Heel Pain Treatment

Acoustic Wave Therapy: The Advanced Treatment for Heel Pain

Acoustic Wave Therapy (by Storz Medical) is the MOST PROVEN treatment regimen for non-resolving heel pain and is gaining in popularity since it is completely non-invasive (no incisions) / non-surgical.

Developed in Germany over 20 years ago, Acoustic Wave Therapy (AWT) was previously known as Extra Corporal Shock Wave Therapy (ESWT) and had been used primarily for the dissolving of kidneys stones (lithotripsy). In early 2001, FDA approved ESWT for orthopedic after U.S. Medical research revealed the effectiveness of ESWT to be as successful as surgery for the treatment of tendon and ligament injuries. Today ESWT (now called AWT by Storz Medical Corporation) treatment now supersedes heel pain surgery due to its superior efficacy and safety.

The Answer is Acoustic Wave Therapy for Heel Pain

You've probably heard of the new technology that eliminates kidney stones through the use of soundwaves known as Lithotripsy. Now that same technology can be used to eliminate chronic heel pain (plantar fasciitis). Dr. Lee was the first doctor to bring ultrasound-guided shockwave therapy to the West Coast as the founder of SoCal ESWT, a physicians group specializing in the use of shockwave therapy for plantar fasciitis and Achilles tendon pathologies. Dr. Lee has an 18 year successful track record utilizing shockwave therapy for the treatment of ankle and foot tendon pathologies.

How does Acoustic Wave Therapy work?

Acoustic Wave Therapy (AWT) is a noninvasive, non-surgical option for the treatment of intense and relentless heel pain associated with the chronic condition known as Plantar Fasciitis.

The Plantar Fascia is a strong ligament structure (tensile strength of 4000 lb/ sq. inch) that helps to maintain the structure and arch of the foot. It extends from the base of the toes to the heel bone or calcaneus bone.

The Plantar Fascia is almost as wide as the foot and plays an important role in the support of the foot.

Plantar Fasciitis is the condition caused by overuse or injury. When the Plantar Fascia is strained due to overuse, improper shoes, or poor foot structure it gets irritated and tender. The resulting inflammation causes the symptoms of pain that include: a burning sensation on the sole of the foot, and recurring foot pain especially after getting out of bed in the morning or sitting.

Plantar fasciitis is clinically diagnosed by a physician, based on patient history and examination.

Treatment with AWT focuses high intensity sound waves (“shockwave”) into the tissue being treated around the fascia, near the heel. The stagnated injury that was causing the pain becomes an acute inflammation whereby the body responds by increasing circulation and cellular metabolism around the affected soft tissue. The stimulation of the body’s own healing process is accentuated creating the formation of new blood flow to the injured tissues thereby accelerating the healing process and finally leading to complete healing of the tissues. In contrast to heal pain surgery, AWT truly heals the ligament and creates strength rather than weakness. Once the strength of the fascia returns, the pain resolves completely.

The treatment regimen consists of a 20 minute Therapy Session performed once a week for 3 weeks. Typical healing results are seen at 6-8 weeks after the last AWT treatment.

Links to information about Acoustic Wave Therapy:
https://www.eswt.info/en/
https://www.stosswellen-praxis.com/en/orthopaedics/articles/foot.html

Studies on the use of Shock Wave Therapy:
https://www.storzmedical.com/en/disciplines/orthopaedics/literature.htm

Heel Pain Frequently Asked Questions

There are several common causes of chronic heel pain. They are: inflammation of the plantar fascia (plantarfasciitis), stress fracture of the heel bone, Achilles tendonitis, nerve compression, and inflammation of the small muscles of the foot. Often there are combinations of these areas involved. The exact cause for each person needs to be evaluated by a specialist. The specific cause of heel in each case determines the type of treatment regimen and the prognosis.

What can be done about chronic heel pain?

The initial treatment of chronic heel pain by Dr. Lee may include a combination of stretching exercises, oral anti-inflammatories, arch taping, custom arch supports (orthotics), night splints, and injections.

If after a consistent attempt at these treatments a new "no incision" procedure called E.S.W.T. can be performed. E.S.W.T. is the alternative to incisional surgery based on the technology used in non-invasive kidney stone removal. This 15 minute procedure allows patients to return to work almost immediately, has no incision to heal, and allows walking in regular shoes immediately. E.S.W.T. replaces most of the necessity for "Endoscopic Plantarfasciotomy" (EPF) or Bone Spur Surgery.

I had a friend who had a shot for his heel pain. He said it was extremely painful. Is that true and why?

It is true that most people experience exceptional discomfort while receiving an injection in the heel. The main cause of this is due to pushing in the medicine too quickly (pressure). If the injection is done slowly to allow the pressure in the heel area to dissipate while injecting the amount of pain caused by the shot is decreased by almost 95% . If the doctor is giving you the injection very slowing (over 3-5 minutes) then he is doing a great job because you won't have much discomfort!

Some clinicians contend that the cause of pain is due to the acidity of the medication, however, in my experience I have found the contribution of acidity to pain to be virtually none.

I have sore feet and arches. Do those arch supports or inserts on TV or in the stores really work?

Sometimes. The Over-the-counter pre-made arch supports are designed as a "one size fits fits all" type device so that they can mass produce them for the public. In minor conditions where the problem is only mild these devices can be effective. However, if they do not solve the pain or problem within a few weeks they probably won't work.

The design of these products vary from company to company and sometimes offered with certain gimmicks or "magic" designs. Don't fall for these as a reason to get a better product. One may spend anywhere from $25 to $300 for these pre-made devices.

My advice:

- Do not to pay more than $50 for them. They aren't worth much more than that. - If they don't work the first time, don't go out and try a different one potentially wasting your hard earned money. Rather, see a Podiatrist and have a professional opinion rendered. Often times a custom support (orthotic) needs to be made and most insurances cover them. If you don't have insurance the cost of custom orthotics are between $350 and $500.

I have several pairs of those custom orthotics and they've never worked. Why not?

The effectiveness of an orthotic device depends on three issues:

I heard from my friend that shots in the foot are painful. Is that true?

Unfortunately, most doctors cause severe pain with injections to the foot. This just doesn't have to be. Dr. Lee has perfected a technique that is virtually painless. REALLY! Combined with a gentle touch and a cold spray that numbs the skin thousands of patients have testified that his injections are remarkably painless.

Achilles Tendon Stretches

Achilles Tendon Stretches*