Extracorporeal Shock Wave Therapy for Plantar Fasciitis, Pittsburgh
Plantar Fasciitis
ESWT: An Overview
The benefits of extracorporeal shock wave treatment (ESWT) for plantar fasciitis are broad and profound. ESWT can be effectively used in conjunction with other therapies to address acute and chronic soft tissue wounds as well. ESWT seems to work along many different pathways to facilitate healthy and complete healing. Among the benefits of ESWT are:
- an increase in blood flow perfusion
- epithelialization (reepithelialization) – covering the injury with new skin and mucous membranes
- facilitation of wound closure
- improved angiogenesis – formation of new blood vessels and capillaries
- improved tissue granulation – the filling of the wounds
- reduced necrotic fibrin tissue – dead tissue
- reduction in duration of healing
- reduction in the need for antibiotic use
Orthopedics Treatment
Musculoskeletal injuries are among the most common reasons for visiting a physician in the United States. More than 25% of Americans suffer from one kind of musculoskeletal impairment or another. This accounts for over 130 million doctor’s visits and $850 billion yearly. There is research currently underway examining the effectiveness of ESWT on these types of injuries. If successful, shock wave therapy could be added to the arsenal of effective, non-invasive treatments at physican’s disposal. ESWT, Extracorporeal ShockWave Therapy, Shockwave therapy or lithotripsy, was originally developed by Dornier MedTech to break up kidney stones in the body. The therapy was approved by the FDA in the early 1980s and today is the standard treatment of choice for urinary stones. Because it’s delivered outside the body (extracorporeally), many of the risks associated with surgery are eliminated. In fact in ESWT or orthotripsy, the shock waves actually stimulate the body’s own repair mechanisms.
About the Treatment
The 1/2 hour visit starts with the area of pain being identified by the patient and usually confirmed with ultrasound imaging. That affected area is then lightly numbed and the patient is asked to sit on a exam table or chair. After a gel is applied to the foot and therapy head, the head’s water-filled cushion is placed against the foot. Shock waves are released from the device as Dr. Christina positions the foot. Shock wave therapy relieves pain and provides a short recovery period, with very few risks or side effects. Most patients are able to resume normal activity the next day.
What is extracorporeal shock wave therapy and how does it work?
Extracorporeal Shock Wave Therapy, also referred to as ESWT Philadelphia , is a nonsurgical method that delivers high-energy acoustic (sound) waves to a targeted area in order to to treat various musculoskeletal conditions, including plantar fasciitis. ESWT NYC works in 3 ways:
- Desensitization. Local anesthesia is administered prior to the procedure. However, the ESWT is a very powerful machine, and the targeted area will become increasingly desensitized throughout the procedure.
- It changes a chronic injury into an acute injury. Chronic injuries occur from overuse of an area of the body over an extended period of time. Plantar fasciitis is an example of chronic injury.
- Vascularization. During the ESWT procedure, microscopic and controlled injuries are induced. These injuries “jump start” the overall healing process by promoting the growth of new blood vessels in the achilles tendon (vascularization), and giving your body the tools that it needs to heal itself naturally.
Benefits of ESWT vs. Surgery
ESWT is a non-invasive procedure requiring only local anesthesia to the targeted treatment area.
Surgery is an invasive procedure where you will need to be placed completely under general anesthesia.
ESWT has little to no downtime, other than not participating in overly strenuous activities for 2-8 weeks following the procedure.
Following plantar fasciitis surgery, patients will be required to wear a protective boot and/or use crutches. The healing time following surgery is a minimum of 3 weeks +.
Physical therapy is not needed following the ESWT for plantar fasciitis
Several months of physical therapy is often required and needed following surgical correction.
While ESWT is not covered by most insurance companies, it is cost effective.
Surgical procedures can be very expensive, especially if a patient has a high deductible or poor health care coverage.
What is Plantar Fasciitis?
