Experimental Therapy For Sore Heels Has Skeptics

Dressed in street clothes, Tara Cassidy Driscoll lies face-down on an examining table at the Massachusetts General Hospital. Orthopedic surgeon George Theodore is about to blast her foot with powerful shock waves generated by sound.

After numbing her foot with Novocain, Theodore turns on an expensive German-made machine that beams tightly focused sound energy at Cassidy Driscoll's heel, near the point where her painful plantar fascia attaches to the heel bone. Suddenly the room is filled with the rhythmic click-click-click of a metronome.

It's a kind of paradox: Theodore is damaging her foot in order to heal it.

"The shocks are like a little baseball bat hitting the tissue," Theodore says. "It's producing a little bit of a repair process — a little microbleeding."

The healing process takes place over several months after the shock-wave therapy, which Theodore does in a single treatment. [Other centers use lower-energy shock waves over several treatments.]

Theodore has been doing the shock-wave therapy for plantar fasciitis for about eight years, after longer experiences in Europe. It's the same technology used since the 1980s to blast kidney stones, an application called lithotripsy, but for foot problems doctors use less intense shock waves.

Shock-wave therapy for plantar fasciitis is beginning to catch on around the U.S., partly since this stubborn type of foot pain is so common — and so difficult to treat. Nearly 2 million Americans seek care for plantar fasciitis (pronounced PLAN-tar FASH-ee-EYE-tus) every year.

Theodore tells Cassidy Driscoll that shock-wave therapy gives her a 60 to 80 percent chance of reducing her pain by half; about one-quarter of patients will become pain-free from the treatment.

After the 20-minute treatment, Cassidy Driscoll says she felt no pain, only a sort of tapping. She gets off the table, walks out of Theodore's office and drives herself home. Two days later, she says her foot felt bruised, but she didn't have enough pain to require medication.

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