A shock wave is the resultant acoustic energy wave of an explosion. For kidney stones, the shock wave must be focused to specifically apply the energy wave to the desired area as well as in the foot.

ESWT offers improvement in pain relief of Plantar Fasciitis (inflammation of the plantar fascia) and functional restoration with negligible (few) complications. It is a safe procedure and has lack of risks and complications. The cost is very expensive and the cost of ESWT is not covered by all insurances and the patient is forced to pay out of pocket. The procedure can cause microfractures of the calcaneus (heel bone). Also, some patients require several treatments.

Indications for ESWT include plantar fasciitis, chronic heel pain, avascular degeneration, and where conservative treatment has not prevailed and the condition still persists.

The OSSATRON is indicated for use in patients with chronic proximal plantar fasciitis who have failed to respond to conservative treatment such as physical therapy and stretching exercises, orthotics, night splints, NSAIDS, (non-steroidal anti-inflammatory drugs), cortisone injections, or previous surgery.

Because the OSSATRON has not been tested on subjects with the following conditions, it's safety and effectiveness is unknown: diabetic neuropathy, ankle or foot fracture, Peripheral Vascular Disease (poor circulation), skeletally immature patients, pregnancy, severe osteoarthritis, rheumatoid arthritis, osteoporosis, metabolic disorders, osteomyelitis (bone infection), and systemic infection.

There are no known contraindications to ESWT with the OSSATRON for treatment of chronic proximal plantar fasciitis.

Patients with bleeding disorders that may prolong clotting time may be at risk for bleeding following OSSATRON. Anesthesia should be administered prior to the procedure.

Between April 1998 and November 1999, 302 patients were treated for chronic proximal plantar fasciitis using OSSATRON ESWT. 260 received active or placebo. 42 were not randomized. Pain scale was 5-10 with10 being severe. Evaluations were obtained at 4, 8, 12 weeks post-treatment.

234 randomized patients showed a statistically significant difference in treatment versus placebo groups. Following one OSSATRON ESWT, 62% of patients met with success. 76% of all patients who received treatment, had acceptable results after 1 treatment and no longer required long term treatment or surgery. 38 complications were reported of 302 subjects.

The patient should be instructed to discontinue any medication containing aspirin or an NSAID for 3 days prior to ESWT to minimize bleeding. Patient should bring running shoes to wear home as weight bearing is allowed after the procedure. ESWT should be performed with anesthesia local or regional since the procedure is painful. Position the OSSATRON perpendicular to the patient table with the therapy arm in the horizontal position, and the coupling membrane near the plantar surface of the affected foot. The head may be placed in the vertical position, coupling membrane up, for the affected side aligned with the membrane. A total of 1500 shocks are delivered for effective treatment of chronic heel pain syndrome. Total OSSATRON treatment time is 13-15 minutes for delivery of 1500 shocks at 2.0 Hz. Upon discharge, patients are advised not to participate in stressful activity for the affected heel for 4 weeks. Orthotics are encouraged.