Plantar Fasciitis (often referred to as a “heel spur”) is a common cause of heel pain and affects about 2.5 million people each year in the U.S. Historically, surgery was the only alternative when conservative treatments like ice, orthotics, physical therapy, medication and cortisone failed. Today, with Extracorporeal Shock Wave Therapy (ESWT), that pain can be relieved with a gentle 18 minute treatment done right in the podiatrist’s office The muscle that stretches along the bottom of the foot (the plantar fascia) is responsible for maintaining the arch of your foot. This is the muscle that becomes inflamed or irritated.
What causes plantar fasciitis?
- Common sports injuries
- Overweight people (stand or walk frequently)
- Flat or high-arched feet
- Improper shoes
- Frequent running on sand
- Increasing age
Frequently Asked Questions
Symptoms Of Plantar Fasciitis
Sometimes plantar fasciitis can be hard to identify as it’s only symptom is pain the mid part of your feet or in your heel, you may feel pain in only one feet but it’s possible in both if both of your legs suffered from the equal pressure.
Plantar fasciitis is pain is usually serious in morning, when you take your first step out of the bed. This pain and discomfort subsides as you continue walking but returns if you take rest and start activities again.
It may be hard for you to climb stairs with plantar fasciitis but activities may relieve your pain, however after you stop the pain may return.
The pain will keep returning and going away until you don’t treat it!
Are There Misconceptions About Plantar Fasciitis?
Yes, here are some of the most common ones:
- Only Athletes Get Plantar Fasciitis: No, it’s true that athletes are at the highest risk of plantar Fasciitis due to increased activity with their feet, but anyone can develop plantar fasciitis, even those who live a sedentary life.
- Plantar Fasciitis Can Affect Only Older Adults: This isn’t the truth, people might think this because older adults have a weakened and old plantar fascia while younger individuals have much healthier one, which makes older adults more prone to plantar Fasciitis, but it’s possible fit anyone to develop this problem.
- Surgery Us The Only Solution: If your plantar Fasciitis Is in early stages then there’s no need for any surgery, it can be easily healed with physical therapy, medicines, and lifestyle changes. However, if you have ignored it for a really long time then you will need surgery!
When Surgery Is Needed For Plantar Fasciitis?
As mentioned earlier, surgery can be your option if only you haven’t got treatment for it for a long time, but it can be also a choice if conservative treatments do not work for you at all and you see no improvement. If other treatments don’t work even after 6-22 months, then you might need these surgical options:
- Plantar Fascia Release: A surgery that involves cutting a portion of plantar fascia which relives tension and reduces pain.
- Gastrocnemius Recession: If the tight calf muscles have contribute to to plantar fasciitis then this procedure will be used to lengthen the Gastrocnemius muscle which will improve flexibility and relive strain on plantar fascia.
Can Plantar Fasciitis Affect Other Body Parts?
Yes, other body parts like knees, hips, lower back, leg muscles, and other foot structures can get affected by plantar Fasciitis because of changes in gait due to pain.
What Causes Plantar Fasciitis?
Plantar fasciitis is really common problem and most of the time it is caused because of repetitive injuries on your fascia, which is a ligament in your heel.
There are many factors than can cause injuries to your fascia, these can include strenuous exercises or working on hard surfaces.
Furthermore, being over 40 highly increases your chances of increasing plantar fasciitis since at this age your fascia isn’t as strong as it used to be, which can make you more likely to develop this problem.
Lastly, if you are a women you are also at a risk of plantar fasciitis.
Do Children Get Plantar Fasciitis?
Yes, just like mentioned before everyone can get plantar fasciitis and kids aren’t an exception. However it’s not common in kids as much as adults and older people.
They may develop plantar fasciitis because of unsupportive shoes, injuries or playing too much. But the problem can be solved by applying ice and rest.
If the problem doesn’t go away then it’s time to look for a good doctor.
Can Plantar Fasciitis Cause Long-Term Complications If Left Untreated?
