Plantar fasciitis is an inflammation of the tissue that runs across the bottom of the foot and connects the heel to the toe. It is a common problem for runners, and it causes pain in the heel and sometimes the arch of the foot. If plantar fasciitis symptoms do not improve after six months of traditional physical therapy techniques, physicians may prescribe extracorporeal shock wave therapy (ESWT).
History
The ESWT technique comes from lithotripsy, a technique that uses sound waves to break up kidney stones that are too large to be passed. The use of sound waves to treat problems with the bones, joints, muscles and connective tissues ("musculoskeletal" problems) was developed in Europe in the early 1990s, and plantar fasciitis was the first musculoskeletal problem for which the FDA approved treatment with ESWT.
Features
ESWT for plantar fasciitis uses shock waves to cause tiny injuries within the plantar fascia in order to stimulate healing, although no one is certain exactly how it works. The treatment is noninvasive and uses a probe that is gently rubbed over the affected area.
ESWT can use either high-frequency or low-frequency shock waves. Therapy with high-frequency shock waves may only require one treatment session, while low-frequency ESWT usually requires repeated visits. Your physician will decide how many treatments to use. ESWT can be done in the doctor's office and doesn't require any anesthesia.
ESWT is generally used for patients whose plantar fasciitis symptoms have not improved after six months or more traditional therapy. ESWT is used as an alternative to surgery.
Alternatives
Traditional therapy for plantar fasciitis can include rest, applying ice to the plantar fascia, taking anti-inflammatory medications, and using exercises to stretch the calves and Achilles tendon or strengthen the muscles in the foot. Studies have shown that night splints that stretch the calves are an effective therapy for plantar fasciitis. Orthotic devices worn in the shoes can also be helpful for people with plantar fasciitis. These conservative treatments are successful for 80 to 90 percent of plantar fasciitis sufferers; ESWT could be an option for the 10 to 20 percent for whom conservative treatments do not work. In rare cases, if no other form of treatment works, surgeons may operate on the foot.
Prevention/Solution
It is important to pay close attention to any activities that may cause heel pain, such as running, jumping, or being on your feet for long periods of time. Keeping a pain journal in which you record your activities and how you feel can help you to notice which activities cause heel pain or make it worse.
Wearing the right shoe is important for people who are prone to plantar fasciitis, especially runners. Shoes that do not provide proper arch support can make it much easier to develop plantar fasciitis.
Runners who do not stretch adequately often develop tight muscles in the back of their legs, and this can lead to plantar fasciitis. Runners should do gentle stretching daily, especially of the hamstrings and calves.
Considerations
While many people feel that ESWT has helped their plantar fasciitis heel pain, there is still no widespread agreement among scientists about how effective it is. ESWT is also more costly than traditional methods of treatment, and it can have side effects like pain, tingling, swelling or bruising, although side effects are rare and generally mild. For these reasons, it is best to try more conservative treatments for six months before considering ESWT, and to use ESWT as a way to try to avoid surgery if other therapies do not work.
Tags: plantar fasciitis, plantar fasciitis, conservative treatments, heel pain, shock waves, after months