Heel spurs, bony protrusions on the underside of the heel bone, are a common cause of chronic heel pain. Affecting millions of people worldwide, they can significantly impact daily activities and overall quality of life. Heel spurs often occur alongside plantar fasciitis, an inflammation of the plantar fascia, which further exacerbates the pain.
Traditional treatments for heel spurs include rest, ice, anti-inflammatory medications, physical therapy, orthotic devices, and, in severe cases, surgery. While these methods can provide relief, they may not be effective for everyone, and some patients may continue to experience pain despite trying multiple treatment options. In addition, surgical intervention carries risks and requires a lengthy recovery period.
In recent years, shockwave therapy has emerged as a promising alternative treatment for heel spurs. This non-invasive, low-risk procedure uses high-energy sound waves to promote healing and alleviate pain. Shockwave therapy has gained popularity due to its potential to provide long-lasting relief, minimal side effects, and shorter recovery times compared to traditional treatments. The following sections will delve deeper into the science and application of shockwave therapy for heel spurs.
Understanding Heel Spurs
Definition and causes
Heel spurs are calcium deposits that form bony protrusions on the underside of the heel bone (calcaneus). They develop over time due to repetitive strain on the foot’s soft tissues, including the plantar fascia, a thick band of tissue that connects the heel bone to the toes. Common causes of heel spurs include walking or running on hard surfaces, wearing poorly fitted or worn-out shoes, and carrying excess body weight, which places additional stress on the feet.
Symptoms and diagnosis
Heel spurs themselves may not cause pain; however, the associated inflammation and strain on surrounding tissues can lead to discomfort. Symptoms typically include a sharp, stabbing pain in the heel, which may be more pronounced in the morning or after periods of inactivity. Pain may also worsen during or after exercise.
Diagnosing heel spurs involves a thorough physical examination and a review of the patient’s medical history. Imaging tests, such as X-rays, magnetic resonance imaging (MRI), or ultrasound, may be used to confirm the presence of a heel spur and rule out other potential causes of heel pain.
Risk factors and prevention
Certain factors increase the risk of developing heel spurs, including age, obesity, biomechanical abnormalities (e.g., flat feet or high arches), and occupations or activities that require long periods of standing or walking. To prevent heel spurs, it is crucial to maintain a healthy body weight, wear well-fitting and supportive shoes, and engage in regular stretching and strengthening exercises for the feet and lower leg muscles. If you are experiencing persistent heel pain, consult a healthcare professional to determine the underlying cause and appropriate treatment options.
The Science of Shockwave Therapy
Shockwave therapy is a non-invasive treatment that uses high-energy sound waves to stimulate the body’s natural healing process. It is commonly used to treat various musculoskeletal conditions, including heel spurs, plantar fasciitis, and tendinopathies. There are two main types of shockwave therapy: focused shockwave therapy (FSWT) and radial shockwave therapy (RSWT). FSWT generates high-pressure, narrow waves that penetrate deeper into the tissue, while RSWT produces lower-pressure, broader waves that dissipate over a wider area.
Shockwave therapy works by delivering a series of acoustic impulses to the affected area, creating microtrauma and stimulating the body’s healing response. This process increases blood flow and cellular activity, promoting tissue regeneration and reducing inflammation. Additionally, shockwave therapy can help break down scar tissue and calcification, which can contribute to the pain and immobility associated with heel spurs. Shockwave therapy offers several benefits over traditional heel spur treatments. It is a non-invasive procedure with minimal side effects and faster recovery times compared to surgery. Clinical studies have shown that shockwave therapy can provide long-lasting pain relief and improved function for many patients.
Shockwave therapy may not be effective for everyone, and multiple sessions may be required to achieve optimal results. While the procedure is generally well-tolerated, some patients may experience discomfort during or after treatment.
Shockwave Therapy for Heel Spurs
Treatment process and duration
Shockwave therapy for heel spurs typically involves a series of treatments, with each session lasting approximately 15-30 minutes. The exact number of sessions required depends on the severity of the condition and the patient’s response to treatment. Generally, patients undergo 3-5 sessions spaced one week apart. Before the procedure, a gel is applied to the skin to enhance the transmission of shockwaves. The clinician then administers the acoustic waves to the affected area using a handheld device.
Success rates and clinical studies
Numerous clinical studies have demonstrated the effectiveness of shockwave therapy for heel spurs and associated conditions like plantar fasciitis. Success rates vary, but many studies report significant improvements in pain and function for up to 80% of patients. It is important to note that individual results may vary, and some patients may require additional treatments or adjunct therapies to achieve optimal outcomes. See the end of this article for links to the studies.
Comparisons to traditional treatments
Shockwave therapy offers several advantages over traditional heel spur treatments. It is non-invasive, has a lower risk of complications, and typically involves shorter recovery times compared to surgery. Furthermore, it can provide long-lasting pain relief and improved function for many patients who have not responded to conservative treatments, such as orthotics, physical therapy, and anti-inflammatory medications. However, it is essential to consider the cost of shockwave therapy and the potential need for multiple sessions when comparing it to other treatment options.
