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Plantar fasciitis can feel like a cruel daily ritual – that sharp heel pain stabbing you with your first steps every morning, or a burning ache after you’ve been sitting. If you’re living with plantar fasciitis, you know the frustration. You’ve likely tried everything: rest, stretching, icing, orthotics, night splints, maybe even injections – yet the pain keeps coming back. It’s exhausting and disheartening. Shockwave therapy offers a ray of hope as a non-surgical option that might finally break this cycle of pain. In this post, we’ll explore how shockwave therapy for plantar fasciitis works, what the evidence says, and how our whole-body approach at Unpain Clinic may help when other treatments have failed. (Results may vary; always consult a healthcare provider.)
Plantar fasciitis is one of the most common causes of chronic heel pain. It involves irritation or micro-tearing of the plantar fascia – a thick ligament-like band of tissue on the bottom of your foot that connects your heel bone to your toes. When this fascia is overstressed, it can become inflamed and degenerated (a process some experts call “fasciosis” rather than fasciitis). The classic symptom is heel pain with your first steps in the morning or after long periods of rest. It may feel like walking on pins and needles or even broken glass. The pain can ease as you warm up, but often returns after prolonged standing or at the end of the day.
What causes it? Plantar fasciitis usually develops from cumulative strain. Common causes and risk factors include:
Overuse or repetitive impact: Long-distance running, dancing, or jobs that keep you on your feet can stress the fascia over time.
Poor foot mechanics: Flat feet or very high arches, abnormal gait, or improper footwear can alter weight distribution and put extra tension on the fascia.
Tight muscles and lack of support: Tight calf muscles or Achilles tendons increase pull on the heel. Weakness in the hips or core can force the foot to compensate (for example, fallen arches or overpronation), overloading the fascia.
Age and weight: It’s most common in middle age. Being overweight adds strain to the foot with each step.
In many cases, plantar fasciitis starts subtly and gets worse over time. If the pain has persisted for more than 3–6 months, it’s considered chronic. Chronic plantar fasciitis often means the tissue isn’t healing properly on its own – possibly because the underlying issue (like muscle imbalances or biomechanical problems) hasn’t been addressed. That’s why some people struggle with heel pain for years.
Why do typical treatments fail sometimes? Traditional approaches like rest, anti-inflammatory medications, cortisone injections, or standard physical therapy exercises can provide temporary relief of symptoms, but they often don’t fix the root cause. For example, anti-inflammatories and steroid shots may reduce pain in the short term, but they don’t correct biomechanical problems and steroids can weaken the fascia if used repeatedly. Orthotics and night splints can support the foot, yet if weak core or hip muscles are the real culprit, the relief disappears once you’re out of the brace. Stretching and massage are helpful for tight tissues, but if the dysfunctional movement pattern isn’t corrected, you’re likely to keep re-injuring the area. Many people “try everything” diligently – from rolling a frozen water bottle under the arch daily to expensive shock-absorbing shoes – and still wake up to that familiar pain. It can be truly demoralizing.
The key insight is that foot pain isn’t always just about the foot. Our bodies work as connected systems. A plantar fascia under constant strain is often a symptom of problems up the chain – tight calves, weak glutes, even an old back or hip injury changing how you walk. In fact, Unpain Clinic’s experience has shown that the real problem is almost never just in your heel: often an imbalance or old trauma elsewhere forces your foot to compensate. So until those issues are found and treated, the heel pain can keep returning. This understanding sets the stage for why shockwave therapy can be so effective – especially when combined with a whole-body approach.
Shockwave therapy – more formally Extracorporeal Shockwave Therapy (ESWT) – is an evidence-backed treatment for chronic plantar fasciitis. It was originally developed to disintegrate kidney stones using acoustic waves. In orthopedics, those same high-energy sound waves are directed at injured tissues to stimulate healing. Over the past two decades, many studies (including randomized trials and meta-analyses) have evaluated shockwave therapy for plantar fasciitis, especially in cases that don’t improve with conventional care.
So, does it actually work? According to multiple high-quality studies, yes – shockwave therapy often helps when plantar fasciitis becomes chronic. A 2013 meta-analysis of several clinical trials (encompassing ~654 patients) concluded that shockwave therapy is a safe and effective treatment for chronic plantar fasciitis that hasn’t responded to at least 3 months of standard therapy Patients who received shockwave had significantly better pain relief and functional improvement at 12 weeks compared to those who got sham treatments. In fact, their heel pain scores continued to improve over 12 months, whereas placebo groups did not. The authors of that analysis “recommend the use of ESWT for patients with substantial heel pain despite a minimum of 3 months of nonoperative treatment.”
