If you've been struggling with persistent plantar fasciitis that hasn't responded to traditional treatments, you may have heard about shockwave therapy. Some patients call it "electric shock therapy," but don't worry - it's nothing like what that name suggests!
Shockwave therapy for plantar fasciitis is actually a gentle, non-invasive treatment that many patients find surprisingly comfortable. It's become an increasingly popular option for stubborn heel pain cases, offering hope when other treatments haven't worked. But what exactly is it, does it hurt, and could it help you finally get back to pain-free walking?
What is Shockwave Therapy? (And Why It's Not Actually "Electric Shock")
Let's clear up the confusion first: shockwave therapy has nothing to do with electrical shocks. There are no electrical currents, no risk of electrocution, and most patients describe the sensation as rhythmic tapping rather than anything shocking or painful.
The treatment uses sound waves - similar to ultrasound - that are delivered to your heel through a handheld device. Think of it as a very targeted, therapeutic massage using sound waves instead of hands. Most people find it quite tolerable, and many even find the rhythmic pulsing sensation oddly relaxing.
During treatment, you'll simply lie comfortably while your physiotherapist applies the device to specific areas around your heel and arch. The whole session typically takes just 10-15 minutes, and you can return to normal activities immediately afterward.
How Does Shockwave Therapy Help Your Heel Pain?
Here's the simple explanation: shockwave therapy helps "wake up" your body's natural healing process in areas where healing has stalled. When you've had plantar fasciitis for months, sometimes the damaged tissue gets stuck in a cycle where it's not healing properly.
The sound waves from shockwave therapy give that healing process a gentle nudge, encouraging:
Better blood flow to the injured area
Reduced pain signals
Improved tissue repair
Breakdown of any scar tissue that might be causing stiffness
Many patients notice some improvement within the first few weeks, though the full benefits often continue developing for months after treatment.
The Science Behind Shockwave Therapy or ESWT (For Those Who Want the Details)
For readers interested in the technical aspects, shockwave therapy (properly called Extracorporeal Shockwave Therapy or ESWT) works through several well-researched biological mechanisms:
Neovascularization
The acoustic waves stimulate the formation of new blood vessels in the treated area. Improved blood supply means better oxygen and nutrient delivery to the damaged plantar fascia, accelerating the healing process.
Pain Reduction
Shockwave therapy appears to disrupt pain signals and reduce sensitivity in nerve endings. This can provide both immediate and long-term pain relief for many patients.
Tissue Regeneration
The controlled micro-trauma created by the shockwaves triggers the release of growth factors and stem cells, promoting the repair and regeneration of damaged fascia tissue.
Breaking Down Calcifications
In cases where heel spurs or calcifications are present, shockwave therapy may help break down these deposits, reducing mechanical irritation.
Expert Insight: "Shockwave therapy offers us an excellent non-invasive option for patients whose plantar fasciitis hasn't responded to initial conservative treatments. The research shows it can significantly reduce pain and improve function, particularly in chronic cases where other interventions have plateaued."
Is Shockwave Therapy Effective for Plantar Fasciitis?
The evidence supporting shockwave therapy for plantar fasciitis is substantial and growing. Multiple clinical studies have demonstrated its effectiveness:
Research Outcomes
Pain reduction: Studies show 60-80% of patients experience pain reduction
Functional improvement: Most patients report improved ability to walk and perform daily activities
Long-term benefits: Effects often continue to improve for months after treatment
Success in chronic cases: Particularly effective for plantar fasciitis lasting longer than 6 months
Comparison to Other Treatments
Research suggests shockwave therapy can be more effective than:
Corticosteroid injections (longer-lasting results and has lower side effects)
Standard physiotherapy alone (when combined with exercise)
Placebo treatments (significantly better outcomes)
When is Shockwave Therapy Most Effective for Heel, Arch or Achilles Pain?
