The Center for Podiatric Care and Sports Medicine

Long-Term Effectiveness of Extracorporeal Shockwave Therapy For Plantar Fasciitis

Posted by on Thursday, June 27th, 2013


The Center for Podiatric Care and Sports Medicine offers New York City residents the most advanced therapies and treatments for a wide range of sports injuries, foot problems and chronic conditions. Plantar fasciitis (or severe heel pain) is one of the most common conditions we see here. Often, plantar fasciitis is caused through repetitive motion or overuse, which creates micro-tears in the plantar fascia tendon that runs from the heel along the arch of the foot. Sometimes wearing worn-out shoes can be to blame as well. One of the treatments we’ve seen some success with is Extracorporeal Shockwave Therapy (ESWT).


Scientific Evidence

A study by Dr. Lowell Weil Jr. DPM found that 82% of patients treated with ESWT found pain relief, compared to 83% of the patients who underwent percutaneous plantar fasciotomy surgery. However, the group that received shockwave therapy for plantar fasciitis were able to return to work and resume daily activities much quicker than the foot surgery group.

Dr. Weill also presented the results of a long-term study on ESWT for heel pain at the 2010 American College of Foot and Ankle Surgeons Annual Scientific Congress. This study concluded that 87.5% of the 75 patients who received shockwave therapy were either “satisfied” or “very satisfied” with the results of their ESWT treatments nine years later.

Of these satisfied patients, 24% were able to discontinue all aspects of maintenance treatement, including support devices, special shoes, medication, orthotics and physical therapy. Another 24% of the patients were able to maintain a 95.8% improvement, while the remaining 76% of patients continued heel pain treatments with a 79.9% overall improvement.

A study out of Taiwan found that, after more than five years, 82.7% of ESWT patients reported results that were either “excellent” or “good.” Only 11% of the group reported poor results, compared to 9% in the control group. Even more impressive, they found the heel pain recurrence rate for the control group was 55%, but only 11% in the ESWT group.

A study from Austria found the success rate climbed over time. After six weeks, 81% of patients reported successful pain reduction. Shortly thereafter, 88% reported improvement. At the final phone followup after 73 months, 96% of the patients said their heel pain felt dramatically improved.

What Is Extracorporeal Shockwave Therapy Like?

People have described ESWT as the feeling of a baseball bat tapping their feet. The podiatrist will use a gun and tube attached to an air compressor to deliver shockwaves to the foot at a rate of about 10 times per second. This sensation prompts the body to direct resources there in order to heal itself faster.

How Much Does ESWT Cost?

Generally speaking, the cost can range from $900 to $3,000 for ESWT, depending on the number of sessions needed, your geographic location, and the severity of the condition. However, keep in mind that you do not have to pay a facility fee or anesthesia fee with ESWT, nor do you have a risk for additional expenses related to complications or much down-time from work. You will need to check with your insurance provider to see if this cost is covered on your policy. Some health care companies refuse to look at the mounting evidence suggesting shockwave therapy as a noncontroversial, proven treatment for plantar fasciitis, while others — like Emblem Health, for instance — will only cover ESWT in cases of plantar fasciitis or epicondylitis.


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.