The Center for Podiatric Care and Sports Medicine

What Is Shockwave Therapy For Foot Pain?

Posted by on Wednesday, May 15th, 2013


The NBA playoffs have left many pro athletes sidelined with foot injuries. Chicago Bulls center Joakim Noah and LA Lakers guard Kobe Bryant have both had shockwave therapy for foot pain. This relatively new technique is a noninvasive, FDA-approved procedure that stimulates blood circulation and healing by delivering pressure waves into the painful area. The session only takes about 15 minutes and sometimes delivers immediate pain relief. Other times, it may take up to four weeks before significant results are felt.

Who Needs Shockwave Therapy For Foot Pain?

Rosemary Smith told the UK Daily Mail that heel pain had crippled her. One day she was standing at the photocopier thinking her feet were just aching from standing all day at work. Over the next eight months, she realized something was wrong with both her feet. She switched to flatter shoes and took painkillers, but found no relief.

“I started turning down invitations unless someone was giving me a lift, and I found a different job which meant more sitting down,” she recalls. Exercise was out of the question. She visited a podiatrist to learn foot stretches for her condition, which “helped a little,” but failed to cure her unending pain. Smith was told that the surgery success rate was only 60% — and that 90% of patients will find reprieve within a year without surgery. Yet, her pain was so unbearable she couldn’t wait that long. That’s when she learned about extracorporeal shockwave therapy for foot pain.

“While doctors don’t know exactly how it works, we think it creates micro-damage which inflames the tissue, so the body responds by healing,” says Dr. Dominic Radford, the London Bridge Hospital doctor who treated Rosemary Smith.

Chris Walker, a consultant in orthopedic surgery from Royal Liverpool University, explains, “The idea of using shockwaves or lithotripsy to break up kidney stones has been around for 20 years or so, but only recently have we realized that it can also help heal tendons or ligaments, which is very exciting. It’s been shown to have a success rate of 80 per cent. It’s most effective in patients who have had plantar fasciitis for a long time — over six to 12 months.”

What Does Shockwave Therapy For Foot Pain Feel Like?

“The shocks are like a little baseball bat hitting the tissue,” says Dr. George Theodore of Massachusetts General Hospital.

During extracorporeal pulse activation treatment, the podiatrist uses a gun and tube attached to an air compressor box to fire a shockwave into the foot. Dr. Radford explains that the waves are transmitted ten times a second to travel through the damaged ligament with more force than walking or running to prompt healing. The foot is typically an area that sees little blood flow and, therefore, heals very slowly. So, when this procedure is done, the blood rushes into the foot to start healing immediately.

“It felt very odd,” Rosemary Smith admitted, “like someone bouncing a hard ball off the underside of my foot — but it didn’t hurt.” Her doctor turned up the intensity and delivered more shocks, but the procedure numbed the nerve endings, so she didn’t notice the difference.

Does Shockwave Therapy For Plantar Fasciitis Work?

“When I got off the bed, my feet felt more comfortable than they had in years,” said Rosemary Smith.

Since the anesthetizing effect is only temporary, Smith had to return for three treatments spaced a week apart to continue prompting the feet to heal themselves. Each time, she felt greater relief. After six months, she felt completely healed. Her feet still ache after shopping or standing for hours, but she no longer has to “tiptoe out of bed” and she is now able to wear high heels again.

Clinical trials show that extracorporeal shockwave therapy (ESWT) is both safe and effective in the treatment of plantar fasciitis and foot pain. A study by the Trauma Center Murnau in Germany reported that ESWT resulted in a 73.2% reduction in heel pain, compared to a 32.7% reduction achieved with a placebo. While this may not seem like a significant difference from a clinical standpoint, the report said that shockwave therapy patients achieved significant improvements in morning pain and ability to achieve daily tasks. In other words, their quality of life was much better and their pain felt significantly diminished after shockwave therapy.

While it’s still somewhat controversial among “traditionalists” who feel patients should be cured with enough time, icing and stretching, the most innovative podiatrists are adding this advanced therapy to their repertoire to benefit athletes who need to get back to their sports quicker and chronic plantar fasciitis sufferers who feel the pain has gone on for far too long.


If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.