Shockwaves fired into my foot cured my crippling pain – and got me back into heels



23:26 GMT, 3 December 2012

'My left foot started to hurt when I walked,' said Rosemary Smith

'My left foot started to hurt when I walked,' said Rosemary Smith

Most of us can’t wait to kick off our shoes at the end of a long day at work and rest our weary feet.

But when Rosemary Smith started getting shooting pains through her feet, she sensed this was more than just aches and pains.

‘My left foot started to hurt when I walked,’ says Rosemary, 45, a full-time carer from Bankside, London.

‘I was doing some photocopying at the time and at first thought it might be just aching from all the standing.’

But eight months later it had spread to the right foot.

searched on the internet and realised she had the characteristic
symptoms of plantar fasciitis — also known as policeman’s foot because
it is traditionally associated with lots of walking and standing.

one in ten of us will suffer from it at some time — it occurs when the
plantar fascia, a ligament which runs along the bottom of the foot,

The plantar
fascia has a poor blood supply, which means it can be very slow to heal.

So over time it becomes inflamed and weakened and liable to even more
tearing and pain.

causes patients intense pain in their heel, especially after sport,
walking or lots of standing, although others who take less exercise get
plantar fasciitis too,’ says Dr Dominic Radford, consultant in sport and
exercise medicine at the London Bridge Hospital.

A classic sign is heel pain in the morning, he adds.

‘Patients often say getting out of bed is agony, perhaps because the ligament stiffens up and tightens during the night.

‘This condition can persist for years, as the ligament degenerates and gets weaker and becomes extremely painful as it develops further microtears.’

Plantar fasciitis is largely an affliction of middle-aged people, adds Chris Walker, consultant in orthopaedic surgery at the Royal Liverpool University Hospital.

‘This is down to three factors. First, as we get older, our soft tissues are not so good at healing, and the scar tissue isn’t as good quality.

Still suffering from debilitating foot pain, Rosemary had shockwave treatment

Still suffering from debilitating foot pain, Rosemary had shockwave treatment

‘Second, we tend to put on weight as we get older, so instead of walking with a spring in our step we tend to stomp.

'And third the muscles in our feet are less toned, so we walk on the insides of our feet, and that’s where the plantar fascia attaches itself.’

To tackle the problem, Rosemary switched from high heels to flatter, more comfortable shoes, and took painkillers, but the foot pain soon became unbearable.

‘I started turning down invitations unless someone was giving me a lift, and I found a different job which meant more sitting down.

'Exercise was too painful — I couldn’t even bear the journey to the swimming pool — so I put on three stone in weight, which didn’t help because it put more pressure on my feet.’

/12/03/article-2242517-0A749CCD000005DC-236_233x350.jpg” width=”233″ height=”350″ alt=”Plantar fasciitis is associated with lots of walking and standing” class=”blkBorder” />

Plantar fasciitis is associated with lots of walking and standing

‘The idea of using shockwaves or lithotripsy to break up kidney stones has been around for 20 years or so, but only recently have we realised that it can also help heal tendons or ligaments, which is very exciting. It’s been shown to have a success rate of 80 per cent.’

Mr Walker adds: ‘It’s most effective in patients who have had plantar fasciitis for a long time — over six to 12 months.

‘Here, the inflammation has settled down and the healing has stopped, but the patient still has chronic pain — not just a bit of pain in the morning. Shockwave therapy disrupts it and inflames it again so it can heal properly.’

Some experts are also administering injections of the patient’s blood directly into the foot, to stimulate the healing process, but more research is needed to prove the benefits of this technique, says Dr Radford.

Shockwave treatment is increasingly becoming available on the NHS. The treatment takes just five minutes for each foot, and patients don’t need an anaesthetic.

‘We use a box containing an air compressor, which is attached by a tube to a handpiece shaped a bit like a gun,’ says Dr Radford.

‘We place the gun onto the heel of the foot, and then pump air pressure along the tube to fire a metal pellet in the gun which strikes a metal cap at the end of the barrel.

‘This fires shockwaves at ten times a second, which travel through the patient’s skin to the damaged ligament with far more force than the impact of walking or running, and reaches deep into the damaged area to prompt it to heal.’

He adds: ‘The patient returns seven and 14 days later for two more treatments.

'Because we have kick-started the body’s own healing process, the ligament should go on healing over the next few months so the pain dies away.’

Last May, still suffering from agonising and debilitating foot pain, Rosemary had shockwave treatment with Dr Radford at the London Bridge Hospital using her private health insurance.

‘It felt very odd — like someone bouncing a hard ball off the underside of my foot — but it didn’t hurt, so he turned up the intensity and delivered more shocks,’ she says.

‘When I got off the bed, my feet felt more comfortable than they had in years, though Dr Radford explained that some patients feel a temporary anaesthetising effect because the nerve endings are numbed.

‘A couple of days later, my feet started hurting again — but I had three treatments, a week apart, and each time they felt better afterwards.’

Six months on, the agonising pain is gone.

‘My feet still ache if I’ve been shopping or standing for hours. But I don’t have to tiptoe out of bed and can dash off to get the post as soon as it drops through the door.

‘And, of course, I can wear my high heels again.’