✅ Medically reviewed by Dr. Thomas Biernacki, DPM — Board-Certified Podiatrist · Last updated April 6, 2026

ESWT Treatment for Plantar Fasciitis[Extracorporeal Shock Wave Therapy]

ESWT treatment for plantar fasciitis is proven effective in medical research! ESWT is also known as extracorporeal shock wave therapy.

What is ESWT Shockwave Therapy?

• ESWT stands for Extracorporeal Shock Wave Therapy is a non-invasive method that uses pressure waves to treat various musculoskeletal conditions.
• High-energy acoustic waves (shock waves) deliver a mechanical force to the body’s tissues.

PROs vs. CONs of ESWT shockwave therapy:

There have been numerous research studies validating the effectiveness of ESWT shockwave therapy. These are some of the

Pros of ESWT therapy:

• 91% Success rate in relieving medical problems (as per clinical studies)
• Non-invasive.
• No anesthesia is required.
• No risk of infection.
• No scarring.
• No downtime.
• Over 80% patient satisfaction.
• Cost-effective.
• Faster, easier healing.

Cons of ESWT therapy:

• Some insurance plans do not cover ESWT.
• No readily available in most regions or cities.
• It can be a very costly machine to acquire for most medical practices.
• It is not 100% successful for every patient.
• Proper patient selection is needed for best results.

When should I avoid ESWT therapy?

• Complications are infrequent with ESWT shock wave therapy.
• People with poor sensation (neuropathy) or hypersensitivity in the target area should not have this procedure.
• Open sores should also be avoided. Shock wave therapy is not used in patients with heart conditions or seizures.
• It should not be used during pregnancy.
• This should be discussed with your physician before undergoing the procedure.

What Is Plantar Fasciitis?

• Plantar fasciitis is an excruciating condition where your heel may hurt, feel hot, or swell. The pain is a result of inflammation or microscopic tears of the plantar fascia. The fascia is a thin layer of tough tissue supporting the arch of the foot.
• Sometimes people refer to plantar fasciitis as “heel spurs,” but this is not generally accurate since the heel spurs result from plantar fasciitis. Heel spurs are a calcification that forms due to damage to the fascia.
• Often when you have plantar fasciitis, the pain is at its most intense when you first get out of bed. Sometimes it is noticeable at the beginning of an activity and gets better as the body warms up. Prolonged standing may cause pain, as well.
• Severe plantar fasciitis pain can cause loss of time from work and may lead to partial or total disability. Common surgical procedures used for the treatment of chronic plantar fasciitis may also lead to permanent disability.

2 Phases of Plantar Fasciitis:

There are two phases of the condition. 1)Acute Plantar Fasciitis:

• Acute fasciitis can be inflammation.  Inflammation alone can be treated with numerous conservative treatments.  Anything that addresses rest and inflammation can be helpful.
• Your podiatrist may use a steroid injection, strapping, taping, orthotics, or lasers in this phase.
• If the condition has moved on to phase 2, the tissue is damaged (micro-tearing) and needs to be repaired.

2)Chronic Plantar Fasciitis:

• For phase 2 of chronic plantar fasciitis (fasciosis), high-energy ESWT is FDA approved and shown to prevent surgery.
• Shockwave therapy can more effectively stimulate the chronic phase that results in scar tissue and disorganized tissue throughout the plantar fascia bands.
• ESWT shockwave therapy is a device proven to create this repair without surgery.

How Effective is ExtraCorporeal Shockwave Therapy (ESWT)?

• The effects of ESWT are best documented in areas of changes in tissue density, such as those where a tendon attaches to a bone (enthesopathies) and where a bone attaches to a ligament (neuropathies).
• For this reason, it is very effective for painful connective tissue in the heels. Additionally, ESWT gives hope by relieving pain, eliminating the risk factors associated with surgery, and allowing people to resume their normal lives.

Frequently Asked Shockwave Therapy Questions:

What is extracorporeal shock wave therapy?

• Shock wave therapy is a non-invasive method that uses pressure waves to treat various conditions in the body.
• These include plantar fasciitis, Achilles tendonitis, plantar fibroma pain, Achilles tendon, and muscle pain.
• Acoustic waves (aka shock waves) deliver a mechanical force to the body’s tissues.
• This can cause increased blood flow and blood vessels to develop in chronic and painful tissues.
• What signs indicate this therapy is needed?
• Shock wave therapy may treat conditions such as degenerated tendons, Achilles tendonitis, plantar fasciitis, plantar fibroma formation, back of the heel, and bottom of the heel pain.

