While there are a number of treatments available for plantar fasciitis, many do not provide satisfactory results for the patient and some have undesirable side effects. Shockwave therapy has been shown to be a safe and effective treatment for plantar fasciitis.
What is plantar fasciitis?
Plantar fasciitis is a common cause of plantar heel pain in patients. It is a condition where the plantar fascia ligament becomes irritated, inflamed, thickened and very painful. The plantar fascia is a strong and fibrous structure that runs along the base of the foot, connecting the heel bone to the toes at the ball of the foot. Its purpose is to assist with distributing forces and weight as a person walks, and to support the arch of the foot.
Plantar fasciitis is usually the result of overuse or repetitive strain on the plantar fascia ligament. It occurs most commonly in females, middle aged people, people whose occupations require them to be standing for extended periods of time, those with either flat feet or high arches, and people who engage in a lot of running and walking.
Plantar fasciitis causes a characteristic sharp, hot, stabbing pain at the plantar aspect of the heel (the part where the ligament attaches to the heel bone). Most commonly, patients report the pain is worse in the mornings as they get out of bed, or after a period of rest.
What is shockwave therapy?
Shockwave therapy (also known as extracorporeal shockwave therapy, ESWT) is a treatment that is used across many medical fields. Using a hand-held probe, the sports podiatrist directs high energy sound waves into the patient’s affected area that is requiring treatment. The energy promotes tissue healing and regeneration, stimulates blood flow to the area, and provides the patient with almost instant pain relief.
What are the benefits of shockwave therapy for plantar fasciitis treatment?
Clinical studies have demonstrated shockwave therapy to be an effective treatment for plantar fasciitis. It is a treatment that is championed by many medical professionals including sports podiatrists, because of its efficacy and safety with lack of side effects. Numerous studies have documented the reduction in the thickness of the plantar fascia with chronic plantar fasciitis1,2, which is indicative of healing. A number of studies have also determined that shockwave therapy is an effective treatment in reducing pain for plantar fasciitis sufferers2,3,4. It is a non-invasive treatment and one which can be conveniently performed in-clinic during your consultation with your sports podiatrist.
Is shockwave therapy for plantar fasciitis painful?
Whilst some patients experience slight pressure or discomfort, the treatment is not generally painful. Given that shockwave therapy only usually lasts for around five minutes a session, most patients are able to tolerate it quite well. You should communicate any discomfort to your sport podiatrist as they also have the ability to reduce the intensity of the treatment, and increase it gradually over the course of your shockwave therapy sessions as you become more tolerant.
How many sessions of shockwave therapy for plantar fasciitis are required?
Since the effect of shockwave therapy is cumulative, you will need more than one. Most patients have between three to six sessions, however sometimes more are required depending on the severity and complexity of a condition. Most patients do however experience some pain relief after just one session. Your sports podiatrist will advise you as to how many sessions you will require and what the frequency of these will be. Sessions are usually around a week apart for treatment of plantar fasciitis.
Readers are advised that the information regarding shockwave therapy for plantar fasciitis treatment that is detailed above is for educational purposes only and should not be taken as general medical advice. If you have been diagnosed with plantar fasciitis or wish to discuss the potential benefits of shockwave therapy for your condition, you should make an appointment with a qualified sports podiatrist. Appointments can be made online at https://www.sydneyheelpain.com.au/book-online/ or by phoning (02) 93883322.
Further reading and references
1Vahdatpour, B., Sajadieh, S., Bateni, V., Karami, M., Sajjadieh, H., (2012), Extracorporeal shock wave therapy in patients with plantar fasciitis. A randomized, placebo-controlled trial with ultrasonographic and subjective outcome assessments, Journal of Research in Medical Sciences, 17(9), 834-838.
2Hammer, D. S., Adam, F., Kreutz, A., Rupp, S., Kohn, D., Seil, R., (2005), Ultrasonographic evaluation at 6-month follow-up of plantar fasciitis after extracorporeal shock wave therapy, Archives of Orthopaedic and Trauma Surgery, 125(1), 6-9.
3Lou, J., Wang, S., Liu, S., Xing, G., (2017), Effectiveness of extracorporeal shockwave therapy without local anaesthesia in patients with recalcitrant plantar fasciitis: a meta-analysis of randomized controlled trials, American Journal of Physical Medicine and Rehabilitation, 96(8), 529-534.
4Agil, A., Siddiqui, M. R., Solan, M., Redfern, D. J., Gulati, V., Cobb, J. P., (2013), Extracorporeal shock wave therapy is effective in treating chronic plantar fasciitis: a meta-analysis of RCTs, Clinical Orthopedics and Related Research, 471(11), 3645-3652.
Written by Karl Lockett