Plantar Fasciitis Treatments- Pittsburgh Area

 Plantar Fasciitis

PLANTAR FASCIITIS (HEEL PAIN)

Heel pain that is felt on the underside or bottom of the foot is often caused by an often-painful condition called Plantar Fasciitis.

  • Plantar Fasciitis, also called a heel spur, causes pain, irritation, and inflammation across the bottom of the foot. The plantar fascia, a ligament that runs from the heel of your foot to the ball, connects your heel bone to your toes. When this ligament becomes strained, it can result in chronic pain.

What Does Plantar Fasciitis Feel Like?

  • It’s one of the most common causes of foot discomfort, causing a sharp pain that feels like a pin or knife that’s been stuck in your heel when you wake up in the morning and begin walking. Although the pain will start to subside as you move around through the day, it can reappear if you stand for a long period of time, or when you stand up after sitting behind a desk for most of the day.

Who Is Most Susceptible to Plantar Fasciitis?

  • Runners and other athletes
  • Pregnant women
  • People who are overweight and often stand and walk
  • People who wear shoes that have little to no support
  • People who are getting older

What are plantar fasciitis treatments in Pittsburgh?

There are many treatments available for plantar fasciitis in Pittsburgh.

 plantar fasciitis treatment in pittsburgh
  • Home Physical Therapy. Before you even take your first steps out of bed in the morning, grab a band or a towel and wrap it around the ball of the foot and pull backward toward your nose. Do this several times on whichever arch has pain.
  • Ice it down.- Forget the frozen water bottles, simply get an ice pack, or bag of frozen veggies, and place your heel on it after work every evening. Do this for about 10-15 minutes.
  • Custom Orthotics. You need to take the weight of your body off your arch. this can be accomplished with firm orthotics, with or without a soft topcover. 
  • NSAIDs- Nonsteroidal anti-inflammatory drugs like alleve, naproxen, or ibuprofen can help under your podiatrists' direction.
  • Injections of cortisone. - A powerful anti-inflammatory, cortisone is a medication that is administered via a quick injection into the plantar fascia to reduce pain and inflammation.
  • ESWT Extracorporeal Shockwave Therapy -ESWT - a nonsurgical , noninvasice office procedure to delivers high-energy acoustic (sound) waves into the areaq of maximum pain in either the heel, arch, or Achilles tendon. This is a 20 minute one time procedure with no time off of work and saves many sufferers from unnecessary surgery!
  • Think you have plantar fasciitis in Pittsburgh? Call 878-313-3338 for help locating our nearest office to you.

What Is Plantar Fasciitis?

 
 

 What Are The Benefits of ESWT?

  • It works! It’s a proven pain relief procedure for the discomfort caused by chronic Plantar Fasciitis and heel spurs. The shock waves used in ESWT actually stimulate the body’s own repair mechanisms.
  • It’s less than a 30-minute in-office procedure and has a short recovery period. There’s no need to take a day off of work—you can have this procedure done during your lunch hour. You can also walk as soon as the ESWT is done and you should be able to restart your regular activity the next day.
  • No surgery is required. ESWT is gentle and is performed using shock waves, so there are no incisions made and the risks that are associated with surgery are removed.
  • No pain medication is necessary, and there are no side effects. Your heel will be lightly numbed with gel before the procedure.

What happens during the treatment?

First, your pain will be confirmed with an ultrasound. The affected area on your foot will then be lightly numbed and you’ll lie down or sit on an exam table. After a gel is applied to the foot, shock waves are released from the ESWT device as your foot is properly positioned. The whole office visit takes only 30 minutes.

If you are suffering from Plantar Fasciitis, call Beaver Valley Foot Clinic today to learn more about the benefits of Extracorporeal Shockwave Therapy.


PATIENT TESTIMONIALS

Read what patients are saying about Extracorporeal Shock Wave Therapy…

I’ve had foot pain for over twenty years, no wonder, my job requires being on my feet eight to twelve hours a day, six days a week. Until I tried ESWT, I assumed the pain would be a part of my life forever, thankfully I was wrong.

