Dr. Vincent Giacalone
Podiatric Medicine & Surgery
466 Hook Rd., Suite 24D, Emerson, NJ 07630
Extracorporeal Shock Wave Therapy
What Is ESWT?
Extracorporeal Shock Wave Therapy (ESWT) is a procedure used to treat chronic heel pain (plantar fasciitis/heel spur syndrome). “Extracorporeal” means “outside of the body,” and refers to this non-invasive procedure in which sound waves are directed to the exact area of heel pain. The device used is similar to that currently used in non-surgical treatment of kidney stones.
What Is Plantar Fasciitis?
This painful condition results from inflammation of the connective tissue that stretches from the base of the toes, across the arch of the foot, to the point at which it inserts into the heel bone. It is sometimes associated with a heel spur, in which case it is called “heel spur syndrome.” The condition can usually be successfully treated with conservative measures such as use of anti-inflammatory medications and ice packs, stretching exercises, orthotic devices, and physical therapy. If the condition does not clear up after six months of these treatments, ESWT may be considered.
What is the success rate of shock wave treatment for heel pain?
The studies have consistently demonstrated the high success rate of this treatment. In one particular study (the one reviewed by the FDA) patients pain level before the treatment was an average of 7.7 (out of 10 with 0 representing no pain and 10 representing severe pain). Within 6 weeks after the treatment pain level dropped to 4.6, within 3 months to 3.4 and to 0.6 within 6 months, with 92% reduction in pain by 12 months. Most paints feel significantly better within 12 to 16 weeks after the treatment.
What Happens During ESWT?
Dr. Giacalone will ask you to stop taking anti-inflammatory, Coumadin (warfarin) or aspirin medication approximately five days prior to the procedure. The treatment takes about 30 minutes per foot and is performed under local anesthesia in the office. Sound waves penetrate the heel area and stimulate a healing response by the body. It is a procedure done right in the office and does not require a trip to the hospital.
Who Should Not Be Treated with ESWT?
ESWT is appropriate for most patients, however not appropriate for patients who have a bleeding disorder or who are taking medications that may prolong bleeding or interfere with blood clotting. It should not be used during pregnancy or for children. In addition, its safety and effectiveness have not been established for those with nerve damage, osteoporosis, rheumatoid arthritis, tarsal tunnel syndrome, diabetic neuropathy, severe peripheral vascular disease, metabolic disorders, and infections.
What Happens After Treatment?
There may be some mild discomfort or numbness and tingling after the treatment. Patients should be able to return to work or school the following day with modified or light duties. Avoid going up and down stairs as much as possible and especially avoid using ladders for the first 6 weeks. Heavy activities to be avoided for the 4 to 6 weeks after the procedure including heavy lifting of objects, running, aerobic classes, or sporting activities. Anti-inflammatory medications and ice should be avoided for two days following treatment.
Are There Complications?
As with any surgical procedure, complications may arise. There have been reports of bruising of the skin, swelling, pain, numbness or tingling. There is no incision, cutting of skin or sutures. Following the procedure you may put on your socks and shoes and walk.
ESWT is a new treatment modality, and may not yet be available in all areas of the country. Dr. Giacalone can advise whether you may be a candidate for ESWT. He is specially trained in the use of this FDA approved treatment option.
Does insurance cover shock wave treatment?
The company which provided the shockwave machine the day of your treatment (called excellent Shock Wave Therapy or ESWT for short) will check to see if your insurance will cover the treatment. If you have any out-of-pocket expenses, ESWT will inform you in detail prior to the treatment.
Dr. Giacalone has been trained specifically and extensively in the diagnosis and medical and surgical treatment of foot disorders. Dr. Giacalone has been board certified by The American Board of Podiatric Orthopedics and The American Board of Podiatric Surgery since 1993 and 1995 respectively and is a Fellow of the American College of Foot and Ankle Surgeons. Dr. Giacalone performs surgery at Hackensack University Medical Center in Hackensack, Hackensack University Medical Center @ Pascack Valley in Westwood and Surgicare Surgical Center in Oradell