The Center for Podiatric Care and Sports Medicine

Catch the Extracorporeal Shockwave

Posted by on Monday, April 23rd, 2012


We live in an impatient world. People tap their feet anxiously as thirty seconds tick off a microwave. A line of two people in a coffee shop is enough to make the third person start to sigh and grumble. We groan when it takes more than three seconds for a web page to open. These are tough times to to be a turtle.

This is true in medical treatment as well. When people hear that a procedure will put them in a cast or on crutches for five, six weeks, their jaws drop as they try to comprehend. “Five weeks? But I’m doing a marathon in three. Okay, doc, what can you do to make this thing heal faster?” We have lost all patience with our bodies and their annoying tendency to want nature to take its course.

With that in mind, doctors are always looking for new methods of treatment that will get patients up on their feet faster. And since this is a podiatry blog, we mean “up on their feet” in the most literal way possible!

So today let’s talk about Extracorporeal Shockwave Therapy as a method of treating plantar fasciitis.

Wait, what? Extracorporeal Shockwave Therapy.

Umm…okay…what was that for? Plantar fasciitis. Let’s review that really quickly.

The plantar fascia is the thick band of tissue that connects your heel bone to your foot bone. It runs across the bottom of your foot. Plantar fasciitis is when the plantar fascia becomes irritated. It is characterized by heel pain. Traditional treatment of plantar fasciitis includes rest, ice, anti-inflammatories, orthotics in the shoe to help support the plantar fascia, and calf stretches to help loosen up the tight calf muscles that can cause plantar fasciitis. In extreme cases, there are some surgical treatments, such as the removal of heel spurs that can be caused by plantar fasciitis, or sectioning of the plantar fascia.

What is Extra…whatever? Extracorporeal Shockwave Therapy. Let’s make it easy and call it ESWT.

ESWT is the administration of shock waves to the painful or injured area (that’s acoustic waves, not, thankfully, earthquake shock waves). These are usually given in three treatments, twice with shock waves at such a low intensity that the patient feels little to no pain, and once with high intensity shock waves that will require either general or local anesthesia. Check this blog for a video showing EWST.

Why would this work? The idea is that the shock waves will create a microtrauma in a part of the body that will then spur on the body’s healing action, for example increasing blood flow to the area. In other words, it tricks the body into trying to heal itself more quickly. This is similar to the microfracture surgery many athletes have had, where tiny holes are drilled in their bones in order to stimulate the growth of new cartilage.

When would you use this for plantar fasciitis? Podiatrists will first try to treat plantar fasciitis with the standard rest, ice, orthotics, stretching course of action. Only when that fails will other treatments be considered.

At that point it comes down to which is better, surgery or EWST. Studies have found both to be similarly effective, so then other factors come into play when making the choice. Here are some pros and cons to consider:

  • Pro EWST Traditional surgery requires a longer healing period, a longer time with a foot in a cast and unable to bear weight, and risks such as infection of the wound. EWST has none of these risks, with patients typically able to wear normal shoes and put weight on their feet in a day or two.
  • Con EWST It’s fairly expensive and many insurance companies don’t cover it.

There are also patients out there who have had EWST and felt it was ineffective or not as effective as they had hoped. The key to making sure EWST works is to make sure you choose a podiatrist who is very experienced with the procedure and knows how to get the most out of it. The podiatrists at The Center for Podiatric Care and Sports Medicine (212.996.1900) have been using EWST for a number of years with a great deal of success and know how to get the most out of it for each patient.

If you have plantar fasciitis, and are not sure what to do, contact the podiatrists at The Center for Podiatric Care and Sports Medicine to discuss the right course of treatment for you, including EWST. Dr. Josef J. GeldwertDr. Katherine Lai, and Dr. Ryan Minara have helped thousands of people get back on their feet.


If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.