Extracorporeal Shockwave Therapy (ESWT)

Shockwave therapy
Summary

Extracoroporeal shockwave therapy (ESWT) is an effective, non-surgical method of treating tendon and ligaments problems in the foot and ankle.  It is particularly good at treating Achilles tendon and plantar fascia problems.  

Factors to Consider

Symptoms from Achilles tendinopathy and plantar fasciitis vary significantly between patients.  Some patients may have discomfort to the heel only after strenuous exercise whereas others will have severe pain that prevents them from walking comfortably or doing their normal activities.  

It is likely that you have already tried non-surgical treatments for your foot such as pain killers, shoe modification, physiotherapy and orthotics.  If these measures have not improved your symptoms then the next logical step is to consider shockwave therapy before considering surgery.  Shockwave therapy is not appropriate for all patients and so your surgeon will assess your suitability.

Description of Surgery

ESWT produces high energy shockwaves that are released from a probe when applied to the affected area.  The shock waves pass into the diseased tissue to break down scar tissue as well as encouraging increased blood flow to produce a healing response.  

The procedure can be performed in the outpatient department and takes about 15 minutes.  It can be quite uncomfortable when the ESWT is applied but this should settle within a few minutes of the procedure.  It is usual to need 3 sessions of ESWT, sometimes up to 5.   

What are the risks?

Following treatment you may experience some swelling or pain.  These generally resolve within a week.  There is a very small chance of tendon/ligament rupture.  The only other risk is that it may not improve your symptoms.

After Surgery

Pain

You may require some simple painkillers following the procedure

Physiotherapy

ESWT works well in combination with physiotherapy and so it is likely that your surgeon will arrange for you to see a physiotherapist.  Physiotherapy can be arranged local to you.  

Driving

You can drive when you feel you are safe to drive.  This means that you feel confident that you have full control of your car and are able perform an emergency stop.  This will vary between patients but very occasionally you may need a few days off from driving.  

Return to work

This depends on what your job is but most patients should be able to continue to work while having treatment

What to expect

Recovery following this can be quite variable.  Your symptoms should be approximately 80% better by 3 months following your last treatment with the majority fully recovered by 6 months.  It can, however, take up to a year for some patients to fully improve.