— Terrence L. Salay, Steel Worker, Aliquippa, PA
Working 12 hours a day in the steel mill guarantees you one thing, unbearable foot pain. The worse it got, the less I could work, until ESWT. It has truly changed my life. In just two weeks I was pain free. It doesn’t get any better than that, unless we win the Super Bowl of course.

— Frank Franklin, Steel Mill Supervisor, New Brighton, PA
“I have traveled every road to try and find relief for my heel spurs-shots, taping, medicine, show inserts, losing weight and wore tennis shoes. Results-no result, until ESWT. If you don’t believe me just ask my feet.”

— Annette Marshalek, Bentleyville, PA

Questions for Dr Teimouri DPM about Heel Pain, email her here!

PODIATRY CLINIC HOURS
         Mon to Fri: 8:00 am to 5:30 pm
         Emergency evening and weekend appointments

Call for information on Plantar Fasciitis or schedule an appt 878-313-FEET (3338)

WE CARE ABOUT YOUR FEET:

  • Friendly comfortable offices
  • Short wait times-your time is important too!
  • 23 years Podiatric foot care experience
  • Convenient Podiatry offices near you
  • Board Certified in Foot Surgery by ABFAS
  • Personalized treatment plans for every patient
  • Family owned business that treats our patients like family
  • Minimally invasive nonsurgical alternatives for many problems
  • Staff who get to know you

Frequently Asked Questions about cause and treatments for PLANTAR FASCIITIS

What is Shock Wave Therapy -also called ESWT, and Extra-corporeal Shock Wave Therapy?

  • Shock wave therapy is not new. It has been around since the 60's as lithotripsy in the treatment of kidney stones. It a 20 minute non-invasive treatment for plantar fasciitis and other chronic musculotendinous injuries.  Extracorporeal Shockwave Therapy delivers small bursts of high intensity sound waves into chronically damaged fascia in the heel and arch. It is these areas which cause the painful arch symptoms in most patients. This allows these tendons to heal the right way and symptoms to improve.  We typically recommend that our Plantar fasciitis Mt Lebanon patients ask about ESWT after exhausting conservative treatments and before surgery.

How does ESWT work?

 Image of ESWT Machine for Achilles Shockwave Therapy, Pittsburgh PA

Image of ESWT Machine for Achilles Shockwave Therapy, Pittsburgh PA

  • ESWT uses the most effective mechanisms to treating plantar fascia pain and more chronic injuries.  In an over-use injury like plantar fasciitis, tendons and ligaments of the heel and arch where the plantar fascia connects to the calcaneous become inflamed damaged due to overuse.  The arch never gets a chance to heal properly. Extracorporeal Shock Wave Therapy intentionally causes controlled amounts of damage, which is micro-trauma, at the exact point on ultrasound guidance where the fascia inserts into the heel bone. One might think this is the opposite of what one wants to do—why would one want a treatment to create more damage?  Actually shock wave therapy  triggers the body’s own healing response.  It jump starts the natural healing mechanisms.  It also accomplishes two other specific goals. The first one -breaks down scar tissue that has formed and creating fresh collagen production.  Tendons and ligaments are made primarily of collagen, and in an over-use injury this collagen gradually breaks down.  The micro-trauma caused by Shock wave actually stimulates collagen production as part of the triggered healing process.  Secondly, it increase the flow of blood to the area.  ESWT treatments increase blood flow to the injured area, which an injured area requires in order to heal correctly.  Note that fascial tissue usually has very poor blood flow, which makes healing much more difficult, and ESWT directly promotes increased blood supply.  We recommend ESWT for chronic plantar fascia pain Pittsburghs patients.

What's  Shock Wave Therapy treatment like?

  • After a thorough exam is performed, along with a detailed H&P, the podiatrist will discuss with you if this is the most appropriate treatment.  Once you're cleared for Extracorporeal Shock Wave Therapy, the heal is cleaned and regional lidocaine is administered.  Shockwave is generally very well tolerated, but if numbing isn’t even needed, then in most cases you are receiving a low intensity instead of high intensity treatment which is not FDA approved.  Like lithotripsy for kidney stones, the foot is placed on a  “water bladder” which is a part of the ESWT generator.  The high intensity pressure wave energy travels best through water. 3800 pulses of high intensity waves of energy are administered to the plantar fascia and heel and arch. The patient hears a clicking sound as the pressure waves are generated, and usually feels little to no pain.  The treatment is 18 minutes long once it has started.

