I Had Shockwave Therapy but It Didn't Help. What Should I Look At?

Key points in 30 seconds

1. If it isn't improving, we look at whether the conditions that caused the pain are still there.
2. A collapsed arch and the way you walk don't disappear with treatment.
3. We check how you stand and walk first.
4. We work on inflammation, the arch, and walking all together.
5. If nothing changes after several months, we look at the diagnosis itself again.

What we often hear

• "I've had shockwave therapy several times, and it's the same."
• "It's only a bit better while I'm getting it, then it hurts again."
• "I don't know what else to do now."

I had shockwave therapy but it didn't help. What should I look at?

It's not that the treatment was wrong; you need to look at whether the conditions that caused the pain are still there. If the collapsed arch and the way you walk stay the same, the inflammation comes back even after it's calmed down.

People who ask this have usually already had several sessions. They say it's a bit better during treatment, but after a while the pain returns. Then the next step isn't more of the same treatment; it's finding what's still there.

What do you mean by conditions that are still there?

A sunken foot arch, a walk where your weight passes through only one side of the foot, and the amount of time you spend standing or walking each day. These three don't disappear with treatment.

When the arch has sunk, the plantar fascia stretches more with every step. When your weight passes only along the outer edge, calluses form there and the pain stays there too. If you stand all day for work, there simply isn't enough time to recover.

So what do you do first?

We first check how you stand and how you walk. Only by knowing what has collapsed and which way your weight passes can we decide what to support.

After checking, we do three things together: calming the inflammation in the painful spot, supporting the collapsed arch, and changing the way you walk. Do only one, and the others undo it.

What are the limits of this judgment?

What's written here is a pattern we've seen in the clinic, not data comparing which approach is better side by side.

To be clear, this article isn't saying one treatment is better than another. Shockwave therapy works on the inflammation side, and what we're talking about here are the other conditions that remain. The two don't replace each other; they look at different things.

Also, if nothing changes at all after several months, the diagnosis itself needs another look. Heel pain has many causes besides plantar fasciitis.

We start by looking at why there was no response. When the same treatment didn't work, sometimes the diagnosis is different.

If you've had shockwave therapy several times and nothing has changed, come see us. Before repeating the same treatment, it needs another look.

How much things improve differs from person to person, depending on time spent standing at work and the condition of the arch.