The Center for Podiatric Care and Sports Medicine

Extracorporeal Pulse Activation Therapy ( EPAT) for Heel Pain

Posted by on Wednesday, February 16th, 2011


Heel pain is very common among  competative and weekend athletes. The pain is localized to the bottom of the heel and along the arch.The pain can be quite persistent,lasting for months or even years. Plantar Fasciitis( heel pain that is mechanical in origin) is characterized by pain and stiffness upon arising in the morning. The pain has a tendency to decrease after a few minutes only to recur at the end of the day. In the early stages of plantar fasciitis the pain is more inflammatory in nature .The more chronic and longer lasting the pain the more the problem becomes one of  Plantar Fasciosis or degeneration of the fascia.

The treatments are quite different depending on how long you have had heel pain.

Treatment options for the inflammatory type of fasciitis can consist of the following: padding and strapping,therapeutic orthotic insoles,oral anti inflammatory medication,cortisone injections,achilles and plantar fascial stretching.

As the heel pain becomes more chronic, the following can be effective treatment options: Prefabricated and custom made orthotic devices, night splint, repeat cortisone injections or our preference bio puncture with homeopathic agents( to be discussed in a later blog) , physical therapy, cast or boot immobilization.

If there has been no improvement with the previous recommendations then EPAT( Extracorporeal Pulse Activation Therapy) is a very advanced and highly effective non-invasive treatment approved by the FDA. The technology is based on a unique set of pressure waves that stimulate the metabolism,enhance blood circulation and accelerate the healing process. Damaged tissue gradually regenerates and eventually heals.

The non-invasive EPAT has virtually no risks or side effects. In some cases, patients may experience some minor discomfort which may continue for a few days. It is normal to have some residual pain after intense exercise or a full day of work.

The beneficial effects of EPAT are often experienced after only 3 treatments. Some patients report immediate pain relief after the treatment,although it can take up to 4 weeks for pain relief to begin. The procedure eliminates pain and restores full mobility. Over 80% of patients treated report to be pain free and/or have significant pain reduction.

If  EPAT is not successful: PRP (to be discussed in a later blog), bipolar radio frequency, endoscopic plantar fasciotomy are further viable treatment options.

Dr. Geldwert and Dr. Lai presented a study on the conservative treatment of Plantar Fasciits at the American College of Foot and Ankle Surgeons annual meeting and they found that 87% of their patients responded to Custom made orthotic devices and a stretching program. Subsequent to that study, Dr. Geldwert  found that with the use of EPAT the success rate incresed to close to 95%.

EPAT is an emerging technology in the US and, unfortunately, insurance companies do not yet cover the EPAT treatment. The EPAT treatment fee is reasonable by most patient standards and is a significant savings compared to paying deductibles,multiple co-pays and other non-insurance covered expenses as you attempt several months of conservative treatments,surgery and rehabilitation.

If you would like more information about EPAT , other treatments for Plantar Fasciitis or need an appointment for evaluation and treatment call 212-996-1900 or 914-328-3400.


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.