Plantar fasciitis is an inflammation of the plantar fascia, which is a band of tissue that runs along the bottom of your foot and connects your heel bone to your toes. This condition can cause heel pain that’s often more severe or noticeable in the morning.

Traditional treatments for plantar fasciitis include rest, physical therapy, and medication — but in recent decades, shock wave therapy has emerged as a treatment option.

Shock wave therapy uses high levels of targeted acoustic energy to promote healing and reduce pain. It’s noninvasive and may help people with plantar fasciitis avoid more extensive treatments like surgery. But the treatment doesn’t work for everyone and the results can be unpredictable.

Read on to learn more about what the research says about the efficacy of shock wave therapy, how the procedure works, and what to expect from the results.

How does shock wave therapy for plantar fasciitis work?

In shock wave therapy, a healthcare professional will apply penetrating waves of ultrasound energy to an inflamed area of your body, creating microtrauma in that area. This microtrauma prompts a healing response in your body.

In response to shock wave therapy, the body can:

  • Create new blood vessels that bring more blood and nutrition to the inflammation.
  • Receive hyperstimulation of nerve endings, resulting in immediate pain reduction.
  • Break down calcifications.
  • Increase cell permeability for increased healing.

Shock wave treatment is noninvasive and can dramatically lessen pain and other plantar fasciitis symptoms. This makes it an ideal alternative for people who may not want to take medication or receive invasive surgical treatments.

A small 2021 study suggests that shock wave therapy is an effective treatment for plantar fasciitis. The researchers found that four sessions of shock wave therapy helped reduce the thickness of the plantar fascia. It also reduced symptoms of inflammation in the area.

Procedure for shock wave therapy for plantar fasciitis

Shock wave therapy is noninvasive, meaning it happens on the outside of your body. It is performed on an outpatient basis, so you’ll be able to go home once your procedure is complete.

There aren’t generally any specific steps you need to take before a shock wave procedure. But you’ll likely be receiving local anesthesia or a sedative, so it’s a good idea to have someone else take you to and from your appointment.

Once you arrive at the facility for your treatment, here’s what you can typically expect from the procedure:

  1. You’ll be asked to remove your socks and shoes.
  2. You’ll lie flat on a cushioned table, with your stomach down and your legs supported by a pillow.
  3. You’ll receive either a sedative or local anesthesia in your heels so that you don’t feel pain during the procedure.
  4. You’ll have ultrasound gel applied to your heels.
  5. A technician will use a specialized probe to deliver compressed air shock waves to your heels.

The procedure takes about 10 to 20 minutes per foot.

You might feel some mild discomfort as the shock waves penetrate your heel. Depending on the severity of your plantar fasciitis pain, you may need to return for two to four additional shock wave sessions.

How effective is shock wave therapy?

In general, shock wave therapy is thought to provide some symptom relief for about 44% to 80%Trusted Source of people who receive this treatment.

Shock wave therapy for plantar fasciitis is generally considered an effective treatment, according to a 2021 study. Yet the wide range of results shows that it may not work for everyone.

Shock wave therapy is associated with a rapid decrease in pain, a small 2020 studyTrusted Sourcesuggests. Data from multiple studies indicates that shock wave therapy — especially focused shock wave therapy (FSW) and extracorporeal shock wave therapy (ESWT) — is most effective at reducing symptoms, according to 2017 researchTrusted Source.

And many people with plantar fasciitis who’ve received shock wave therapy report experiencing a dramatic decrease in pain — case studies confirm many of these experiences.

Yet there have not been any large-scale studies to back up these findings and anecdotes. Studies about the lasting effects of shock wave therapy years after treatment are inconclusive.

A 2018 case-series study indicates that shock wave therapy in combination with other treatments might be more effective than shock wave therapy alone. For example, combining physical therapy and shock wave treatment may promote long-term, sustainable healing.

 
What are the pros and cons of shock wave therapy?

Shock wave therapy has many possible benefits, but it’s not the best solution for everyone.

Some of the benefits of shock wave therapy include that it:

  • is a noninvasive treatment with minimal preparation and recovery needed
  • resolves pain quickly
  • is considered safe
  • has a lower risk of complications than medication or surgical treatments
  • can help people with plantar fasciitis avoid unnecessary surgery

Some of the downsides of shock wave therapy that you should consider include:

  • It’s not effective for everyone.
  • You may need multiple treatments over time to see significant results.
  • Many insurance companies don’t cover shock wave therapy.
  • Treatments can be expensive without insurance coverage.
  • Complications can include temporary pain, bruising, swelling, and numbness.
How much does shock wave therapy cost for plantar fasciitis?

A survey of multiple medical practices suggests that the cost to receive shock wave therapy for plantar fasciitis without insurance coverage averages around $1,000.

The exact cost for shock wave therapy can depend on:

  • the type of shock wave therapy a doctor or specialist recommends
  • the treatment facility you choose
  • the number of sessions you need
  • your geographical location
  • your health insurance coverage

Health insurance doesn’t always cover shock wave therapy for plantar fasciitis. Check with your insurance provider before you make an appointment to receive shock wave therapy treatments.

 
What are other treatment options for plantar fasciitis?

Shock wave therapy isn’t the only option for plantar fasciitis. Many other treatment options are available for this painful condition.

The right treatment for you depends on the severity of your symptoms and how you respond to treatment. Some common treatment options include:

  • Lifestyle changes: Simple lifestyle modifications like rest and avoiding activities that cause pain can help symptoms resolve in just a few months. If your pain is severe, crutches or a walking boot can help keep you from placing your full weight on your feet while your inflammation lessens over time.
  • Ice: Applying ice to the inflamed area can help reduce pain and swelling.
  • Medication: A doctor might recommend nonsteroidal anti-inflammatory drugs (NSAIDs)to help relieve pain and reduce swelling. Over-the-counter NSAIDs can help treat mild pain, while prescription NSAIDs can help with more severe or chronic pain.
  • Physical therapy: Physical therapy can help you gain muscle strength and flexibility that can promote healing as well as reduce pain.
  • Splints: A doctor or physical therapist might advise you to wear a splint at night to support your foot and reduce motion that can worsen swelling or pain.
  • Arch supports: Wearing arch supports in your shoes can help relieve plantar fasciitis pain.
  • Injections: Steroid injections can deliver medication directly to your heel for fast pain relief. The relief you get from these injections is temporary, so you may need to receive injections every few months to help relieve pain if you have chronic inflammation.
  • Ultrasonic tissue repair: Ultrasonic tissue repair uses ultrasound to guide a needle into your heel. The needle breaks up damaged tissue, and the damaged tissue is removed from your body.
  • Surgery: In severe cases of plantar fasciitis, surgery might be necessary to detach damaged tissue from the bone.
The takeaway

Shock wave therapy can help some people with plantar fasciitis reduce pain. This technique has been in use for over two decades, and studies suggest that it can be an effective treatment.

But not everyone with plantar fasciitis will experience relief from this treatment, and shock wave treatment for plantar fasciitis isn’t covered by most health insurance plans.

Talk with a doctor if you have plantar fasciitis and are curious about shock wave treatment — they can help you decide if it makes sense as a treatment for you.