Extracorporeal shockwave therapy (EST)

Extracorporeal shockwave therapy (EST) is a fairly new type of non-invasive treatment. Non-invasive means it doesn't involve making cuts into the body.

EST involves using a device to deliver high-energy soundwaves into the skin. The soundwaves can sometimes cause pain, so a local anaesthetic may be used to numb the area.

It's claimed that EST works in two ways. It's thought to:

• have a "numbing" effect on the nerves that transmit pain signals to your brain
• help stimulate and speed up the healing process

However, these claims haven't been definitively proven.

The National Institute for Health and Care Excellence (NICE) has issued guidance about the use of EST for treating plantar fasciitis.

NICE states that there are no concerns over the safety of EST, but there are uncertainties about the effectiveness of the procedure for treating heel pain.

Some studies have reported that EST is more effective than surgery and other non-surgical treatments, while other studies found the procedure to be no better than a placebo (sham treatment).

For more information, you can read the NICE guidance about using EST for treating plantar fasciitis (PDF, 96.4kb).