Shockwave Therapy for Plantar Fasciitis - Heel Pain Treatment in Rochester, NY

For anyone who has had pain, specifically pain in their feet, they know how life-changing it can be to become pain-free.  Having the freedom to walk and/or exercise free of any painful ailments can make all of the difference. This article will provide insights on the specific ailments that can cause pain and the helpful/effective treatments that can help patients become pain-free!

Anatomy of the Foot

Each foot is made up of 26 bones, 30 joints and more than 100 muscles, tendons and ligaments, all of which work together to provide support, balance and mobility.

Common heal/foot ailments? Nearly one-fourth of the body’s bones are in our feet. Joints are formed wherever two or more of these bones meet. Giving the foot its shape, support and the ability to move are muscles. Many tendons attach these muscles to the bones and ligaments that hold the bones together to maintain the foot’s arch (Arthritis.org). Specifically, the foot is susceptible to many stresses. Foot problems can cause pain, inflammation, and/or injury. These common problems can result in limited movement and agility.

Feet Ailments

When there is a disfunction with the muscle, joints, bones, tendons and/or ligaments, people might experience some discomfort or specific ailments. Below are common issues people experience.

Bone Spurs

Bone spurs are bony projections that develop along bone edges. Bone spurs (osteophytes) often form where bones meet each other in your joints. Most bone spurs cause no signs or symptoms. In some cases, though, bone spurs can cause pain and loss of motion in your joints You might not realize you have bone spurs until an X-ray for another condition reveals the growths. (Mayo Clinic)

Achilles tendon injury

The Achilles tendon is a strong fibrous cord that connects the muscles in the back of your calf to your heel bone. If you overstretch your Achilles tendon, it can tear (rupture) completely or just partially (this injury is common when playing recreational sports). Surgery is often performed to repair the rupture. But, for many people, however, nonsurgical treatment works just as well (Mayo Clinic).

Morton neuroma

Morton's neuroma involves a thickening of the tissue around one of the nerves leading to your toes. This can cause a sharp, burning pain in the ball of your foot. Patients may have stinging, burning or numbness in the affected toes, limiting mobility and discomfort.  This aliment is common for people who wear high heels often. Treatment options are available - corticosteroid injections or surgery. (Mayo Clinic).

Plantar fasciitis

Plantar fasciitis involves inflammation of a thick band of tissue that runs across the bottom of your foot and connects your heel bone to your toes. Plantar fasciitis can cause severe pain that usually occurs with your first steps in the morning. Patients may get some relief during the day but that can be temporary after long periods of standing or after exercising (Mayo Clinic). Plantar fasciitis can cause the rupture of tendon, fat pad necrosis and flattening of the arch, which increases strain and heel pain.  People who experience this heel pain in Rochester  should seek a medical professional’s opinion.

Who Is Most Susceptible to Plantar Fasciitis?

What causes plantar fasciitis?

Though our feet are enabled to withstand high amounts of stress, pressure and shock absorption,  long periods of this stress or tears in the tissue can cause plantar fasciitis. Patients might be high risk if they have:

Tight calf muscles

Make it difficult to flex your foot and bring your toes up toward your shin

Obesity

Increased BMI causes a decrease in the stiffness of plantar fascia and an increase in the thickness of the plantar fascia as well as the thickness and stiffness of heel pad (NCBI).

Very high arch

High arched feet, also known as cavus feet, is a disorder characterized by an abnormally high arch in the foot. This causes excess amounts of weight to be placed on the ball and heel of the foot, which can cause pain (this ailment is mostly inherited at birth) (Orthopedic Associates).

Repetitive impact activity (running/sports)

High impact activities can cause microtrauma to the plantar fascia and can exceed the body's capacity to recover (American Family Physician).

Improperly fitting shoes

High heeled shoes or improperly fitting shoes can create or develop Plantar Fasciitis.

Who Is Most Susceptible to Plantar Fasciitis?

Patients who neglect the calf muscle (people who dont stretch after exercise), have flat feet and high arches and wear heels consistently (and for long periods of time).

What are the symptoms of Plantar Fasciitis?

Patients usually feel pain, that feels like a sharp stabbing pain and/or upon stepping out of bed or they were sitting for a long time (the muscles are tight). Patients may have less stiffness and pain after you take a few steps. But your foot may hurt more as the day goes on (a stabbing pain).(UofMMedicine).

Diagnosis of Plantar Fasciitis

Detailing the pain and when the pain occurs to a medical professional is key to finding a proper diagnosis. Upon hearing a patients ailments, a medical professional will use diagnostic imaging studies, such as x-rays or other imaging modalities, may be used to distinguish the different types of heel pain (Foot Health Facts).

Heel Pain Treatments in Rochester ?

