Patient Education

Extracorporeal Shock Wave Therapy

Description

If you’ve ever stood next to a subwoofer or felt your insides vibrate with a particularly close thunderclap, you know that sound has the power to reach inside you. What you may not know is that sound can also be used for healing.

Extracorporeal Shock Wave Therapy, or ESWT, (not to be confused with Extraterrestrial Shock Wave Therapy, for which you need flying saucers) is related to the kind of shock wave therapy performed on people with kidney stones or gallstones. In those cases, sound is used to disintegrate the painful stones that are causing trouble, all without harming the soft tissue around the stones, which is no mean feat. In contrast, ESWT is most often used to treat soft tissues, such as injured tendons and ligaments. So, rather than shattering stones into little tiny bits, your podiatrist may use Extracorporeal Shock Wave Therapy to pass sound waves into damaged tissue, bypassing healthy tissue entirely and stimulating the healing process.

If you opt for ESWT, you’ll get to be treated with a fancy-looking machine, be healed by sound waves, (and really-how amazing is that?), and may even be able to avoid going under the knife. Lucky, lucky you. (And those treated by flying saucers are luckier still.)

Uses

ESWT, at least as far as human feet are concerned, is most commonly used to treat plantar fasciitis (also known as heel spurs). Plantar fasciitis develops when the plantar fascia, or the tendon that runs along the bottom of the foot, becomes damaged. Your podiatrist may treat this condition using several different methods, including immobilization (typically by using casts), shoe supports (including orthotics), and anti-inflammatory medications. However, if these methods don’t substantially decrease your pain, then ESWT may be a much less invasive alternative to surgery. Because the procedure is performed entirely from outside the body (that’s where the ‘extracorporeal’ bit comes from), you can avoid all that nasty business with scalpels.

What to Expect

The machine used in ESWT may look like something out of a science fiction movie. (You may even expect it to rumble around saying, “Danger, Will Robinson!”) However, let’s face it, a lot of medical equipment looks a little like that. Rest assured that the machine is not a set piece – it will actually work to help heal your foot.

Before getting started, your podiatrist will probably inquire about where exactly you’re experiencing pain. This will help him or her to pinpoint exactly where the damage is in your foot. He or she may also use imaging techniques (ultrasound often comes equipped on the ESWT machines) to pinpoint the area needing those sound waves. In fact, the podiatrist may use ultrasound throughout the procedure to keep a close eye on things while the sound waves are actually doing their work. A numbing agent may be applied to your foot in order to avoid discomfort during the procedure. You may also get slathered with gel (or rather, just your foot-slathering all of you in gel would be less effective and kind of uncomfortable).

Once all the prep work is done, it’s time for your foot to encounter the therapy head, or the part of the machine that actually sends out the shock waves. The therapy head is generally filled with water, so it’ll give a little bit when pressed against your skin. Sometimes the therapy head is handheld, and in other cases you may put your foot on top of it while you recline. Then, shock waves will be sent through the therapy head into your foot. Some patients experience some discomfort or pain during the procedure, or for a bit after the procedure, although for most the numbing shot should prevent that. You may also experience some reddening, swelling or bruising in the area for a short while after treatment.

Recovery time after this procedure is gradual, since the healing stimulated by the procedure needs time to take place. Most patients notice significant improvements over a period of about thirteen weeks, although some experience a surcease of pain in as little as a day, and some may need months to fully heal, and might even require additional treatments after the first. Each situation is unique. ESWT seems to be quite effective in many cases. In some studies, it’s been shown to be approximately 80% to 90% effective at eliminating symptoms in patients whose plantar fasciitis didn’t respond to other treatments.

Obviously, Extracorporeal Shock Wave Therapy isn’t necessarily the best treatment for everyone. Your podiatrist will be able to offer you sound advice on the things that will help your particular injury to heal most effectively.