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PAIN AND RECOVERY AFTER ESWT THERAPY

Posted by J AND J on 7/22/05 at 13:18 (178846)

Having had foot pain for over 6 years, and working on concrete and standing for 12 to 16 hrs. a day sometimes, I decided to have ESWT instead of invasive surgery. This was done five weeks ago and I have been on short term disability for 5 weeks. I am still having pain and doing limited activities and walking. My podiatric surgeon indicates he does not know for sure if I will continue to have pain or what to expect if I go back to work shortly. The pain is still in my heel area and sometimes down the center of my foot by the plantar faciititis band. My tissue measurement was 8.21mm (not sure if this is of the band itself?) but have the ultrasound here.. Normal is apparently 2.69mm. My doctor says it could be six months till I know what is going on. There is no problem with my staying on short term disability as far as my employer is concerned. I feel like my doctor is encouraging me to get back to work and that concerns me as I do not want to be back to the high level of pain I experienced before this procedure. If I go back to work now into the excessive hours and time on my feet (having to lift 100 lbs.) what can I expect. Can I expect my foot to get better with time even though I am working? What is the success of this procedure and when does someone think about a surgical procedure.

Re: PAIN AND RECOVERY AFTER ESWT THERAPY

Robert B. on 7/22/05 at 18:19 (178860)

ESWT is still (IMHO) not an exact science more like a hit or miss science, I opted not to try ESWT because of the recovery time (or in some cases the lack there of).

My orthopedic surgeon said 'Studies have indicated that recovery time may be as little as one month or up-to 6 months and in some cases up to a year. Many times a second or even a third treatment is required prolonging recovery.

Currently, my ortho has me in a day time brace for TTS and PF and a night splint. The brace affords me the mobility I need. The brace isn't promising a full recovery but it has eleviated the majority of the pain (still have those bad days).

As far as surgery, I would only as a last resort have it attempted. There are other treatment available, investigate them, ask your doctor.

One thing to remember, your feet have to support you for the rest of your life, there really is no long term study (20, 30 40, etc) as to the effect ESWT will have years down the line.

Re: PAIN AND RECOVERY AFTER ESWT THERAPY

Dr. Z on 7/22/05 at 18:39 (178862)

Robert B

Just so you know. ESWT isn't indicated with patients that have TTS. ESWT can take time to heal but the serious complications that go along with any type of pf release or TTS release are avoided for ESWT. ESWT has long term plus 10 year follow ups.

Re: PAIN AND RECOVERY AFTER ESWT THERAPY

Robert B. on 7/22/05 at 20:36 (178884)

Why is it that anytime someone posts something that another Dr. (besides Dr. Z) passed along that controdics your opinion, you (Dr. Z) gets so defensive? Aren't other entitled to an opinion? He doesn't feel ESWT is the cure all to beat cure alls for PF. He's opinion, sorry... Don't take it to heart. Medical practice is an an art, each has their own way of judging a picture or portrait.

I posted what I was told, and never mentioned that the Dr. wanted to use ESWT on my TTS. It was the PF portion and he didn't and doesn't recommend it as a viable treatment for PF.

Re: PAIN AND RECOVERY AFTER ESWT THERAPY

Dr. Z on 7/22/05 at 20:49 (178892)

Robert B

I am not defensive. I want to make sure that the correct information is presented. The fact that your doctor wanted to treat your pf and not your TTS is just wrong and will leave to complications and poor results. ESWT was never indicated for TTS with PF. I have make this clear and wanted to make sure that either posters or doctors reading this web site clearly understand this exclusion.
Doing ESWT on patients that don't have first step morning pain is another big exclusion that posters and doctors need to understand.
Should I let this go. If I do some poor poster may have ESWT when they shouldn't have the procedure.
Sorry if you though my post was defensive. This isn't opinion this is fact. It would be like driving down a one way street. Your doctor and really don't care if he is an orthopedic and or podiatric physician gave you wrong, incorrect information concerning an important exclusion for ESWT.

Re: PAIN AND RECOVERY AFTER ESWT THERAPY

Robert B. on 7/22/05 at 22:28 (178903)

I never mentioned that the doctor was treating my PF and not the TTS. He is treating me for both, and having good results. With no down time.

The more I read and see, the more the ESWT providers/practitioners need some standardization/FDA enforcement. One pediatrist I saw diagnosed both the PF with TTS and recommended ESWT. Now I am reading from your post that ESWT is not indicated for PF with TTS. He (the Dr.) also mentioned that the first morning step with or without pain isn't always an indicator of PF and still continued to recommend ESWT.

