I'm Shocked!! Plantar Fasciitis Cure.. My Experience with ESWT

This write up won't be of much interest to some. It's not motorcycle related. . I wrote this for a couple of websites where people post information on medical procedures they've gone through so others will get a real perspective as to what it's like to go through it...Thought I'd share.. FYI.. I have had plantar fasciitis for over a year.. On Jan7th, 2012, I had a procedure done called ESWT (extracorporal shockwave therapy).. If any of my peers has plantar fasciitis and are considering getting treatment... read on.. If not... don't waste your time....

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Hello, my name is Jerry and I have plantar fasciitis. For those lucky enough to not know what this is...plantar fasciitis is common in middle-aged and old codgers, such as myself or sometimes younger people who are on their feet a lot like athletes, hookers, or soldiers. It can happen in one foot or both feet. In a nutshell... the plantar fascia, ( the flat band of tissue (ligament) that connects your heel bone to your toes) gets weak, swollen, and irritated (inflamed). Tissue starts to tear. Your heel or the bottom of your foot hurts when you stand or walk. It feels like your heel is horribly bruised all the time. Not fun.

I've had this for over a year.. tried the usual treatments... stretching, shoe inserts both cheap and expensive...cursing...voodoo...blaming it on President Bush, etc, etc.. Nothing has worked. I had to give up virtually all my outdoor exercise .. ie.. hiking, walking and at my age (56)... NOT exercising is not an option. Anyway... after countless hours researching the condition, speaking to countless people who have had the problem, and at least a dozen calls to the psychic hotline, I came to the conclusion that If I wanted to rid myself of the condition I'd have to either A. have surgery (which has about a 60% success rate) or B. do a procedure called ESWT (extracorporal shockwave therapy) which has a 85% success rate.

Option A: The standard arthroscopic-type surgery is more invasive and requires you to wear a boot for a few weeks with a long recovery time. Most insurance covers this procedure. Basically they make two incisions on both sides of your heel.. go in with a small camera and a knife and clip some of the ligaments.. (kinda like a vasectomy except in the foot. ) If they do NOT get it right.. you're fucked. I read a few on-line reports of people who had this procedure and it screwed them up and made things worse. A medical roll of the dice at the least..

Option B: ESWT aka.. extracorporal shockwave therapy is non-invasive and if it doesn't work.. you can still look at other alternative methods. Basically the doctor uses the same shockwave machine they use to destroy kidney stones except they aim it at your heel. The shockwaves stimulate tissue growth in the damaged area causing the problem area (in theory) to heal itself after about 2 months. ESWT is as common in Europe as angry Muslims and covered by insurance over there. Unfortunately.. this ain't Europe.. yet. The procedure is still statistically rare here in the US (under 5% have the treatment) and is NOT covered by insurance. My fucking luck. The procedure runs around $1800 and takes about 1/2 hour. It 's usually done in your pediatrist's office rather than a hospital.

After some lengthy discussions with my podiatrist I scheduled the procedure. Fortuitously, the traveling ESWT machine was due in town the very next am so the timing was perfect. I pictured it like this.. I'd go in.. bring a book.. they'd numb me...I'd lay on the table and read for the 20 minute procedure.. then I'd walk out with a big smile on my face and a new lease on life. Unfortunately, reality was quite different. Now that it's over I'm here to share my experience of the procedure with others in hopes that you'll be better informed.

First... I was told that the procedure was mostly painless and I'd walk out of the office afterwards and could even go back to work the next day if I took it easy. Sweet. I was told they'd give me vallium to relax me prior to the treatment, but I declined. I was more worried about the 2 shots to numb my heel than the actual procedure as I'd heard no mention of pain at any of the websites I'd been researching.. not that I have anything against mood altering drugs. Anyway.. I was told the pain would be minimal so why would I need to be drugged? As I've been married 4 times.. I'm accustomed to pain. I drove myself to the clinic, walked in, signed over some of my retirement money, and waited. A few minutes later they ushered me back to the doctor/ nurse area and the first thing they all say in unison... "you didn't drive yourself did you??.. I said .. "Yes.. You said I could walk out after the procedure and even go to work if I took it easy." What the doctor failed to mention prior to me writing the check or in the pre-procedure discussion was that when they numb the heel for the procedure.. you can't really feel your foot or walk very well or drive.. Great.. NOW you tell me. They are not happy and proceed to look at me as if I'd thrown feces all over their walls. The doctor says that he can drive me home afterwards if necessary, but I can tell he'd rather have a pointy stick shoved in his eye...

The numbing process was almost painless.. He numbed my skin with something like freon then I couldn't feel the needle that followed. Sweet. The doctor had told me that this was the worst part.. In reality.. that was not true. After about 15 minutes, I got off the numbing table to walk to the next room for the treatment and my foot felt like it had been removed and replaced with a HoneyBaked Ham. Thank the lord above I had brought my Leki hiking stick or I couldn't have walked the 20 feet to the other room or to my SUV afterward. No mention of this in the pre-procedure talk. No offer of crutches or a shoulder to lean on.

