Shock Wave Therapy (ESWT)

Extracorporeal shockwave therapy for heel pain

At Parkside Orthopaedics and Sports Medicine Centre, our experts offer a full range of non-surgical and surgical treatments for heel pain. In some cases, a non-invasive procedure called extracorporeal shockwave therapy can give you pain relief and encourage healing. We can use this procedure to treat the heel conditions Achilles tendinopathy and plantar fasciitis.

What are Achilles tendinopathy and plantar fasciitis?

The most common causes of heel pain are:

• Achilles tendinopathy (pain at the back of the heel): Your Achilles tendon is a large band of tissue from the back of your lower leg to your heel. Pain, stiffness or swelling along the back of your heel could be a sign of Achilles tendinopathy. This condition is caused by intense or repetitive strain of the Achilles tendon. The condition can affect anyone, but is more common if you play sports that involve a lot of running or jumping.
• Plantar fasciitis (pain at the bottom of the heel): Plantar fasciitis causes pain on the bottom of your foot, around the heel and arch. The plantar fascia is a thick band of tissue along the bottom of your foot between the heel and toes. This tissue can become inflamed through repeated strain. The condition is often worse when you start walking after a period of rest. It is more common if you do a lot of running or wear shoes with poor support.

There are some simple, non-surgical treatments for Achilles tendinopathy or plantar fasciitis. They include rest, an ice pack, painkillers, injections, physiotherapy and shoe inserts (orthotic devices). If your symptoms do not improve enough after these treatments, you may consider having extracorporeal shockwave therapy.

What is extracorporeal shockwave therapy and how does it work?

Extracorporeal shockwave therapy is a minimally invasive procedure. It does not involve having any anaesthetic, medication or surgery.

The term ‘extracorporeal’ means outside of the body. A special machine produces impulses of energy called shockwaves. They are sound waves and not electrical impulses. A hand-held device sends these shockwaves through the skin to the painful part of your foot.

The shockwaves increase blood flow to the painful area. This prompts your body’s healing process to start and speeds up that natural process. Shockwaves can also make the nerve endings in your foot less sensitive to pain and break down any scar tissue.

If you have Achilles tendinopathy or plantar fasciitis, extracorporeal shockwave therapy can help to reduce your pain and other symptoms.

How can I prepare for having extracorporeal shockwave therapy?

Before having extracorporeal shockwave therapy, we arrange a full assessment for you at Parkside Orthopaedics and Sports Medicine Centre. A specialist foot and ankle consultant asks about your symptoms and medical history, and examines your feet. You may need to have an MRI or ultrasound scan. Our Diagnostic Imaging Suite performs high quality scans in a relaxed, comfortable environment.

If your consultant thinks that extracorporeal shockwave therapy is suitable for you, they explain how to prepare. You need to stop taking any anti-inflammatory medicines, such as Ibuprofen, for two weeks in advance. It is best to wear loose, comfortable clothes on the day of the procedure. You can eat and drink normally before your treatment.

What happens during extracorporeal shockwave therapy?

Extracorporeal shockwave therapy is an outpatient procedure at Parkside Orthopaedics and Sports Medicine Centre. This means that you can go home on the same day. Your consultant carries out this procedure and answers any questions that you may have.

We ask you to lie down and give you a pillow to support your legs. Each treatment session lasts about five minutes. We put some gel on the painful area of your foot and then place a hand-held device on the gel. The shockwaves pass through your skin, spread inside the damaged foot tissue and prompt your body to heal naturally.

Is extracorporeal shockwave therapy painful?

Many patients say that extracorporeal shockwave therapy feels like gentle flicks against the skin. You may have a little discomfort during the short procedure, but should be able to cope with this. Your comfort is our priority. We can adjust the machine settings to help you manage any discomfort.

Is extracorporeal shockwave therapy a safe treatment?

 The National Institute for Health and Care Excellence (NICE) considers extracorporeal shockwave therapy to be a safe procedure. NICE has produced guidelines on using the therapy for Achilles tendinopathy and plantar fasciitis. We follow these guidelines carefully.

After the procedure, you may have some temporary redness or swelling in the treated area. If you get these side effects, they should resolve within a week. You can take mild painkillers, such as paracetamol, to relieve any brief discomfort. However, it is important to avoid anti-inflammatory medicines like Ibuprofen and ice packs throughout your treatment. They may disrupt the healing process.

What happens after extracorporeal shockwave therapy?

After your treatment session, you can get up and walk straight away. When you go home, you can continue your usual activities, return to work and wear your normal shoes. We recommend that you avoid strenuous exercise or running for 48 hours after the treatment.

How many sessions of extracorporeal shockwave therapy do I need?

You usually need three sessions of extracorporeal shockwave therapy, which are each held one or two weeks apart. In some cases, you may need five treatment sessions. Your consultant advises you about this and reviews your progress. You may notice an immediate improvement in your symptoms or it could take a few weeks to get significant pain relief.

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Studies show that extracorporeal shockwave therapy is often an effective treatment for Achilles tendinopathy or plantar fasciitis. Our expert team at Parkside Orthopaedics and Sports Medicine Centre offer this specialised, non-surgical treatment to reduce your pain.

To enquire about the price of extracorporeal shockwave therapy, please call 020 3925 1062 or complete  this form online.

To make an appointment at Parkside Orthopaedics and Sports Medicine Centre, please call 020 3944 0568 or complete this form online. Appointments are available six days a week.

Mr Pal Ramesh
Consultant Orthopaedic Surgeon

Qualifications
MBBS, M Ch, FRCS, FRCS (Orth)

Clinical Interests
Achilles tendon disorders including tendonitis, acute and chronic rupture reconstruction Ankle sprains and fractures Arthroscopy...

Mr Pal Ramesh

Qualifications
MBBS, M Ch, FRCS, FRCS (Orth)

Clinical Interests
Achilles tendon disorders including tendonitis, acute and chronic rupture reconstruction Ankle sprains and fractures Arthroscopy...

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