When your
feet hurt, you hurt all over! Nowhere perhaps, is this old saying more true than
in the case of heel spur - plantar fasciitis syndrome, where each step, all 12,000
to 18,000 a day, often on hard, unyielding, concrete floors is painful.
There
is almost an epidemic of heel spur pain (plantar fasciitis) seen in podiatry offices
each and every day in this country. The aging of the baby boomers, 10-hour (and
more) days at work on hard floors, the overweight population, and aerobics ect.
have all contributed to this painful debilitating problem in America. Most of
the patients with this painful condition are helped with very conservative office
therapy, including anti-inflammatory medications, cortisone injections, orthotics
(shoe inserts), stretching and or physical therapy. Podiatrists believe that over
90% of painful heel patients should improve with these traditional therapies.
For more information on these treatments, please see my article on heel
pain.
For the last two years, a new and exciting modality in the United
States of non-surgical treatment has been available for the heel pain sufferer.
This method has been used and studied in Europe for many years, and was approved
in this country by the FDA (in October 2000) as effective in the treatment of
plantar fasciitis if other conservative therapies have failed. This new and exciting
method is Extracorporeal (out of the body) Shock Wave Therapy or ESWT,
also just simply called shock wave.
For many years, it has been known that
high energy shock waves can have profound affects on the human body. During W.W.II,
it was noted that submariners suffered internal injuries when the submarine was
near an explosion, even though the sub itself was not injured. Studying this effect
led directly to the eventual development of medically effective shock wave therapy
and to the "crushing" of kidney stones" using this high energy.
This procedure is called lithotripsy. Physicians performing lithotripsy soon noted
new bone growth along the ribs that were exposed to the shock wave directed towards
the kidney. From this, they reasoned, the shock wave had an affect also on the
soft tissue-bone interface, and from this discovery, shock wave for soft tissue
and bone has evolved and is now called Orthotripsy.
Orthotripsy,
in Europe, can be used for chronic heel pain from plantar fasciitis, tennis elbow,
non-union of bones, avascular necrosis of bone, and Achilles tendonitis. In this
country, it has been approved for chronic plantar fasciitis, either with or without
heel spur when conservative therapy has failed. It has also been approved for
tennis elbow. There are several brands of machines available for use. Dr. Gurvis
uses the Ossatron equipment imported and owned by HealthTronics Company of Atlanta,
Georgia. This equipment delivers the highest "strength" of shock wave,
and is felt to be the best for the particular problem of plantar fasciitis. The
Ossatron uses what is known as the electrohydraulic method of generating shock
waves, and these are the higher energy waves. Some other pieces of equipment use
electromagnetic wave generation, and while still effective, they are of lower
energy.
It is important that other less costly methods of treatment are
attempted prior to the use of shock wave therapy, as they are usually effective.
Should you still have pain after conservative therapy, your doctor may offer you
the option of ESWT prior to suggesting surgery.
The Procedure
You are scheduled in an operating room and are administered anesthesia.
While you are asleep, headphones are placed to prevent damage to your hearing,
as each shock wave is very loud. This procedure lasts between 7-15 minutes, depending
on the size and location of the painful area. In that time, 2000 shock wave pulses
are delivered. It is important to remember, these are shock waves only, and no
cutting or open operation is involved.
After this, you will go home, and may safely return to work the next day. The effects of the shock wave may be immediate as it can stabilize the pain receptors, but more often is delayed and may begin to be noticed between 2-3 months after treatment. Recovery and improvement can be expected for over 6 months after the ESWT treatment was performed.
Results:
Recent studies have demonstrated, that using the highest, yet still safe, power settings, 75% to 83% of the patients with heel spur - plantar fasciitis pain are significantly improved. Remember, these patients are already the ones who have failed conservative therapy, so they are, indeed, the more stubborn ones to treat. With the use of this modality, surgery for plantar fasciitis - heel spur syndrome, while not becoming a "thing of the past", should, at least, become a rarity.
Doctor Gurvis has been performing this Shock Wave Therapy for 6 years and is experienced in both its use, and knowing when to use it. His success rate is approximately 80%
Avon Podiatry
Avon
Station Medical Center
8244 E. US Highway 36, suite 120
Avon, Indiana
46123
317-272-0556
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