What is Extracorporeal Shock Wave (ESW) treatment?
"Extracorporeal" means "outside the body". Shock waves are created
by very strong acoustic (sound) energy. Your ESW treatment will
be performed with a device called the OssaTron.
The OssaTron is a shock wave generator,
very similar to the shock wave devices used to treat kidney stones
without surgery. The shock waves are created by a spark plug that
is enclosed in a soft plastic dome filled with water. During ESW
treatment, this dome is placed against the heel so that the shock
waves pass through to the heel. ESW treatment has recently been
found to be effective to treat chronic proximal plantar fasciitis,
a condition that causes pain in the heel of the affected foot
and is sometimes referred to as "heel spurs".
What other treatments are available for
treating chronic proximal plantar fasciitis?
Many patients w/ heel pain get better after trying one or several
conservative treatments, which include:
Non-steroidal anti-inflammatory medications (NSAID’s),
such as Celebrix, Mobic, Arthrotec, Padding and strappings, plantar
night splints, Non-prescription medication, e.g., Advil (ibuprofen)
or Aleve (naproxen), steroids, e.g.,(Cortisone) injections, and
Orthotics
In difficult cases of chronic proximal plantar fasciitis, open
or arthroscopic surgery may be performed.
Who should consider having ESW treatment
for proximal plantar fasciitis?
ESW treatment with the OssaTron is for patients who have had heel
pain for at least 1-3 months and who have tried other methods
for treating their heel pain. In the OssaTron clinical study,
the treated patients had failed to respond to at least three attempts
at conservative treatment: two prior courses of non-invasive treatment,
including physical therapy, antiinflammatories or the use of an
orthotic device; and one prior course of pharmacological treatment.
ESW treatment with the OssaTron is for patients who can tolerate
anesthesia prior to the ESW procedure. ESW treatment with the
OssaTron causes some pain or discomfort.
Who should NOT have ESW treatment for
proximal plantar fasciitis?
Anyone taking medications that may prolong
or interfere with blood clotting
Anyone with a history of bleeding problems
Children
Pregnant women
Because the OssaTron has not been tested
on people who have the following conditions, its effect, safety,
and effectiveness on someone who has one of the following conditions
is unknown:
Tarsal tunnel syndrome, or other nerve entrapment
disorders (damage or pressure on the nerves to the foot)
Diabetic neuropathy (nerve damage due to diabetes)
Fracture of the foot or ankle
Significant peripheral vascular disease (problems with the circulation
in the blood vessels in the legs)
Severe osteoarthritis
Rheumatoid arthritis Osteoporosis
Metabolic disorders
Malignancies
Paget's disease
Osteomyelitis
Systemic infection
Dr. Galluzzo or Dr. Rodriguez can provide you with additional
information about these and other conditions, and how they might
affect the decision to perform ESW treatment.
What are the side effects and complications that
could happen?
The ESW treatment may cause skin reddening
or bruising of the treated foot, which usually clears within a
few days.
The ESW treatment may cause numbness or tingling in the treated
foot.
The ESW treatment may not help heel pain in your case. You may
have episodes of pain similar to the pain you had before treatment.
The pain may continue for a few days to several weeks after treatment.
What will happen on the day of the ESW
treatment?
Dr. Galluzzo or Dr. Rodriguez will probably ask you to come to
the hospital or surgery center a few hours before the ESW treatment
is scheduled. You should wear shorts or loose fitting clothing
that can easily be rolled up to the knee of your affected leg.
Otherwise, you may be asked to change from your own clothes into
a hospital gown. The staff may take your temperature, pulse and
blood pressure and ask you some questions about your general health.
They will also make sure you have signed a consent form for the
ESW treatment.
The ESW treatment may cause some pain or discomfort, so an anesthetic
is commonly given before the procedure. Usually, this will be
either a local anesthetic or with an IV local sedation and a local
anesthetic called a heel block.
An ESW treatment for chronic proximal plantar fasciitis usually
takes about 20 minutes. The ESW treatment is performed as an outpatient
procedure; no overnight hospital stay is necessary.
What will happen after the ESW treatment?
You should restrict stressful activity involving the treated foot
for up to 4 weeks after treatment. “Stressful activity”
may include running or jogging, doing heavy housework or yard
work, and participating in sports. Some patients need a mild pain
medication following ESW treatment. Although some patients in
the clinical study felt immediate relief from pain after the ESW
treatment, it is more common for it to take up to 6 weeks for
pain relief to begin.
I have more questions about ESW treatment
for heel pain. How can I get more information?
Talk to your doctor, if you have any questions. In order to use
the OssaTron to treat chronic proximal plantar fasciitis, your
doctor had to complete a specialized training program. The training
program not only allowed your doctor to learn how to perform the
ESW treatment, but it also included information about shock wave
energy in general, and information from the OssaTron clinical
study. Therefore, your doctor is the best person to talk to if
you have any questions or concerns about ESW treatment for chronic
proximal plantar fasciitis with the OssaTron. |