Does ESWT work?  How successful is Shock Wave Therapy for Plantar Fasciitis?

  • Shockwave therapy works! It  has an excellent success rates for chronic plantar fasciitis treatment especially compared to painful and often unnecessary surgery!  Several research papers have estimated ESWT’s success rates at 80% or higher.  In these research papers, success was defined as a “good” or “excellent” outcome according to the patient, which means that the patient has normal function with or without minor pain, or normal function with no pain at all.   Dr. Teimouri DPM in our Bridgewater Foot Clinic has been in practice for 23+ years and has seen many satisfied patients since 2002.

Is ESWT painful? Does it hurt?

  • No, ESWT is not painful. Patients can feel either minor discomfort or nothing at all after being lightly numbed.  Our patients with plantar fasciitis in Moon Township are usually surprised at how comfortable the ESWT treatment really is, some patients have even fallen asleep!

Who is the ideal ESWT candidate?

  • Any one who has tried and failed 3 conservative treatments; like stretching, icing, arch supports, and has not found relief, is a good candidate for Shock Wave Therapy.  Any one considering a surgical approach should definitely consider minimally invasive or non-invasive procedures like Shock Wave Therapy first—we strongly recommend ESWT to many of our plantar fasciitis Beaver patients.

Who should not get ESWT or Shock Wave Therapy in New York?

Some patients don’t qualify for an ESWT, but it has been used successfully on all major patient populations.  

  • Over or near bone growth center until bone growth is complete
  • If you have a calcaneal stress fracture, this is not generally indicated.
  • When a malignant disease is known to be present in or near the treatment area
  • Infection in the area to be treated
  • Patient has a coagulation disorder or taking anti-coagulant medications
  • Patient has a prosthetic device in the area to be treated

I’ve had cortisone injections but they did not work.  Is ESWT right for me?

  • ESWT is a great option for non-healing plantar fascia patients who have not achieved full relief with shots.  In fact, Shock wave treatment has reduced the need for more injections in most patients. Every one is different and while there are no absolute rules, make sure to discuss it with your podiatrist.

Are patients  satisfied with ESWT?

  • Yes.  Many of our patients with plantar fasciitis in Wexford have been satisfied and have recommended it to their friends and families!

Is ESWT NYC a type of surgery, and is ESWT invasive?

  • Extracorporeal Shock Wave Therapy does not cut the skin at all and is not considered surgery.  ESWT is non-invasive treatment; this is a major reason doctors prefer it as a better option than surgery.

Is Extracorporeal Shock Wave Therapy a good option for patients who have failed open surgery for plantar fasciitis?

  • Yes, ESWT is a good option for those who have failed traditional plantar fascia surgery.  Many people with failed surgery get excellent results with ESWT.
 Orthotripsy, ESWT machine for Achilles Tendinitis, Pittsburgh PA

Orthotripsy, ESWT machine for Achilles Tendinitis, Pittsburgh PA

What are the most common side-effects of ESWT , Philadelphia?  What are potential ESWT complications?

  • ESWT in Philadelphia is not an invasive procedure and so may have a little numbness or soreness for several days after the procedure usually with no other ill effects.  Our Plantar Fasciitis Beaver patients frequently report this as the extent of their common side-effects.

How does one prepare for a Extracorporeal Shock Wave Treatment?

  • There is not any special prep needed before Extracorporeal Shock Wave Therapy  in New Jersey.

Are there medicines should I quit taking before ESWT treatment?

  • Before ESWT patients should discontinue NSAIDS, Coumadin, and other blood thinners, as these would increase bruising to the area.

What should I do after my  Extracorporeal Shock Wave Therapy procedure?  What’s the ESWT after-care?

  • No special post procedural care is necessary.  A patients can use heat but not ice if wanted after treatment. Tylenol is OK for pain.

When can I expect to see the maximum results of the procedure?

