When conservative care methods like physical therapy, orthotic insoles, shoe modifications, stretching, and cortisone injection fail to provide relief, a variety of advanced treatment options are available for heel pain.
Advanced Tissue Repair Services:
Shockwave Therapy
The process of shock wave therapy involves the application of ultrasound energy by a healthcare professional to an inflamed area in your body, which results in the creation of microtrauma in that specific area. This microtrauma stimulates a healing response in your body.
The body has the ability to respond to shock wave therapy by:
- Create new blood vessels that bring more blood and nutrition to the inflammation.
- Receive hyperstimulation of nerve endings, resulting in immediate pain reduction.
- Break down calcifications.
- Increase cell permeability for increased healing.
Shock wave treatment provides a noninvasive approach to significantly reduce pain and other symptoms associated with plantar fasciitis. Therefore, it serves as an excellent alternative for individuals who prefer not to take medication or undergo invasive surgical procedures.
According to a small study conducted in 2021, shock wave therapy appears to be a viable treatment option for plantar fasciitis. The study revealed that undergoing four shock wave therapy sessions resulted in a decrease in the thickness of the plantar fascia and alleviated symptoms of inflammation in the affected area.
Procedure for shock wave therapy for plantar fasciitis
Shock wave therapy is a noninvasive procedure that takes place externally on your body. It is conducted on an outpatient basis, allowing you to return home once the treatment is finished.
Before a shock wave procedure, it is not necessary to follow any particular steps. However, it is recommended to arrange for someone to accompany you to and from the appointment as you may receive local anesthesia or a sedative.
Once you reach the facility for your treatment, here is typically what you can anticipate from the procedure:
- You’ll be asked to remove your socks and shoes.
- You’ll lie flat on a cushioned table, with your stomach down and your legs supported by a pillow.
- You’ll receive either a sedative or local anesthesia in your heels so that you don’t feel pain during the procedure.
- You’ll have ultrasound gel applied to your heels.
- A technician will use a specialized probe to deliver compressed air shock waves to your heels.
The duration for each foot of the procedure usually ranges from 10 to 20 minutes.
As the shock waves enter your heel, you may experience a slight discomfort. The number of shock wave sessions you may require depends on how severe your plantar fasciitis pain is. This could range from two to four additional sessions.
How effective is shock wave therapy?
When considering the sequence of thoughts, shock wave therapy is commonly believed to offer symptom relief for approximately 44% to 80% of individuals who undergo this treatment, according to a trusted source.
A 2021 study suggests that shock wave therapy is generally effective for treating plantar fasciitis. However, the varying outcomes indicate that it may not be effective for every individual.
A recent study conducted in 2020 suggests that shock wave therapy is linked to a fast pain reduction. Findings from various studies indicate that the most effective methods of shock wave therapy in alleviating symptoms are focused shock wave therapy (FSW) and extracorporeal shock wave therapy (ESWT), as stated in a research conducted in 2017.
Many individuals afflicted by plantar fasciitis who have undergone shock wave therapy often report a significant reduction in pain, and this is further substantiated by case studies validating these accounts.
However, there is currently a lack of extensive research and empirical evidence to support these findings and personal accounts. The effectiveness of shock wave therapy in producing long-term effects years after the treatment remains unclear, as studies have yielded inconclusive results.
A case-series study conducted in 2018 suggests that the effectiveness of shock wave therapy could potentially be enhanced by utilizing it alongside other treatments. Physical therapy combined with shock wave treatment, for instance, may contribute to prolonged and sustainable healing.
What are the pros and cons of shock wave therapy?
Although shock wave therapy has many potential benefits, it may not be the optimal solution for every individual.
– Has several advantages – Provides numerous benefits – Offers various advantages – Comes with multiple benefits – Presents several advantages – Brings several benefits
- is a noninvasive treatment with minimal preparation and recovery needed
- resolves pain quickly
- is considered safe
- has a lower risk of complications than medication or surgical treatments
- can help people with plantar fasciitis avoid unnecessary surgery
When considering shock wave therapy, it is important to take into account some of its drawbacks.
- It’s not effective for everyone.
- You may need multiple treatments over time to see significant results.
- Many insurance companies don’t cover shock wave therapy.
- Treatments can be expensive without insurance coverage.
- Complications can include temporary pain, bruising, swelling, and numbness.
PRP (Platelet Rich Plasma) Injection Therapy
Platelet rich plasma therapy, also known as PRP therapy, is an advanced and innovative approach used to treat chronic pain and plantar fasciitis. In cases where conservative treatments have been ineffective, it is possible that there is a lack of blood supply essential for healing, as well as the presence of chronic scar tissue in the affected area. Essentially, the body perceives the damaged region as the new normal and fails to initiate the healing process. The objective of platelet rich plasma treatment is to enhance blood supply and promote the growth factors needed for healing in the damaged plantar fascia.
Treatment is conducted in the office using ultrasound guidance to accurately position the material in the desired area of persistent scar tissue. Blood is drawn from the arm, similar to lab work blood draws, to obtain the required blood. The blood is then processed in a specialized machine to concentrate the PRP cells, which are subsequently injected back into the damaged tissue. Following the injection, measures are taken to safeguard the patient from pain and swelling, as well as to manage stress on the area during the healing phase.
Stem Cell Therapy
The field of medicine has been significantly advanced by the injection of mesenchymal stem cells, more so than any other single treatment in the past ten years. Stem cells, which are responsible for tissue building and repair, play a crucial role in various medical improvements, such as vision correction and enhancement of liver function. These stem cells can be found in body fat as well as bone marrow. The method we prefer involves extracting the stem cells from the bone marrow using a small needle while the patient is under local anesthesia. Subsequently, the bone marrow is spun in a specialized machine to concentrate the stem cells, which are then injected back into the plantar fascia region. This process helps increase the number of healing cells in the area and significantly reduces swelling. Although complete pain resolution may take 4-6 weeks, most patients typically experience a positive response within the first two weeks of treatment.
Relef Procedure
Rel?F (pronounced relief) is the trade name for a radio frequency procedure used to treat damaged soft tissue, specifically the plantar fascia in cases of plantar fasciitis. This procedure utilizes radio frequency technology to break up scar tissue in the plantar fascia and applies heat to increase blood flow and promote healing. The skin is kept cool through a patented liquid mist technology while the probe transfers heat to deeper layers of tissue. This procedure is performed in an office setting without the need for anesthesia. Following the procedure, a boot is worn to protect the foot for approximately one week. In some cases, it may be necessary to undergo two procedures to fully resolve plantar fasciitis.
Tenex Procedure
The Tenex procedure involves removing scar tissue and improving blood flow in the plantar fascia. Chronic scar tissue is common in cases of severe plantar fasciitis. The procedure utilizes ultrasound technology and a patented suction device to break up and remove scar tissue. It can be performed in the office with local anesthesia or in a surgery center with mild sedation. The process starts with a small needle hole in the heel, where a probe is inserted into the scar tissue area under ultrasound guidance for precise placement. The scar tissue is then broken up and suctioned out of the heel. After the procedure, the foot is placed in a boot for protection for 1-2 weeks. Typically, it takes around 4 weeks for the heel pain to fully resolve.