If you noticed the original post, I mentioned 20, 30, 40 etc. as years of long term studies, I (and he, my new Dr.) realized that the was a 10+ year study.

And your concern that 'Some Poor Poster' will get ESWT when they shouldn't, doesn't that revert to standardization between the Dr. providing this type of service? If 'some poor poster' walks into a providers office and asks for ESWT, isn't it the provders/Dr. responsibility to proper inform and treat?

Who has the correct information? 3 doctors, 7 different recommendations regarding ESWT.

Re: PAIN AND RECOVERY AFTER ESWT THERAPY

Elyse B on 7/23/05 at 05:50 (178906)

robert B - forget it, you are beating a dead horse. You absolutely cannot contradict nor offer an opinion that differs from the doctors so don't try. I think it is a good thing for posters to post the recommendations that 'their' podiatrists gave them regarding ESWT so we all can at least try and get a fair and balanced offering on ESWT and not just 'positive, there are no side effects and it is the best treatment with no down sides except the price' that we hear on this Board.

Re: PAIN AND RECOVERY AFTER ESWT THERAPY

Dr. Z on 7/23/05 at 08:36 (178911)

Robert
You are absolutely correct. This is one of the reasons that Dr. Ed and myself have formed the http://www . ASMST.com. The purpose is to educate the patient and the doctor. There are standards and indications and exclusions for ESWT to make it an effective treatment.
Heelspurs.com is another place where there is the opportunity to learn about the indications, diagnosis of heel pain and such treatments as ESWT.

Re: PAIN AND RECOVERY AFTER ESWT THERAPY

Dr. Z on 7/23/05 at 08:40 (178912)

Elyse B

My post was directed toward what Robert's doctor stated. I never disagreed that this wasn't told to him. Would you have just let me let it go.?
This isn't about positive or negative reports on ESWT . This is about inclusions, exclusion criteria.

I understand where Robert is coming from. Please explain where you are coming from?

Re: PAIN AND RECOVERY AFTER ESWT THERAPY

Elyse B on 7/23/05 at 10:02 (178916)

same place as Robert.

Re: PAIN AND RECOVERY AFTER ESWT THERAPY

Dr. Z on 7/23/05 at 10:38 (178921)

and where do you think his place is ? On second though its Saturday have a nice day. Its sunny and I am going to enjoy this day . Auvoir my foot frinds !!

Re: PAIN AND RECOVERY AFTER ESWT THERAPY

Robert B. on 7/23/05 at 13:18 (178923)

Dr. Z.,

If you are the same Dr. Z from Southern Jersey, I had a consultation with you about 18 months ago (never went any further than a consultation with you for reasons that I don't feel should be shared in this forum), presented you with MRI, X-rays, nerve conductivity tests, etc. Your current posts controdict what I was told by you in your office regarding ESWT, PF and TTS.

It is a great day, sunny, warm, I can get around with little pain and tend to my horses. Maybe even get some work in on breaking my latest goofball.

Re: PAIN AND RECOVERY AFTER ESWT THERAPY

Dr. Z on 7/23/05 at 16:23 (178934)

Robert B,
I have no idea who you are or if you are talking about me . I will again repeat if you have true TTS and pf then ESWT won't help you. If you e-mail me at (email removed). and give me you last name I will check to see if you were ever a patient of mine.
Glad you can get around with little pain and tend to your horse.

Re: PAIN AND RECOVERY AFTER ESWT THERAPY

Dr. Z on 7/23/05 at 20:42 (178949)

Robert B

I have been thinking about this. If you did come to me to consult your foot condition it is very possible that I though that ESWT could help you if you had both pf and TTS. That was eightteen months ago. After thousands of ESWT cases that I do and review my opinion is that ESWT for pf and TTS doesn't help the patient that much. That is why you go to an experienced doctor and I will tell you I do have experience with ESWT. Still waiting for your e-mail

Re: PAIN AND RECOVERY AFTER ESWT THERAPY

Robert B. on 7/24/05 at 08:52 (178975)

What is that going to accomplish by sending my name? You admitted that you THOUGHT EWST would help PF with TTS 18 months ago, now your thoughts have changed after 1,000s of ESWT treatments (glad I didn't pay for it).

Best bet Dr. Z., let this one go, and work on standardizing this procedure .............

Re: PAIN AND RECOVERY AFTER ESWT THERAPY

Dr. Z on 7/24/05 at 10:15 (178981)

Robert B
I would like to review your chart. I want to see where my thinking was when I saw you. There could be alot of other factors. I would appreciate the opportunity to go back and take a look at your chart with your permission. (email removed)