Yes, leaving plantar fasciitis can be really dangerous, here are some complications you may face as a result:
- Chronic Pain: Leaving the condition untreated isn’t going to make it’s pain go away, the pain will stay there but not only that, it will increase even more and more until you don’t get the treatment. Your feet might even get stiff because or the pain or it can even reach to the entire foot, which is really painful to even think.
- Heel Spurs: Chronic inflammation leads to development of heel spurs, which are bony growth on the heel bone.
- Altered growth: Walking with pain is really painful and to avoid this people change the way they walk which is called changing gait. They might to this on purpose or without knowing, while it’s not a bad thing, it can put pressure on the other parts of the body and can influence with body’s balance, which is obviously not good.
- Decreased Mobility: As we just mentioned, walking with pain is really difficult, thanks to discomfort, pain and change in gait which will surely lead in decreased mobility. As walking faster or taking big steps is much more painful, so you will try to walk slowly to avoid pain.
- Fascia Rupture: This is a condition where the tears on your fascia has increased a lot in number to the point your fascia will literally snap. Such condition is really painful and you probably won’t be able to walk, internal bleeding is possible, you might even notice bruising. If your rupture isn’t too serious then treatments like rest, and physical therapy can help. However, in severe cases surgery is important. So, make sure you get the treatment before it leads to a dangerous rupture.
danger signs for plantar fasciitis
Other athletes besides runners also have an increased risk of developing plantar fasciitis. Plantar fasciitis can also affect those whose employment require them to stand on hard surfaces, like teachers, nurses, and mail carriers.
Obesity, a sedentary lifestyle, high or low foot arches, and limited flexibility of the Achilles tendon or calf muscles are other risk factors.
Patients who desire to start an exercise routine are advised to be patient. To prevent issues like plantar fasciitis, always remember to stretch and move slowly.
How long does it typically take to recover from plantar fasciitis?
The recovery time for plantar fasciitis can vary significantly from person to person. Some individuals might experience relief from symptoms within a few weeks to a couple of months with appropriate treatment and self-care measures. However, for others, the recovery process can be more prolonged, extending to several months or even a year or more.
Several factors influence the duration of recovery, including:
- Severity: The severity of the plantar fasciitis, including the extent of inflammation and tissue damage, can impact the recovery time.
- Consistency of Treatment: Regularly following the recommended treatment plan, including exercises, stretches, footwear modifications, and any prescribed therapies, can expedite recovery.
- Compliance: Adherence to healthcare provider’s advice, such as wearing orthotic devices or night splints, plays a crucial role in the healing process.
- Underlying Factors: Factors such as obesity, foot mechanics, and overall health can influence the recovery duration.
Can plantar fasciitis reoccur after successful treatment?
Yes, plantar fasciitis can reoccur even after successful treatment. Several factors contribute to the possibility of recurrence:
- Foot Structure: Individuals with certain foot structures, such as flat feet or high arches, may be more prone to plantar fasciitis. Even with successful treatment, the underlying foot mechanics can continue to stress the plantar fascia, leading to a recurrence.
- Improper Footwear: Wearing shoes without proper arch support or cushioning can contribute to the recurrence of plantar fasciitis, especially if the footwear exacerbates foot stress.
- Intense Physical Activity: Engaging in high-impact sports or activities that put stress on the feet, especially without proper warm-up or stretching, can increase the risk of plantar fasciitis recurrence.
- Weight Gain: Excess body weight can strain the plantar fascia, and weight gain after successful treatment can lead to a recurrence of symptoms.
How Plantar Fasciitis Impacts Daily Activities?
Plantar Fasciitis can affect your daily activities in different ways, here’s how:
- Morning Pain: Plantar Fasciitis pain is most intense at the morning especially when you take the first step of the day. As the injured plantar fascia stretches after a long time and renews old tears, which makes walking especially in morning really painful?
- Standing: Standing is painful since there’s a constant discomfort on your foot, so you can’t stand still or comfortably. Plus this gets worse on harder surfaces since they don’t provide any fort of comfort to your injured feet.