  • Patients usually feel significant relief by month three, although after the first two weeks or so it often improves little by little as the area heals itself naturally. Symptoms lessen gradually in the following weeks  after the ESWT, and usually disappear completely.

When can patients resume normal, everyday activities after a Shock Wave Therapy like house work, driving, running and walking?

  • You can resume normal daily activities immediately; however running, tennis and high impact activities should be delayed for several weeks.

How soon can I go back to higher impact, vigorous activities like sports and weight lifting?

  • We tell our patients with plantar fasciitis in McCandless to wait for fourteen days to resume vigorous activity to be absolutely certain of an optimal outcome.

What’s the best outcome I can expect after Extracorporeal Shockwave?

  • After ESWT one can expect complete relief of the symptoms of plantar fasciitis and resume normal activities with no restrictions.

What’s the  worst outcome I can expect from ESWT?

  • There is not any procedure guaranteed to succeed 100% of the time.  For example, a patient with several failed surgeries with extensive fascia, tendon, and ligamentous damage may experience no relief at all.  This being said, ESWT has not been shown to  make plantar fasciitis or other conditions worse.

Is ESWT covered by insurance?  What are the costs of the procedure?

  • Many of our Plantar Fascia, Mars patients have had insurance cover this procedure, the office manager will check insurance eligibility for each person or you can call and check your benefits.

Is ESWT FDA approved?

  • Dornier EpoSTM Ultra by- Dornier Medical Systems, Inc.; FDA inspection of the manufacturing facility determined that the applicant was in compliance with the Quality System Regulation (21 CFR 820). Approval for this PMA application was issued on January 15, 2002.
  •  The National Institute for Clinical Excellence (NICE) reviewed the procedure in 2015 and approved Shockwave therapy for general use in all medical facilities.
  • Indications for Use The Dornier EpoSTM Ultra is a non-surgical alternative for the treatment of chronic plantar fasciitis for patients with symptoms of plantar fasciitis for 6 months or more and a history of unsuccessful conservative therapy. Plantar fasciitis is defined as the traction degeneration of the plantar fascial band at its origin on the medial tubercle of the calcaneus.

What else is Shockwave Therapy used for?

  • Extracorporeal Shock Wave Therapy was originally developed in the 1960's as lithotripsy, to break up kidney stones, and was soon adapted to treat other conditions.  Now ESWT is often used to treat tennis elbow,  achilles tendonitis, plantar fasciitis and other soft-tissue injuries.  Theoretically, Shock Wave Therapy can be used to provide an effective treatment for many over-use injuries involving fascia, tendons and ligaments.

Plantar fasciitis studies: 

Plantar fasciitis Study #1 (Click to see full study - Free Registration is required to view this study)
Ching-Jen Wang, MD, and his colleagues found 82.7% good-to-excellent results and a 12% recurrence rate in plantar fasciitis patients at an average 5 years to 6 years after extracorporeal shock wave treatment. They compared these results to those of patients treated conservatively: 55% good-to-excellent results and a 55% recurrence rate.
Short-term studies on shock wave treatment for plantar fasciitis have shown 91% satisfactory results and a 6% recurrence rate, Wang said at the American Academy of Orthopaedic Surgeons 74th Annual Meeting.


Plantar fasciitis Study #2 (Click to see full study)
"The results of this study confirm that ESWT administered with the Dornier Epos Ultra is a safe and effective treatment for recalcitrant plantar fasciitis."

Plantar fasciitis Study #3 (Click to see full study)
It was concluded that ESWT was both efficacious and safe for participants with chronic proximal plantar fasciitis that had been unresponsive to exhaustive conservative treatment.

Plantar fasciitis Studies (Click to see full studies on pages 17 & 18)
http://www.ismst.com/pdf/abstracts12congress.pdf
Study #15 entitled: "Effectiveness of Shockwave Therapy in Patients with Chronic Plantar Fasciitis" found on page 17
Study #16 entitled: "Plantar Fasciitis: Four Years After ESWT" found on page 18
Study #17 entitled: "ESWT in the Treatment of Plantar Fasciitis: follow-up at three years" found on page 18