Here’s one research article behind the treatment for patients with heel pain due to chronic plantar fasciitis.
*Gollwitzer, H. et al. Clinically relevant effectiveness of focused Extracorporeal shock wave therapy in the treatment of chronic plantar fasciitis: a randomized, controlled multicenter study. J Bone Joint Surg Am. 2015 May 6;97(9):701-8. doi: 10.2106/JBJS.M.01331.
The objective of the present study was to test whether focused Extracorporeal shock wave therapy is effective in relieving chronic heel pain diagnosed as plantar fasciitis. Two hundred and forty-six patients (98.4%) were available for intention-to-treat analysis at the twelve-week follow-up. There was a significant difference (p = 0.0027, one-sided) in the reduction of heel pain in the Extracorporeal shock wave therapy group (69.2%) compared with the placebo therapy group (34.5%). Extracorporeal shock wave therapy was also significantly superior to the placebo therapy for the Roles and Maudsley score (p = 0.0006, one-sided).
Regenerative medicine is the process of replacing or
regenerating cells and tissues to restore normal function and reduce pain.
I use alternative (non-injection) regenerative therapies in
Shockwave irritant therapy is an excellent alternative to injection therapy without the injection.
Shockwave therapy also known as pulse wave therapy causes inflammation. This will kick-start regeneration by stimulating the body to send in macrophages, which are cells that trigger the healing response. Shockwave therapy is an irritant therapy especially good for muscle, tendon and joint pain including chronic neck and back pain, rotator cuff injuries, Achilles tendon problems and plantar fasciitis.
Peptides used to be only administered by getting expensive shots (injections) that have to be given into your muscles. I use Peptides in pill form. Peptides decrease inflammation and pain which helps cartilage heal, and decreases tissue breakdown. I have seen good results with Peptides for my patients with osteoarthritis (OA) and degenerative disc disease (DDD). It really helps reduce gut inflammation too. Peptides break larger molecules into smaller units. The ones I use are specific messengers for painful inflammation of the spine, cartilage and gut.
Light Therapy/Laser Therapy
Laser light therapy results in cell signaling and mitochondrial recruitment and is another non-invasive regenerative therapy. Laser light initiates the healing response, repairing damaged tissue by stimulating new, healthy tissue cells. I have 4 light therapy devices in my office so that I can provide a broad spectrum of light wave therapy. The use of light therapy into an injured area is safer than injecting fluids into the body.
PEMF stands for ‘peripheral
PEMF stimulates the microcirculation. It’s one of my most
impressive non-injection therapies. Increasing microcirculation improves
lubrication. PEMF has FDA approval for urinary incontinence because it also
stimulates the pelvic floor muscles.
Most people can self-diagnose plantar
fasciitis, it starts with pain in the heel and foot especially if you
participate in high-impact activities like jogging, dancing, or basketball.
Other risk factors include having low or high arches, and/or tight calf muscles.
Every patient I see with plantar fasciitis has tight calf muscles.
It can often be treated with rest, anti-inflammatory medicine, and icing. I see a lot of stubborn cases. If you have had a steroid injection and it didn’t work keep reading. You may be ready for pulsed shockwave therapy. Here is my top 3 treatments for plantar fasciitis:
1. Dropped arches
Plantar fasciitis is common in athletes, particularly in runners or people who recently increased there load i.e. weight lifting increases, increased walking distance, increased running distance, or just increased body weight from pregnancy. The message is check your shoes for good support, consider an insert, and possibly replace your footwear.
Remember I said every plantar fasciitis patient I’ve seen has short tight calf and leg muscles and tendons. This tightness changes the alignment of the foot and ankle, creating a negative chain reaction that can travel as far up as the lower back and even the neck. Come in so I can teach you how to properly stretch the calfs and strengthen your arches on the bottom of your feet.
2. Shockwave For
Shockwave is a pulse therapy device I use to send strong ultrasound like impulses into the fibrous tissue on the underside of the foot. It has a deep penetration sensation and shockwave therapy is fast becoming the non-invasive, non-drug technique of choice for heel pain caused by plantar fasciitis.
Nothing, not even deep tissue massage is as helpful at loosening the tendons, ligaments, and fascia as the shockwave machines. I have 3 different machines because every patient is different.
People with chronic plantar fasciitis need shockwave therapy to help break up the scar tissue caused by the acute inflammation. Shockwave therapy loosens up the fibrous tissue band, allowing it to return to its natural shape.
I’ll also teach you how to roll a lacrosse ball, tennis ball, or golf ball on the sole of your foot to help roll out the plantar fascia. You will probably learn the latest in correct posture training from my ELDOA therapist as well. I recommend the shockwave for plantar fasciitis at least once a week for 3 sessions and then we re-evaluate. Many patient’s feel relief for plantar fasciitis after the first session.
