What Is Extracorporeal Shockwave Therapy?

Extracorporeal Shockwave Therapy is a non-invasive treatment for chronic tendonitis.  The most common uses in the foot and ankle are for chronic plantar fasciitis and chronic Achilles' tendonitis. The technology for ESWT was originally used to treat kidney stones. Now, it has multiple musculoskeletal indications.

Presently the FDA, for treatment of plantar fasciitis and tennis elbow, approves this technology in the US. In the future, possible approvals may be given to treat patella tendonitis, shoulder tendonitis, Achilles’ tendonitis, pseudoarthrosis, stress fractures and shoulder calcification. There is also an FDA study to treat diabetic wounds.

There are several theories as to how ESWT works to promote healing and heal chronic tendonitis. The most accepted one is that the microtrauma of the repeated shock waves to the affected area creates increased, new blood flow into the area. It is this new blood flow that promotes tissue healing. For treatment of plantar fasciitis, or heel pain, the FDA study criteria are quite specific. Patients who experience the best outcomes typically have experienced heel pain for at least six months and had at least three other types of conservative treatments (steroid injections, oral anti-inflammatory medication, orthotics, physical therapy, etc.) without relief.

How is ESWT done?

The procedure is performed in the office without the need for anesthesia.  It takes anywhere from 10 to 30 minutes per treatment and typically 3 weekly treatments are recommended.  Sometimes additional treatments are needed, depending on the individual need of the patient.  The Shockwave device is aimed at the point of maximum tenderness.   This creates an acute inflammatory response where a chronic one exists.  The body then sends healing potential to the area, thus treating the condition.

If you suffer from chronic (lasting longer than 6 months) plantar fasciitis or Achilles’ tendonitis, contact on of the Foot and Ankle Specialists at Academy Foot and Ankle Specialists to see if ESWT is right for you.