Preparing for Shockwave Therapy
Before undergoing shockwave therapy, patients should have a thorough evaluation by a healthcare professional to confirm the diagnosis of heel spurs and determine the suitability of the treatment. This assessment may involve a physical examination, a review of the patient’s medical history, and imaging tests, such as X-rays, MRI, or ultrasound.
Contraindications and precautions
Shockwave therapy is generally considered safe for most patients; however, there are some contraindications and precautions to consider. Individuals with certain medical conditions, such as blood clotting disorders, infections, or tumors in the treatment area, may not be suitable candidates for the therapy. Additionally, pregnant women and individuals with pacemakers or other implanted electronic devices should avoid shockwave therapy. It is essential to inform your healthcare provider of any underlying health issues or concerns before undergoing the treatment.
Although shockwave therapy has been shown to be effective in treating heel spurs for many patients, it is essential to have realistic expectations about the treatment outcomes. Some individuals may require multiple sessions to achieve optimal results, and the pain relief may not be immediate. Additionally, a small percentage of patients may not experience significant improvements despite undergoing the therapy. It is crucial to discuss your expectations and concerns with your healthcare provider before embarking on the treatment journey.
Combining Shockwave Therapy with Other Treatments
Shockwave therapy can be combined with other treatments to enhance its effectiveness and address various aspects of heel spur pain. Complementary therapies may include:
- Physiotherapy: Strengthening and stretching exercises can improve flexibility and reduce strain on the plantar fascia and heel.
- Orthotic devices: Custom shoe inserts or arch supports can help distribute pressure evenly across the foot and reduce stress on the heel.
- Anti-inflammatory medications: Over-the-counter or prescription medications can help manage pain and inflammation associated with heel spurs.
In some cases, a sequential approach to treatment may be recommended, with shockwave therapy being used in conjunction with other treatments over time. For example, a patient may begin with conservative treatments such as orthotics and physical therapy. If these methods do not provide sufficient relief, shockwave therapy may be introduced as the next step before considering more invasive options like surgery.
A collaborative approach to care involving various healthcare professionals, such as podiatrists, physiotherapists, and orthopedic specialists, can help ensure the most effective treatment plan for heel spur patients. Each specialist can contribute their expertise to address different aspects of the condition and provide comprehensive care. It is essential to maintain open communication with your healthcare team to ensure that all treatments are coordinated and tailored to your specific needs.
The Potential of Shockwave Therapy
Shockwave therapy has emerged as a promising alternative treatment for heel spurs, offering a non-invasive, low-risk option for patients who have not found relief through traditional methods. With its potential to provide long-lasting pain relief, minimal side effects, and faster recovery times, shockwave therapy is becoming an increasingly popular choice for managing chronic heel pain.
While shockwave therapy has demonstrated effectiveness for many patients, it is essential to consider individual factors, such as the severity of the condition, patient preferences, and potential contraindications, when determining the most appropriate treatment plan. A comprehensive evaluation by a healthcare professional and a collaborative approach to care can help ensure the best possible outcomes for patients with heel spurs.
If you want to learn more about Shockwave therapy treatment in the Newmarket area, contact FIT Physiotherapy today to learn more.
* Here are some clinical studies that have investigated the success rates of shockwave therapy, specifically for plantar fasciitis and heel spurs:
- Gerdesmeyer, L., Frey, C., Vester, J., Maier, M., Weil, L., Weil, L., … & Scurran, B. (2008). Radial extracorporeal shock wave therapy is safe and effective in the treatment of chronic recalcitrant plantar fasciitis: results of a confirmatory randomized placebo-controlled multicenter study. The American Journal of Sports Medicine, 36(11), 2100-2109. URL: https://journals.sagepub.com/doi/full/10.1177/0363546508324176
- Rompe, J. D., Decking, J., Schoellner, C., & Nafe, B. (2003). Shock wave application for chronic plantar fasciitis in running athletes: a prospective, randomized, placebo-controlled trial. The American Journal of Sports Medicine, 31(2), 268-275. URL: https://journals.sagepub.com/doi/abs/10.1177/03635465030310021901
- Ibrahim, M. I., Donatelli, R. A., Schmitz, C., Hellman, M. A., & Buxbaum, F. (2010). Chronic plantar fasciitis treated with two sessions of radial extracorporeal shock wave therapy. Foot & Ankle International, 31(5), 391-397. URL: https://journals.sagepub.com/doi/abs/10.3113/FAI.2010.0391
- Gollwitzer, H., Saxena, A., DiDomenico, L. A., Galli, L., Bouche, R. T., Caminear, D. S., … & Rahlfs, V. W. (2015). Clinically relevant effectiveness of focused extracorporeal shock wave therapy in the treatment of chronic plantar fasciitis: a randomized, controlled multicenter study. Journal of Bone and Joint Surgery, 97(9), 701-708. URL: https://journals.lww.com/jbjsjournal/Abstract/2015/05060/Clinically_Relevant_Effectiveness_of_Focused.2.aspx
These studies generally report significant improvements in pain and function following shockwave therapy for plantar fasciitis and heel spurs. However, it is essential to note that success rates may vary depending on factors such as the study population, treatment protocols, and the type of shockwave therapy used (focused or radial).