Treatments For Heels

The OssaTron® is currently indicated by the FDA to treat heel pain (chronic plantar fasciitis) which has failed to respond to conservative therapies.

What is Plantar Fasciitis?

Although the exact etiology in unknown, causative factors suggested are plantar fascia inflammation and blood vessel network degeneration. Radiographic findings indicate that 60-75% of patients with heel pain will have a heel spur present. Although initially associated with subcalcaeal pain, the spur has never been established as the cause of pain and does not routinely disappear after successful treatment with ESWT.

A patient usually reports of a gradual onset of pain at the medial side of the heel. The pain is characterized as sharp and/or aching. Classically, the pain is worse upon arising in the morning and in the early stages of the condition will usually subside after a few steps. As the condition persists, the pain will continue for longer periods and return after resting for only 30-45 minutes during the day.

Patient Characteristics

Patients with a history of current or recent drug therapy that interferes with tissue healing, such as immunosuppressive agents or long term corticosteroids, should be carefully evaluated prior to treatment with the OssaTron®. Use of such medications may reduce the effectiveness of ESWT. Patients should wait at least four weeks after a cortisone injection before treatment with the OssaTron®.

Prior to treatment with the OssaTron®, patients should be carefully screened for concomitant conditions which could be responsible for or contribute to the symptoms. These may include tarsal tunnel syndrome or other nerve entrapment, radiculopathy, diabetic neuropathy, stress fracture of the calcaneus, significant peripheral vascular disease, seronegative arthropathies, rheumatoid arthritis, and other similar conditions.

The necessary extent of pretreatment evaluation should be determined by the treating physician.

Contraindications

Potential Effects of ESWT

• Pain during the treatment
• Localized numbness, tingling or decreased sensation
• Local subcutaneous hematoma or bruising
• Misdirection of the ESWT can affect major nerve or blood vessels
• Anesthesia complications
• Rupture of plantar fascia

Discharge Orders

• To avoid re-injury to the affected area, the patient should be advised to restrict stressful activity involving the affected heel for 4 weeks - e.g. heavy work, yard work, sports.
• Schedule the necessary follow up visits as recommended by the physician.
• Patients may experience some pain or discomfort in the treated heel after the anesthesia effects have subsided. They may also continue to experience for 1 to 2 weeks the same type of heel pain they experienced prior to treatment. Pain is manageable by OTC pain medication (without anti-inflammatory ingredients). Patients should not take anti-inflammatory medication, as inflammation is the desired effect from ESWT, to stimulate the healing process.
• Based on the findings during the OssaTron® clinical trials, maximum healing effect of the procedure cannot be evaluated until 12 weeks post treatment. The healing effect is also dependent upon individual patient response.

What to Expect

• Before an OssaTron® treatment a patient can expect the physician to consult with them regarding their procedure.
• The area of pain will be marked with a marker.
• Anesthesia will be administered.
• After the procedure, once the anesthesia wears off, the patient will be able to leave the facility shortly thereafter with discharge ordered provided by the physician.
• The patient may have no pain following the treatment, but it may return to a lesser degree than the original pain level. The pain will gradually lessen over the next few weeks. If after 12 weeks you still have pain, then you should consult with your doctor about further treatment.