- Difficulty In Walking: Of course you are in pain, especially a heel pain so it’s obvious walking won’t be the most fun task. This can get worse if you need to walk a long distance or run. In such situations, people may change their gait to avoid pain, but unfortunately this can cause pain in other parts of the body.
- Impact on Work: If you have a job that requires a lot of standing or walking, plantar fasciitis can easily decrease the quality of your work and may even make it impossible for you to work properly.
- Emotional Impacts: Chronic pain, not being able to walk properly and bad quality life can cause stress and frustration.
Can Age Affect The Likelihood Of Developing Plantar Fasciitis?
Yes, unfortunately plantar fasciitis is a lot likely to happen in older people, here’s now:
- Degeneration: Older people’s plantar fascia doesn’t have the same elasticity as young people, which makes it more prone to injury.
- Slower Healing: Older people often have slower healing, which makes it hard for the body to heal the tears in fascia.
- Increased Foot Stress: As you get older, feet’s natural padding decreases which puts much more pressure and stress on plantar fascia, making it even more painful.
What Are Risk Factors Of Plantar Fasciitis?
Its true that plantar fasciitis can be developed without any obvious cause! but there are some risk factors that can make you more likely to develop plantar fasciitis, if you are wondering what are those risks then here are some of them:
1. Obesity
It’s the leading cause if plantar fasciitis in young people! Excess weight puts a lot of pressure on your feet which makes it really hard for your facial to maintain pressure, which results into plantar fasciitis.
Plantar fasciitis is common in pregnant women too, but they don’t have to worry about it since once they are done with their pregnancy they won’t suffer from it again.
2. Aging
As we get older our body parts get older and weaker, which me and they can’t work the way they used too.
The same goes for our fascia too, so people over 40 are more likely to develop plantar fasciitis even if they don’t have any risk factors.
However, if you improve your blood circulation you can prevent more damage, so start working out.
3. Jobs That Doesn’t Provide Enough Rest To Your Feet
Jobs like teaching, nursing, or factory work requires standing for a long duration, sometimes all the day.
Standing for too long will put pressure on your feet which may stretch your fascia as well and if you don’t give enough rest to your legs then you may develop plantar fasciitis.
So try to take rest if you do such kind of jobs!
4. Heavy Exercises
Exercises are good but not if they are high impact ones. Exercises like long distance running and ballet dancing requires too much stretching of your feet which can develop plantar fasciitis easily.
But it doesn’t mean you should avoid these exercises, properly stretch before starting and take proper rest then you don’t face any kind of difficulty.
How To Prevent Plantar Fasciitis?
Preventing plantar fasciitis is the best treatment. Here are some actions you can take to assist stop the recurrence of plantar fasciitis.
- Don the proper footwear
- If required, think about using supporting inserts.
- reduce weight
- Maintain your fitness with low-impact exercises like yoga, walking, riding, and swimming.
- Every day, stretch your calf and foot muscles.
Why is my Plantar Fasciitis heel pain worse in the morning?
Plantar fasciitis is often the most painful in the morning because the plantar fascia, the tendon that runs along the bottom of your foot, contracts and tightens when it is not being used. When you step out of bed in the morning, the tightened tendon is overstretched. This overstretching causes microtears in the tendon, in turn causing inflammation and the pain that you are experiencing.
When To Look For A Doctor?
Chronic Heel Pain
Do you experience persistent heel pain? The time to call the doctor might be now. It’s necessary to contact a doctor if you find yourself resting your heel for extended periods of time yet still feel pain. Not just for the wellbeing of your heel but also for pain relief. Having pain can be a burden in and of itself, so do yourself a favor and seek assistance in reducing it.
A Long Time Has Passed
Have heel pain but it’s not constant or only when you put weight on it? Have heel pain but it’s not constant?
If after a week you are still in pain despite trying over-the-counter painkillers? It’s time to schedule an appointment if this is the situation with you.
Why does plantar fasciitis occur so frequently?
