hear you did well sith the Sonorex machine but it sounds like you are in need of further biomechanical workuo.

Re: post ESWT - a year and a half

Dan D. on 5/26/05 at 20:50 (175795)

Dr. Ed,

Thanks for the very helpful information. I will look into these possibilities with a local dr. here. The doctors I have seen did not mention any of this, so I do appreciate your help.