When should I avoid this therapy?

• Complications are infrequent with shock wave therapy.
• People with poor sensation (neuropathy) or hypersensitivity in the target area should not have this procedure.
• Open sores should also be avoided.
• Shock wave therapy is not used in patients with heart conditions or seizures. It should not be used during pregnancy.
• This should be discussed with your physician before undergoing the procedure.

General Details of Procedure:

• A noninvasive probe is applied to the skin.
• An electrical charge creates an energy wave that is focused on the area of concern.
• The shock waves create a force on the tissues that may induce healing. This will allow the formation of blood vessels into the area.
• There is still developing evidence on how this procedure works.
• Some studies suggest that it may be that shock waves cause inflammation and improve blood flow to encourage the body to repair and heal itself. Studies do show that increased blood vessel formation does occur in the new tissue leading to tissue healing.

Specific Technique:

• Shock wave therapy is a non-surgical procedure.
• A probe is placed on the skin after a gel is applied to help conduct the shock waves. Low-energy shock wave therapy often is performed without anesthesia.
• Therapy is more successful with active patient participation, where the patient tells the therapist whether or not the probe is in the area of pain. One or more treatment sessions may be needed.
• We like to perform on average 2-3 sessions.

What happens after the procedure?

• Patients typically bear weight after treatment. Protected walking and running are allowed to occur immediately afterward.
• Although the first time, patients are advised to reduce the level of physical activity for one to two weeks after treatment. There may be some initial soreness.
• Shock wave therapy may give good outcomes for some tendon problems or chronic degenerative conditions. Examples include Achilles tendinitis and plantar fasciitis.

Potential Complications:

• The main complications are pain and hypersensitivity at the site of treatment. These problems typically resolve with time. Pain and disability may persist when shock wave therapy is not successful.

What does a podiatrist do?

• Everything possible regarding the foot & ankle!

ESWT for Achilles Tendonitis:

• If you are having Achilles tendon pain.

List of services our podiatrists provide:

• Toenail Fungus Treatment (Oral or Laser)
• Toenail Trimming.
• Orthotics Fitting.
• Ingrown Toenails.
• Infected Ingrown Toenails.
• Podiatrist pedicure or medical pedicure.
• Trimming of Corns, Trimming of Calluses, and Treatment of Pressure Blisters.
• Diabetic Foot Care & Diabetic Foot Wounds.
• Athletes Foot, Dry Skin, Eczema.
• Foot & Ankle Ulcer Care.
• Infection and Abscess Care.
• Staph Infections in the Toe or Foot Treatment.
• Treatment of Plantar Warts for Your Toes and Feet.
• Foot & Ankle Injections (Steroid or Natural Solutions.)
• Management of Foot & Ankle Fractures (Walking Boots for broken toes or broken feet).
• Heel Pain (Heel Spur or Plantar Fasciitis).
• Custom Orthotics for children and adults (In the office).
• Over the Counter Orthotics for children and adults.
• Podiatrist medical pedicure.
• Extra-Depth Shoes for Patients with Diabetes.
• Diabetic Shoes.
• Gout Treatment.
• Prescription (Refills).
• Telehealth appointments.
• Shockwave therapy (AKA ESWT or EPAT therapy)
• Cold laser therapy (In the office).
• MLS laser therapy (Multi-Wave Locked System laser therapy).
• Laser for peripheral neuropathy (In-Office).
• Senior Toenail Cutting & Toenail Trimming Services.

List of procedures our podiatrists perform in the office:

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Related Treatment Guides

• Plantar Fasciitis & Heel Pain Treatment
• Custom 3D Orthotics
• Sports Foot & Ankle Injury Treatment
• Bunion Treatment

Medical References & Sources

• American Podiatric Medical Association — Plantar Fasciitis
• PubMed Research — Plantar Fasciitis Treatment Studies
• American Orthopaedic Foot & Ankle Society — Heel Pain

References

1. Yin MC, et al. Is extracorporeal shock wave therapy clinical efficacy for relief of chronic, recalcitrant plantar fasciitis? A systematic review and meta-analysis. Medicine. 2014;93(13):e79.
2. Gerdesmeyer L, et al. Radial extracorporeal shock wave therapy is safe and effective for chronic recalcitrant plantar fasciitis. Am J Sports Med. 2008;36(11):2100-2109.
3. Othman AM, Ragab EM. Endoscopic plantar fasciotomy versus ESWT for chronic plantar fasciitis. Arch Orthop Trauma Surg. 2010;130(11):1343-1347.