One explanation is that there is a greater awareness of the necessity for exercise, leading to more individuals incorporating running or walking into their daily schedules, along with an increase in obesity, which can place additional pressure on the fascia. They may not be using suitable stretching techniques or may not be wearing shoes with adequate arch support, which both increase their risk of developing plantar fasciitis.
What to expect from a consultation?
Most medical professionals will begin treating your Plantar Fasciitis by attempting to minimize pain as soon as feasible. A corticosteroid injection may be the first step towards fixing the problem. If not, the doctor might provide a second shot a few weeks later.
If nothing of those remedies relieves your discomfort, you might consider having surgery to address the problem. The long-term objective is to leave you pain-free, which is really all you can ask for while dealing with plantar fasciitis, even though you might have to take off that foot while your heel heals.
I saw an advertisement for ESWT in Pittsburgh and am wondering, what is the effectiveness of ESWT for plantar fasciitis?
In the experience of Pittsburgh podiatrists performing ESWT, there is an 88% success rate after 3 months following ESWT for plantar fasciitis. It is very unlikely that you would need to have a 2nd procedure done. Please take into account that ESWT in Pittsburgh is not a “cure all” and should not be used as the only means of healing. ESWT will give your body the tools it needs to effectively heal. However, you must help the healing process by continuing to stretch daily, icing in the evenings (after 3 months), and wearing supportive orthotics in your shoes.
How can I tell if my heel pain in Baltimore is from plantar fasciitis?
Several symptoms distinguish plantar fasciitis from other foot injuries or ailments. Common symptoms of plantar fasciitis in Baltimore include:
- Shooting or stabbing pain in the heel or arch of the foot
- Pain that is often worse with your first few steps in the morning or after long periods of inactivity
- Pain following exercise, not typically during exercise
If you suspect that you have plantar fasciitis in Baltimore, you can call 724-991-0116 for assistance in locating a podiatrist office in your area.
What should I try before ESWT in Long Island?
You should try and fail 3 conservative treatments including ice, stretching, cortisone injections, night splint, rest and physical therapy. If this doesn’t work, then ESWT in Long Island is an excellent safe and effective alternative to plantar fascia surgery.
How long does it take to recover from plantar fasciitis, and is it a chronic condition?
The recovery time from plantar fasciitis can vary widely depending on factors such as the severity of the condition, how well it responds to treatment, and individual factors. Here are some general considerations:
- Mild Cases: With early intervention and appropriate treatment, many individuals experience relief from symptoms within a few weeks to a couple of months.
- Moderate Cases: Moderate cases of plantar fasciitis may take several months for significant improvement. Consistent adherence to treatment plans, including stretching exercises, orthotics, and lifestyle modifications, is essential.
- Severe or Chronic Cases: Severe or chronic plantar fasciitis may require more extended periods of treatment and recovery. Some individuals may experience symptoms for a year or longer.
- Consistency in Treatment: Consistency in following the prescribed treatment plan is crucial for recovery. This may include rest, stretching exercises, physical therapy, orthotics, and addressing contributing factors like footwear choices.
- Individual Factors: Factors such as age, overall health, and adherence to recommended lifestyle changes can influence the recovery time.
Can plantar fasciitis affect both feet simultaneously?
Yes, plantar fasciitis can affect both feet simultaneously. While it is not uncommon for individuals to experience plantar fasciitis in only one foot, it is also possible for the condition to develop in both feet simultaneously. Factors that contribute to the development of plantar fasciitis, such as biomechanical issues, repetitive stress, or certain lifestyle factors, can affect both feet.
Key points to consider:
- Bilateral Symmetry: Plantar fasciitis often exhibits bilateral symmetry, meaning that similar conditions or stresses affecting one foot may also impact the other.
- Underlying Causes: Biomechanical issues, such as overpronation or high arches, may contribute to plantar fasciitis, and these factors can affect both feet.
- Repetitive Stress: Activities that involve repetitive stress on the feet, such as prolonged standing, walking, or certain exercises, can lead to plantar fasciitis in both feet.