Dornier Epos Ultra - Extracorporeal Shock Wave Treatment or ESWT

A painful heel (bone) spur? The bone spur, an outcropping of bone in the heel, or calcaneus, actually is not the culprit. It’s difficult for people to accept that the spur is not really the issue.

Not only do obesity, high arched and flat feet contribute to the condition, people who stand long hours on the job and especially those who put all their weight on one foot may develop pain diagnosed as plantar fasciitis. The fascia is a fibrous band that originates at the heel bone and inserts into the bases of the toes so that it is maximally taut when at midstance and at propulsive phase of walking when it is as tight as a bowstring.

Anti-inflammatory drugs, physical therapy and orthotics are the conservative treatments with occasional cortisone injections that sometimes relieve the pain. When they fail, I am enthusiastic about the NONSURGICAL APPROACH utilizing the Dornier Epos Ultra, which addresses the pain of plantar fasciitis using non-invasive shock waves. This is the same company that makes the surgery free Lithotripsy machine for kidney stones.

While the equipment has been available for two or three years, Dr. Parker was one of the first podiatrists in Houston to employ it. The unit is positioned against the patient's heel and delivers shock waves while the patient is comfortably under IV sedation and local anesthetic in an outpatient setting. The theory is that the shockwaves cause increased inflammation and blood flow through what is called neovascularization, which allows for the healing of the inflamed and swollen/thickened plantar fascia. Research is ongoing in an attempt to pinpoint exactly how the procedure works.

As it was in the 1980’s when insurance companies didn’t cover the Lithotripsy, many are still in the wait-and-see mode. "They are typically slow to come around. But when you prove that it's effective (63% of the most difficult cases) and cost-effective, then more and more companies will approve it. I expect most of the major ones will in the next year or two. With this equipment, it is typically a one-time procedure, when it works.

Dr. Parker suggests this often when the next step is for the patient to have surgery. You have nothing to loose if the insurance covers the procedure and you have a 63% chance of cure without surgery.

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