Shockwave Therapy for Stubborn Heel and Tendon Pain

A shockwave handpiece held against the bottom of a heel coated with gel

Shockwave therapy is the everyday name for extracorporeal shock wave therapy, shortened to ESWT in the papers linked here. Two pairs of look-alike terms sit inside it. The first is plain ESWT versus the focused form, written f-ESWT in the title of an open label randomized clinical trial on myofascial points and plantar fasciitis. The second is the heel versus the tendon, because the same treatment name is attached to both stubborn heel pain and stubborn tendon pain.

What the sources say, and where they stop

NIH PMC reports that ESWT has been most successful in routine treatment of heel complaints such as plantar fasciitis and in the insertion tendinopathy of the Achilles tendon and mid-portion Achillodynia, and the sentence names specific places, the heel and the Achilles tendon. A description that carries the same label to other parts of the foot has moved past what this source says, and a reader should treat it as a separate claim that needs its own support.

The two articles, by the distinction each draws

Shockwave Results for Chronic Plantar Fasciitis separates results for chronic plantar fasciitis from the broader shockwave label. It leans on a meta-analysis of randomized controlled trials, which pools several trials rather than reporting one.

Focused Shockwave on Calf and Foot Trigger Points separates focused treatment aimed at trigger points from radial treatment spread over muscle and fascia. The two applications share the shockwave name, and the article keeps them apart.

Reading the evidence in order

Sources differ in who they studied. One study of long term effectiveness in amateur runners is about a single group of people, while the meta-analysis named above is not limited to runners by its title. Neither stands in for the other, so a heading that promises lasting relief for everyone deserves a second look.

Next hub

If the confusion is about what is causing the pain rather than how it is treated, Heel Pain: Where It Starts and What Helps sorts the terms out.