Doctors Relieve Chronic Heel Pain with New Shock Wave Therapy System
A First in Atlanta
pain, known as plantar fasciitis, affects some 2.5 million people each
year in the United States. It is a common injury among runners and others
who spend a lot of time on their feet. Those who are overweight or have
high-arched feet also face a higher risk of developing plantar fasciitis.
Now a new machine at Emory
University, and in Atlanta, uses shock wave therapy to relieve this
chronic foot pain. The Food and Drug Administration (FDA) recently approved
the Dornier's Epos Ultra, developed by Dornier MedTech. "Since its approval,
people from all across the country have been calling to find out about
this new therapy," says Christoph Zenker, D.P.M., assistant professor
in the Department of Orthopaedics at Emory. Dr. Zenker treats the majority
of patients undergoing shock wave therapy.
"Plantar fasciitis is a condition
that does not get better with simple rest," Dr. Zenker points out. "However,
once it is diagnosed, it is very treatable."
Before one can become a candidate
for this procedure, all other more conservative treatments must be exhausted,
according to Dr. Zenker. Those treatment methods including icing the
foot, stretching the foot with various exercises and trying standard
anti-inflammatory medications. Oftentimes, doctors will encourage patients
to try prescription orthotics (prescription shoe supports).
"These conventional treatments
will usually help 95 percent of the affected patients," says Dr. Zenker.
"For the other five percent, if the patients do not respond to any of
the care mentioned and if their pain has lasted six months or more,
then they may be candidates for the Dornier's Epos Ultra."
The machine works by using
shock waves to break apart old scar tissue to help bring in new blood
flow or new blood vessel formation, a procedure called neovascularization.
Shock waves stimulate or trigger the body's own repair mechanisms, helping
the body to heal itself. The shock waves are delivered through a water-filled
cushion on which the foot rests. The machine's ultrasound imaging system
helps doctors to pinpoint the exact treatment site. No anesthesia is
needed for the therapy, but the foot can be numbed with an ankle block
before the procedure begins. The treatment takes 15 to 30 minutes and
is performed in the doctor's office.
Because this is a non-surgical
procedure, the risks and costs are greatly reduced. Potential side effects
include some pain and bruising for several days after the treatment.
Those with existing clotting or bleeding problems could experience some
bleeding with the new blood flow. Heavy activity (running, exercising,
other sports activities) should be avoided for about four weeks following
the treatment, then patients can gradually return to their normal activities.
The treatment costs $1,000 at Emory, much less than similar therapies.
Some insurance companies are covering the treatment on a case-by-case
"Shock wave therapy was originally
developed to break up kidney and gall stones for healing purposes,"
says Lamar Fleming, M.D., acting chair of the Emory Department of Orthopaedics
and primary researcher of this therapy. "We first saw this machine in
the German pavilion during the 1996 Summer Olympics in Atlanta. Trainers
were using it to help ease heel pain in German athletes. Several years
later, we started our own double-blind study using the Dornier and found
the success rate of this treatment to be over 80 percent effective for
chronic heel pain."
Doctors around the world,
especially in Europe and Canada, have successfully used this same shock
wave technology since the early 1990s. For more information about this
treatment or to schedule an appointment, please call the Emory Health
Connection at (404) 778-7777.