ESWT is a non-invasive surgical procedure that uses sound waves to stimulate healing in some physical disorders, including plantar fasciitis and Achilles tendinopathy. “Extracorporeal” means “outside of the body” and refers to the way the therapy is applied. As you are being treated in the heel pain clinic, the main conditions being treated are Plantar Fasciitis and Achilles Tendon problems.

How does Shockwave Therapy work?

Energy (sound) waves are applied to the surface of the skin through a probe. These energy waves spread outwards into the tissues. This process is believed to increase blood flow and help to “kick start” the healing process.

How successful is this treatment?

Success rates are encouraging. We constantly audit our outcomes and we are achieving around an 75-80% success rate for patients with heel pain.

Is the treatment safe?

Yes, it is very safe and this has been backed up by medical research. There are some minor risks associated with the treatment, including: Pain during and after treatment (persisting / worsening pain in rare cases), reddening of the skin, bruising, swelling, altered sensation/ numbness & headache. Rupture of the tendon/ ligament has been reported, but is very rare and normally associated with recent steroid injection therapy. As shockwave therapy treatment can be uncomfortable for some people, we recommend bringing some music to listen to, during treatment. This helps some people to relax and find the treatment less painful.

Who is this treatment unsuitable for?

Most people can have this treatment, however, shockwave therapy cannot be given if you:

• Are under 18 years old
• Have a history of cancer/malignancies in the area being treated
• Have a cardiac/heart pacemakers
• Have an infection
• Have had a recent steroid injection in the last 11 weeks into the same area of the body
• Unstable epilepsy / neurological conditions
• Risk of shingles

Relative cautions for discussion with clinician

• Patients on blood thinners, due to the risk of bruising/bleeding
• Patients with established tears/ruptures (poor quality tendon/fascia)

How many treatments will I require?

You will generally be given 3 separate treatments. These are normally about a week or two apart.

When will I start to see an improvement in my symptoms?

Most people will start seeing a reduction in pain at around 6-12 weeks after the final treatment. Some people may notice a reduction in pain sooner or later than this.

Are there any precautions I should take with this treatment?

Yes, before commencing your treatment, you should try and come off anti-inflammatory drugs (Ibuprofen, naproxen, diclofenac). Discuss this first with your healthcare professional.

After each treatment, you should try and rest the foot for about 24 hours. It is best to avoid any impact sports (such as running) or long walks for 24– 48 hours after each treatment.

You shouldn’t do any stretches for between 24-48 hours after the treatment. You are able to carry out general “day to day” activities, such as light walking.

Weight management

It is important to try to manage your weight whilst being treated for heel pain. We know that there is a strong correlation between increased weight and the development of heel pain. 

There may be a chance of recurrence or development of symptoms in the non-treated foot in patients who have a high BMI.

Patients with poor metabolic health and diet are more likely to develop musculoskeletal problems such as heel pain, it is important to optimise your diet and weight as much as possible.

There are many resources that are free to patients to access, an example of these are:

• www.metabolichealth.guide
• www.healthtolife.org 
• www.nhs.uk/better-health/lose-weight/ 

You may also want to speak to your GP regarding further measures to help manage your weight if you feel you need some additional support. 

What happens if I cannot attend one of the shockwave treatments?

In the event that you are unable to attend one of your consecutive shockwave appointments, you may have to start the treatment process again from the start. This may delay your overall treatment.