Other Helpful Treatment For The Foot
I have simple stretches, simple strength movements, and a simple flexibility maneuver that’s crucial to gaining back your foot health and relieve pain.
I could post pictures on the internet but my
stretches and exercises go along with the shockwave therapy. That’s the recipe!
I may also recommend the VibraGenix plate, Phyto Zol serum, and sports taping on the foot or calf. Each case does need a proper evaluation and personalized treatment plan. Please feel free to call my office at 310-444-9393
Extracorporeal shock wave therapy (ESWT) is also referred to as Pulse wave therapy.
Pulse wave therapy is a noninvasive treatment that that uses the force of a sound wave with the goal of reducing pain and promoting healing of the affected area. The mechanism by which pulse wave therapy achieves a therapeutic intervention is that it may disrupt fibrous tissue allowing for the subsequent promotion of revascularization and healing of tissue. Controlled shock wave therapy may damage cell membranes so that nerve messengers (nociceptors pain receptors) cannot build up a potential to transmit pain signals. It is also thought that the shock waves (pulse waves) will break up fascial adhesions, scar or calcium deposits, loosen tight tissue structures, promote resorption of calcium, thereby decreasing pain and improving function. (Hayes 2016a)
I am the only doctor in Los Angeles with 3 different types of pulse wave therapy machines. This allows me to use the best evidence from each of the devices, plus my 7 years of experience using pulse wave therapy, and patient preferences to provide you with the best care.
What are the benefits of the Shockwave Treatment?
Radial shockwave therapy is used to stimulate the body’s natural self-healing process. Most patients experience immediate reduction of pain and improved ease of movement. Shockwave therapy should be tried before costly surgery procedures because it may eliminate your need for surgery. The use of drugs are not needed with this procedure.
How long does the treatment session take?
2000 – 3000 acoustic radial waves are administered per session, which takes approximately 5-10 minutes to apply. After the initial session with Dr. Tucker which includes the evaluation and typically lasts 60 minutes, he will schedule 30 minutes sessions. This allows enough time for questions/answers, and any home therapy recommendations.
How many treatments will I need?
Normally a series of five treatments are scheduled at 4-5 day intervals; there is a small possibility that an additional 3-5 treatments may be necessary if your condition is very chronic.
Does the treatment hurt?
It is a 5-10 minute treatment that may be uncomfortable to some. Others only feel the sensation of deep percussion and do not express discomfort. Dr. Tucker will do everything possible to make you comfortable and able to tolerate your treatment. However, if you cannot tolerate it, the Dr. Tucker can make adjustments on the machine that can decrease the pressure you feel.
Will it hurt after the treatment?
There may be no immediate pain at all, but some discomfort may be experienced 6 – 12 hours after the treatment. In some cases it can last up to 48 hours and in very rare cases, the pain lasted up to 3 days. Dr. Tucker is using other cutting edge technology (i.e. laser, Deep Muscle Stimulator, lymph drainage) to enhance the effects of the Radial Shock Wave Therapy as well as researching the best methods to decrease post treatment soreness.
What should I do if I am in pain after the treatment?
The shockwave therapy is used to trigger an inflammatory response, which is the body’s natural process of healing. For this reason, do not use anti-inflammatory medications. Do not use ice. The pain should subside within 24 hours.
What if it feels good after the treatment?
Even if it feels good, we recommend decreased activity for 48 hours following the treatment.
Is Shockwave Therapy covered by my insurance?
If you have insurance you will want to ask your provider about the requirements of your coverage. Please call the office at 310-444-9393 with specific questions.
What is the success rate of this kind of treatment?
A successful treatment is considered as a patient having at least 75% reduction in pain within 3 months. The current literature worldwide, suggests success rates are around 80 to 90%.
What if it doesn’t work for me?
Although the short-term effects alone are exceptional, the long-term benefits of this treatment may take up to 3-4 months. If after this time there has not been any marked improvement, we will discuss further treatment options.
Are there contraindications and/or precautions?
- Coagulation disorders, thrombosis, heart or circulatory patients
- Use of anticoagulants, especially Marcumar, Heparin, Coumadin
- Tumour diseases, carcinoma, cancer patients
- Polyneuropathy in case of diabetes mellitus
- Acute inflammations / pus focus in the target area
- Children in growth
- Cortisone therapy up to 6 weeks before first treatment
- Blood or nerves supplies too close to the affected area
- Swelling, reddening, haematomas
- Skin lesions after previous cortisone therapy
These side effects generally abate after 5 to 10 days.
We are happy to discuss your case with you. Please call the office at 310-444-9393
Shockwave Therapy is a non-invasive treatment involving the delivery of acoustic shockwaves to affected areas of the body to trigger natural repair mechanisms and stimulate healing. I am now using this in my practice for Achilles tendonopathy, plantar fasciitis, shoulder tendonopathy, calcific tendinitis, patellar tendonosis.