There are several treatments for patients who have Plantar Fasciitis. Patients might choose surgical or non-surgical treatments to treat the ailment and relieve pain symptoms.

Non - Surgical

Patients might opt into non-surgical treatments to help provide a solution that might be less painful and have less down time.

Stretching exercises

There are specific exercises that stretch out the calf muscles help ease pain and assist with recovery. Medical professionals suggest strengthening the arch muscles. To do this a patient would place a towel on the floor, grab the towel with your toes and pull it toward you. While sitting, grasp your toes and gently pull them toward you until you feel a stretch in the arch of your foot. With your back leg straight and heel down. Move your hips forward until you feel a stretch in your calf. Switch legs and repeat. Hold each stretch for at least 30 seconds — don't bounce — and do one or two repetitions two to three times a day.

Avoid going shoeless

Medical professionals suggest wearing shoes to prevent patients putting undue strain and stress on the plantar fascia.

Ice

Icing is a temporary fix help inflammation. Medical professionals suggest putting an ice pack on your heel for 20 minutes several times a day helps reduce inflammation.

Limit activities

Cut down on extended physical activities to give your heel a rest. This will help the heal, heal.

Wear more supportive shoes

Wearing supportive shoes that have good arch support and a slightly raised heel reduces stress on the plantar fascia.

Shockwave therapy

Extracorporeal shock wave therapy (ESWT) is a noninvasive treatment that involves delivery of shock waves to injured soft tissue to reduce pain and promote healing. ESWT is based on the formation of a single pulse acoustic wave generated by either an electromagnetic , electro-hydraulic, or piezoelectric source, able to increase the blood flow at the treatment site by inducing a healing process mediated by inflammation (NCBI). Shockwave therapy is an effective treatment for plantar fasciitis according to the proposed protocol considering pain, function and quality of life (NCBI). A four-dose SWT protocol was described for the treatment of chronic plantar fasciitis (NCBI).

What is acoustic wave?

By using specific ranges of frequency, energy, and pressure, treatment categories are endless and range from musculoskeletal injuries to erectile dysfunction (usually administered by a trained medical professional). Overall, AWT is able to perform specific tasks that lead to optimization, healing, and pain management.  Shockwave therapy is a type of acoustic wave therapy (Frank Institute).

Benefits of Shockwave Therapy

Athletes and patients who have not responded to “first line treatments such as rest, ice, therapeutic exercise, bracing and orthotics, but who are not yet ready to consider more-invasive or surgical options should consider Shockwave Therapy.  Patients who use ESWT are limited to mild bruising, swelling, pain, numbness or tingling in the treated area, and the recovery is minimal compared with that of surgical intervention (Mayo Clinic).

Shockwave Treatment Procedure

It is recommended to have a medical professional to set the frequency was set to 21 Hz, the pressure at 1.6 bar and 1500 shocks to achieve analgesia. For all remaining sessions, the frequency was set to 15 Hz, the pressure at 1.8 bar and 2500 shocks to achieve therapy (NCBI).

Medications

Oral nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be recommended to reduce pain and inflammation (Foot Health Facts).

Orthotic devices

There are several devices that can help with Plantar Faciitis. These are usually custom orthotic devices that fit into your shoe help correct the underlying structural abnormalities causing the plantar fasciitis. Ask your medical professional for more information about these devices.

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Research

Patients with chronic plantar fasciitis improved to statistically significant extent after either rESWT or ABI procedures, with no significant differences seen between groups. The lack of randomization in this pragmatic study is noted, which may have influenced the outcome seen. Potentially larger and more robust studies are required to investigate this treatment comparison further (Clinical Journal Of Sports Medicine) (Clinical Journal of Sports Medicine, 2021).

Compared to local steroid injection, local autologous PRP injection is more effective in relieving pain and improving the foot and ankle function at mid-term follow-up (Science Direct, 2021)

These findings suggest that all treatment modalities provide significant pain relief in patients with painful heel spur. This analysis also demonstrates RT is superior choice for chronic PF in cases of failure with conservative treatments when compared to extracorporeal shock wave therapy and PG. (Turkish Journal of Oncology, 2021).

ESWT seems to be particularly effective in relieving pain associated with RPF. ESWT should be considered when traditional treatments have failed.(The Journal of Physical Medicine Rehabilitation, 2017).

The results of this study demonstrate a positive therapeutic effect of the combination of focused shock wave therapy and a complex tendon supplement in the treatment of plantar fasciitis. Therefore, we believe more studies could support the effectiveness of the combination of physical therapies and supplements (SCIep,2021).

Clinical treatment is recommended for more than 90% of patients. Different clinical treatments have been reported such as orthoses in shoes (shims and insoles), oral anti-inflammatory agents, local infiltrations of corticosteroids, physiotherapy, and shock wave therapy (NCBI).

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