Shockwave Therapy

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Months of heel pain that stretching, new shoes, and inserts haven't fixed? Shockwave therapy is a quick, non-invasive treatment for stubborn plantar fasciitis. There's no needle, no anesthesia, and no downtime. A handheld device sends rapid pulses into the sore area, prompting your own tissue to start repairing. We offer shockwave therapy at our San Mateo office, and every patient starts with a proper diagnosis.

• Chronic plantar fasciitis (heel pain that has lasted several months)
• Heel pain that has not improved with stretching, footwear changes, orthotics, or activity changes
• Heel pain that came back after a cortisone injection wore off
• Selected cases of chronic Achilles tendon pain (Achilles tendinopathy)
• Patients who want to avoid repeated injections, can't take anti-inflammatory medication, or want to stay active during treatment

Shockwave therapy is not the high-energy shockwave used to break up kidney stones, and it isn't trying to break anything. Our clinic uses the enPuls Pro, a radial shockwave device. It delivers lower-energy pressure waves that are strongest near the skin's surface, which suits the plantar fascia where it attaches to the heel.

The treatment works in three steps:

• The Pulse: The applicator sends a rapid series of mechanical pressure waves into the painful spot.
• The Translation: Cells in the fascia and small blood vessels sense that force and turn it into a chemical signal. This process is called mechanotransduction. It increases blood vessel growth and the release of growth factors.
• The Rebuild: Over the following weeks, blood supply improves and the disorganized tissue of a long-standing fascia problem starts to remodel. The treatment also appears to calm local pain signals.

In other words, shockwave doesn't work by injuring the tissue. It delivers a mechanical message that your cells turn into a repair instruction.

• Before: Dr. Lee examines your foot and confirms the pain is actually coming from the plantar fascia. Not all heel pain is plantar fasciitis. She reviews what you've already tried and your health history. Avoid anti-inflammatory medication the day before each session.
• During: Gel is applied to the heel, and the applicator is moved slowly over the painful area for about five minutes. It feels like firm, rapid tapping. It's uncomfortable at the sore spot and tolerable everywhere else. The tender spots help pinpoint where to treat. No anesthesia is needed.
• After: Walk out and go about your day. You may feel mild soreness for a day or two, similar to the ache after an unfamiliar workout. For 4 days after each session, avoid anti-inflammatory medication (Advil, Aleve, ibuprofen, naproxen, aspirin) and don't ice the area. These can blunt the repair response the treatment is meant to trigger. Plain acetaminophen (Tylenol) is fine if you're sore. You can stay active, but avoid overdoing it on the treated foot.

• A typical course is 5 sessions, once a week. A single visit is unlikely to be enough.
• Some patients notice less pain partway through the series. Full results are usually judged around 2 to 3 months after starting.
• In a 2024 review of 11 clinical trials with more than 1,000 patients, shockwave reduced heel pain by an average of about 3 points on a 10-point scale and improved foot function.
• That's an average. Some patients improve more, and some don't respond. Shockwave does not work for everyone.
• It works best alongside good habits: stretching, supportive footwear, and orthotics if you need them.

• Mild and temporary side effects are the most common: soreness, redness of the skin, and occasionally bruising.
• Not a first step. For heel pain that started recently, stretching, footwear changes, and supports are the right place to begin, and most people improve with them.
• Diagnosis comes first. Heel pain from a nerve, stress fracture, or other cause needs different treatment.
• The full series matters. Stopping early is unlikely to give you the benefit.
• Not covered by insurance. Shockwave therapy is a self-pay treatment. Ask us what a full series involves before you start.
• It may not be appropriate for some patients, including those who are pregnant, have a bleeding disorder or take blood thinners, or have an infection or open wound at the treatment site. Dr. Lee will review your health history first.

• Conditions: Plantar Fasciitis & Heel Pain • Achilles Tendonitis 
• Treatments: Custom Orthotics • Sports Injury Treatment • Injections • Achilles/Plantar Fascia Procedures

Book an evaluation and leave with a plan you can start today.