Podiatrist Toronto, ON Sheldon H. Nadal D.P.M.
586 Eglinton Avenue E. Suite 501 Toronto, Ontario M4P1P2
Local: 416-486-9917 Toll free: (877) 456-3338

Shock Wave and Laser Treatment: What Is It About?

Extracorporeal shock wave therapy or EWST – do not let the name intimidate you! The term ‘shockwave’ is not really appealing when you are talking about treatments of any kind. However, shockwaves in treatment have been used longer than you know. Think World War II. Yes, that long.



The first time that a patient was treated with shockwave was in 1980 in Munich, Germany. This patient was treated for kidney stone. During the kidney stone treatment, it was found that the shockwaves did not damage the hip bones. In fact, it even stimulated bone fracture healing by activating osteoblasts which help cells to build bones.


In the 1990s, clinicians started using shockwaves to treat calcific tendonitis in the shoulder and elbow as well as plantar fasciitis in the heel. Shockwaves are also used in plastic surgery to treat burns and ulcers.



Shockwaves are acoustic or sound waves. Examples of these are shockwaves produced by explosives, thunderstorms, and sonic booms produced when airplanes break the sound barrier. There are actually three methods in which shockwaves can be generated:


*Electrohydraulic – This uses an electrode similar to that of a sparkplug to generate shock.

*Electromagnetic – This uses an electromagnetic coil to generate shockwaves.

*Piezoelectric – This uses piezoelectric crystals mounted on a sphere-shaped surface to create shockwaves.


Treatment Guidelines

This procedure can treat chronic heel spur pain and plantar fasciitis. If a patient has had heel pain for at least six months, and has continued to experience pain after conservative treatment options, then this is an excellent alternative. Before having this treatment, a patient  should first be treated UNSUCCESSFULLY with at least two or three of the following modalities:


*Non-steroidal anti-inflammatory drugs (NSAIDs)


*Supportive strappings or tapings

*Cortisone injections

*Below-knee casting

*  physical therapy*Night splints


The following are not allowed to have ESWT:

*Patients with bleeding disorders

*Patients with local infections

*Patients with malignancies

*Pregnant women




Through the years, studies have shown that shockwave treatment, when performed properly, is as effective as surgical treatment. There are also fewer complications following the procedure, compared with surgery. In general, shockwave treatments are also less expensive than surgeries.



With ESWT, there are no known significant complications. Some people have experienced getting localized bruising while others have felt discomfort for a period of time. In rare cases, the local anesthetic used can cause allergic reactions, infections as well as temporary nerve irritation. Comparing ESWT to invasive surgery, however, ESWT is a safer alternative and should definitely be considered before having a surgery.


If you want to know more about this procedure, it is best to see Sheldon H. Nadal, DPM. Here’s a short video clip of him talking about this procedure: ESWT. Call his office today at 416.486.9917.




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