ESWT Extracorporeal Shockwave Therapy

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Extracorporeal Shockwave Therapy (ESWT)
Heel Pain Therapy

Extracorporeal Shockwave Therapy (or ESWT as it is known clinically) is an innovative non-invasive technique for the treatment of plantar fasciosis (chronic heel spur syndrome, achilles tendon spurs and achilles tendonosis). Shockwave treatments were investigated in Germany in the early 1990s. They were found to be effective and safe for the management of chronic pain from tendonitis of the shoulder, elbow, knee and the foot.

The application was brought to the USA and studied extensively for the treatment of plantar fasciitis (heel spur syndrome). After submission and review by the FDA, ESWT was deemed “safe and efficacious” for the treatment of plantar fasciitis.

For Additional Helpful Information on Heel Pain Therapy




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The device utilized by Dr. Radovic is unique in that it uses ultrasound to guide the application of the shock waves. This allows the area of treatment to be visualized during the entire procedure, eliminating the guess work required with other manufacturers’ shockwave machines.

The device produces a wide range of low-to-high energy shockwaves allowing the energy to be focused on the plantar fascia. The intensity and frequency of the shockwaves or pulses are then gradually and incrementally increased.

The procedure is done in an outpatient setting either under local anesthesia or with light sedation. Patients are allowed to walk in regular shoe gear and return to normal activity in 24 hours.

The effective result of ESWT is a change in the physical, chemical and biological composition of the soft tissues. Although the exact mechanism of action of the ESWT on chronic heel pain is unknown, the following explanations have been suggested.

  1. Hyper-stimulation analgesia; which is the stimulation of nerves through a complicated pathway which inhibits pain transmission.
  2. Shockwave induced neovascularization: where the treatment stimulates increased blood supply to the involved area, resulting in a healing response, less inflammation and pain.
  3. Chemical alteration: wherein the ESWT treatment changes or induces the formation of chemical compounds in the treated area resulting in the reduction of pain.

This revolutionary new treatment is being offered as a non-invasive alternative to the surgical management of chronic heel pain (plantar fasciosis, achilles tendon spurs and achilles tendonosis). Historically, this condition has been difficult to treat, due to the underlying changes within the fascia itself. This leads to persistent symptoms which can be resistant to standard conservative treatments such asPlantar Fasciitis orthotics, cortisone injections, physical therapy and non-steroidal anti-inflammatory medications.

Maximal improvement is generally achieved within three months, with many patients experiencing either a significant reduction or complete resolution of the underlying discomfort within this time frame.

Please be advised that you will need to be evaluated by your podiatrist to determine if you are a candidate for treatment with the ESWT.