Shockwave therapy tends to work best for:
Chronic plantar fasciitis (symptoms present for 3+ months)
Cases resistant to standard conservative treatments
Patients wanting to avoid injections
Active individuals seeking faster return to sports or exercise
What to Expect During Shockwave Therapy Treatment for Foot Pain
Understanding the treatment process helps set realistic expectations and reduces anxiety about this advanced therapy.
Initial Assessment
Before starting shockwave therapy, your physiotherapist will:
Assess your plantar fasciitis severity and duration
Review previous treatments and their effectiveness
Examine your foot mechanics and walking pattern
Discuss your goals and expectations
Determine if you're a suitable candidate for treatment
The Treatment Session
A typical shockwave therapy session involves:
Preparation: The treatment area is cleaned and gel is applied
Positioning: You'll lie comfortably while your foot is positioned optimally
Treatment: The shockwave device is applied to specific points on your heel and arch
Duration: Each session typically lasts 10-15 minutes
Comfort measures: Treatment intensity is adjusted to your comfort level
What Does Shockwave Therapy Feel Like?
Most patients describe the sensation as:
Rhythmic tapping or pulsing
Mild to moderate discomfort rather than pain, like a deep ache/toothache sensation
Tolerable and manageable throughout the session
Some tenderness immediately after treatment (usually mild)
How Many Shockwave Therapy Sessions Do You Need?
The number of sessions varies depending on several factors, but typical treatment protocols include:
Standard Protocol
3-6 sessions spaced 5-7 days max
Assessment after 3 sessions to evaluate response
Additional sessions if showing positive response
Factors Affecting Session Number
Severity of condition: More chronic cases may need additional sessions
Individual response: Some patients respond faster than others
Concurrent treatments: Combining with exercise therapy may result in a better outcome
Type of shockwave: Focused therapy may require fewer sessions
Timeline for Results
Immediate: Some patients notice reduced pain within 24-48 hours
2-4 weeks: Patients may report noticeable improvement during this period
6-12 weeks: Peak benefits typically occur during this period
3-6 months: Continued improvement may occur long after treatment ends
Case Study: Mark's Recovery with Shockwave Therapy
Mark, a 45-year-old runner, had been struggling with plantar fasciitis for 8 months. Despite consistent stretching, physiotherapy exercises, custom orthotics, and even a corticosteroid injection, his heel pain persisted, preventing him from returning to his beloved morning runs.
Previous treatments tried:
3 months of stretching and strengthening exercises
Custom orthotic insoles
Night splints
Corticosteroid injection (temporary relief only)
Activity modification and rest periods
Shockwave therapy protocol:
Initial assessment confirmed chronic plantar fasciitis with moderate pain levels
4 sessions of focused shockwave therapy over 4 weeks
Continued home exercise program throughout treatment
Gradual return to running protocol
Results:
After 2 sessions: 40% reduction in morning pain
After 4 sessions: 70% improvement in overall symptoms
8 weeks post-treatment: Return to pain-free running
6 months later: Remained symptom-free with maintenance exercises
Mark's success highlights how shockwave therapy can be the catalyst needed when other treatments have plateaued.
Are There Any Side Effects of Shockwave Treatment?