The 15 minute shockwave treatment, while short.. is painful. The machine is loud and makes the "knock..knock..knock" noise of a CAT scan machine so you have to wear ear protection headphones. They start out with low amplitude bursts then slowly increase the intensity to Death star shattering strength. While the Emperor ..er.. the machine technician is actually pummeling your heel with shock waves, the doctor is constantly moving your foot so all areas are hit evenly. He's manipulating my foot like a party clown twisting up a balloon animal. Even though your foot is numb, when the "blast" hits the most sensitive areas... you feel it big time and it's painful enough to make you sweat bullets and confess to past crimes. I kept expecting him to say.. "Is it safe?" On a pain scale from 1-10.. I'd say a few minutes of the procedure rate about an 8. I'd wager this procedure is banned by the Geneva Convention.

The really painful part lasts only about 5 minutes out of the 15, but these are l o n g minutes. They sheepishly apologize afterwards, but I'm not happy that they neglected mentioning this prior to the treatment and intend on scolding my doc the next time we meet.. Afterwards, when I was about to apologize for leaving the finger indentations and the puddle of sweat on their stainless steel table, the guy that owns the machine (and my podiatrist) told me that I had handled the pain better than almost everyone else they had done... My God!. I thought I had been a wuss by actually yelling to them over the noise of the machine.." Guys.. this hurts BAAAAAD!" What must the other victims...er. patients have done? Cried like little girls? Peed their pants? Begged for mercy? Spoke in tongues?

After the procedure.. I had to sit there for about 40 minutes for the feeling to come back to my foot enough to walk out to my SUV and then drive home. Again.. no offer of crutches. After the numbness wore off a few hours later.. I was walking pretty good without my stick.. Just felt a little sore. Sweet! I was under the impression (because this is what he told me) that that would be the extent of my pain. That turned out not to be true.

Day 2: Got up to pee at around 3am and almost fell out of bed. I couldn't put any weight on my foot.. While my foot was NOT swollen, I couldn't walk without my hiking stick all day. No mention of this in the pre-procedure talk. (or anywhere that I saw on the www.) Why didn't they tell me that I might need crutches for 24 hours?...and/or offered a loaner pair?
Day 3: I'm walking almost as good as Stumpy in Rio Bravo. The heel is still sensitive, but I purposely favor it all day. I'm NOT using my walking stick today. Very little pain.
Day 4: I'm walking almost good as new today with very little pain and just a sinsitive heel. Not bad for a procedure that may (fingers crossed) give me my life back...
1 Week: Walking with only a slight limp. Heel is still sensitive. Seems to get a little better every day.
2 Weeks: Heel is still sensitive. Very little pain, but some. Foot feels tired at end of day. A little better every day.
3 Weeks: Heel is still sensitive. Very little pain, but some. Foot feels tired at end of day. A little better every day.
4 Weeks: This has been the slowest recovery time of anything I've ever done, and my recuperative powers are second only to Wolverine. With that said.. Every day is slightly better. No pain in the am.. sore at night from walking
12 Weeks: I'd guestamate I'm about 50% there... Painless in the am.. always sore at bedtime and this is with light work, no heavy lifting.
6 Months: Months have now passed and yes.. I'm better than I was prior to the treatment. I'd say I'm about 65% better. I still have some pain if I've been sitting a while although it's a different kinda pain than a year ago. Was the treatment worth the money? Yes and No. Ask me in 6 months. ... I think it's over-priced.. but what price do you put on chronic pain alleviation? I am better.. and that's what they promised..
1 Year: I now can honestly say it was well worth the money. I'd say my foot is at about 90-95%.. It's a little sore sometimes after sitting through a movie or walking or hiking a lot, but otherwise.. 90-95% of the time it feels good as new with no pain. When I get up in the am.. I'm not limping any more. Mostly pain-free.
1.5 Years: 100% Pain free! Woohoo!! Top o' the world, ma!

I learned a lot about this procedure by going through it...Very little from my pediatrist. Perhaps other doctors/pediatrists are more thorough in their pre-procedure talk. Would I do it again now that I know it's somewhat painful? Considering the 4 day recovery time.. yes.. Just wish my insurance covered at least some of the cost.

Advice for those going through ESWT (extracorporal shockwave therapy) :
1. Have someone drive you.
2. Bring crutches if they aren't offered.
3. While it won't do anything towards deadening the pain .. take the offered Valium before the procedure. If nothing else, it'll soften the blow of having to fork over $1800 out of your pocket and possibly lessen the anger towards your insurance company for not covering a statistically proven medical procedure that's covered in every other country in the world.

Postscript 11/2016: I spoke with a young lady a few days ago who (after reading my review) had the procedure.. Hers was a little different... She said her doctor actually put her under while doing the procedure... She didn't have to deal with the discomfort that I did.. I don't know if this is something new or if her doctor was a one-off. If I had had a choice, I'd have asked to be knocked out.. The only down side is that I'm sure it would DOUBLE the cost of the procedure and again... if insurance doesn't cover it.. that might be a financial deal breaker for some.

And that's all I've got to say about that....
Jerry D. Finley
Captain / Pirates' Lair