Shockwave therapy is generally very safe, but like any treatment, it can have some side effects:
Common, Mild Side Effects
Temporary soreness at the treatment site (24-48 hours)
Mild swelling around the treated area
Skin redness that resolves within hours
Bruising in sensitive individuals (rare)
Rare Side Effects
Increased pain for 1-2 days post-treatment (usually settles quickly)
Temporary numbness in the treatment area
Who Should Avoid Shockwave Therapy
Shockwave therapy isn't suitable for everyone. It's not recommended for:
Pregnant women
Patients with bleeding disorders
Those taking blood-thinning medications
Individuals with pacemakers (in the treatment area)
Active infections in the foot
Certain nerve disorders
Metalwork in the area
Shockwave Therapy vs Other Plantar Fasciitis Treatments
Understanding how shockwave therapy compares to other options helps you make informed decisions:
Shockwave vs Corticosteroid Injections
Pain relief: Both provide significant pain reduction
Duration: Shockwave effects typically last longer
Risks: Injections carry risk of fascia rupture and fat pad atrophy
Repeatability: Shockwave can be repeated safely if needed
Shockwave vs Surgery
Invasiveness: Shockwave is completely non-invasive
Recovery time: No downtime vs weeks of recovery post-surgery
Success rates: Similar success rates for appropriate candidates
Risks: Minimal risks vs surgical complications
Shockwave vs Physiotherapy Alone
Effectiveness: Combination therapy often most effective
Speed: Shockwave can accelerate physiotherapy results
Compliance: Some patients respond better to passive treatments initially
Maximising Your Shockwave Therapy Results
To get the best outcomes from shockwave therapy:
Before Treatment
Continue appropriate exercises as recommended by your physiotherapist
Maintain proper footwear and orthotic use
Stay hydrated for optimal tissue response
Avoid anti-inflammatory medications 48 hours before treatment (may interfere with healing response)
After Treatment
Light activity is encouraged (avoid high-impact for 24-48 hours)
Apply ice if experiencing post-treatment soreness
Continue home exercises to maintain and build on improvements
Follow up appointments to monitor progress and adjust treatment
Long-term Success
Gradual return to previous activity levels
Ongoing strengthening and flexibility exercises
Proper footwear and orthotic maintenance
Activity modification to prevent recurrence
How Fast Does Shockwave Therapy Work for Heel Pain?
One of the most common questions patients ask is about timeline expectations:
Immediate Response (0-48 hours)
Some patients experience immediate pain reduction
Others may have temporary increased soreness
Both responses are normal and don't predict final outcome
Short-term Response (1-4 weeks)
Most patients begin noticing improvements
Pain levels typically start decreasing
Functional activities become easier
Medium-term Response (4-12 weeks)
Peak benefits usually occur during this period
Significant functional improvements
Return to activities often possible
Long-term Response (3-6 months)
Continued improvement may occur
Tissue healing and remodeling continues
Optimal long-term outcomes typically achieved
Is Shockwave Therapy Right for You?
Shockwave therapy may be an excellent option if you:
Have had plantar fasciitis for 3+ months
Haven't achieved adequate relief with standard treatments
Want to avoid invasive procedures like injections or surgery
Are motivated to combine treatment with appropriate exercises
Have realistic expectations about treatment timeline
Are looking for a well-researched, evidence-based treatment option
Questions to Discuss with Your Physiotherapist
How long have you had plantar fasciitis symptoms?
What treatments have you tried previously?
What are your activity goals?
Are you committed to a comprehensive treatment approach?
Do you have any contraindications to shockwave therapy?
The Future of Shockwave Therapy
Research continues to refine shockwave therapy protocols, with ongoing studies investigating:
Optimal energy levels and session frequencies
Combination with other therapies
Personalised treatment approaches based on individual factors
Long-term outcomes and prevention strategies
Taking the Next Step
If you're struggling with persistent plantar fasciitis and traditional treatments haven't provided the relief you need, shockwave therapy could be the breakthrough you've been looking for. This evidence-based, non-invasive treatment offers hope for those dealing with chronic heel pain.
The key to success with shockwave therapy lies in:
Proper assessment to ensure you're a suitable candidate
Realistic expectations about treatment timeline and outcomes
Commitment to a comprehensive approach including appropriate exercises
Professional guidance throughout the treatment process
Remember, shockwave therapy works best as part of a comprehensive treatment plan, not as a standalone "magic bullet." When combined with appropriate physiotherapy, exercise, and lifestyle modifications, it can be highly effective in helping you return to pain-free movement.
Ready to explore shockwave therapy for your plantar fasciitis? Contact our clinic to discuss whether this advanced treatment option could help accelerate your recovery and get you back to the activities you love.