Newer research strengthens this evidence. For example, a 2025 randomized controlled trial compared focused shockwave therapy to high-intensity laser therapy (another modern treatment) in people with painful heel spurs (often related to plantar fasciitis). Both groups improved, but the shockwave group had slightly greater gains in function. Importantly, heel pain levels dropped dramatically after shockwave: patients’ morning pain scores fell from about 7.8/10 before treatment to 3.4/10 at the three-month follow-up. No significant adverse effects were reported. This suggests shockwave not only reduces pain but helps the foot heal in a lasting way, without the risks of surgery or injections.
A systematic review of 11 trials (658 patients) found that shockwave therapy led to moderate improvements in chronic plantar heel pain, superior to placebo/sham therapy in reducing pain and improving function. In practical terms, many patients reported their heel pain was substantially better and walking was easier after a course of shockwave treatments. Another study using ultrasound imaging showed why: over a series of 4 weekly sessions, shockwave therapy actually thinned the thickened plantar fascia tissue (bringing it closer to normal) and significantly improved pain and disability scores. This kind of tissue change is a sign of true healing, not just pain masking.
How does shockwave therapy help? The treatment works through focused sound waves that penetrate deep into the heel and arch. Unlike a simple ultrasound or massage, shockwaves deliver high-energy pulses that cause a bit of controlled micro-trauma – enough to stimulate the body’s natural repair mechanisms. Research shows shockwave therapy can:
Break up scar tissue and calcifications: If you have any scarred or fibrotic tissue (or a heel spur), the waves help fragment and loosen these abnormal deposits.
Increase blood flow and new vessel formation: Shockwaves create a therapeutic inflammation, triggering release of growth factors and nitric oxide that promote angiogenesis (new blood vessel growth). One study noted up to 200-300% increase in regional blood circulation about 4-6 weeks after treatment – bringing nutrient-rich blood to aid repair.
Stimulate cell metabolism and collagen production: The acoustic pulses jumpstart cellular activity. Fibroblast cells ramp up production of collagen, the protein needed to rebuild a healthy fascia. In essence, shockwaves “wake up” a stalled healing process.
Modulate pain signals: Many patients feel pain relief soon after a session. Part of this is due to decreased nerve fiber sensitivity and release of substance P (a neuropeptide that helps modulate pain and inflammation). Over time, as the tissue heals, pain is reduced long-term.
As Unpain Clinic explains to patients, “shockwave therapy stimulates real healing at the cellular level…breaking down scar tissue, increasing blood circulation, and triggering the body’s natural repair mechanisms.” Unlike treatments that merely mask pain, shockwave aims to fix the underlying tissue quality.
It’s worth noting that not every study showed miraculous results – some early trials in the 2000s did not find significant benefit, possibly due to low-energy devices or improper technique. However, the overall scientific consensus today is that shockwave therapy can significantly help chronic plantar fasciitis, especially when proper protocols are followed (sufficient energy levels, targeting the correct area, and no local anesthetic which can dampen its effect). Guidelines now list ESWT as a recommended non-surgical treatment option for stubborn heel pain, to be considered before resorting to surgery. In fact, surgery for plantar fasciitis (plantar fascia release) is now fairly rare and reserved for only the most refractory cases, given that shockwave and other less invasive measures show good success for the majority of patients.
Realistic expectations: Shockwave therapy for plantar fasciitis is not an instant magic bullet – but it works relatively quickly. Typically, a course of treatment involves a series of sessions (often about 3 to 5 sessions) spaced a week or so apart. Each session only takes about 10-15 minutes to administer. Many patients start to feel some improvement after the first one or two sessions (for instance, slightly less morning pain or being able to stand a bit longer without pain) and then see significant gains by the end of the series. One systematic review noted that benefits are usually measured at the 12-week mark (3 months) after treatment – which is when tissue healing has really kicked in. Patience is important; the body needs time to regenerate tissue. The good news is the improvements tend to be long-lasting, especially if combined with addressing any root causes (more on that next). And unlike an invasive procedure, you’re not left recovering from incisions or facing the risks of infection. The main side effect during shockwave is some discomfort during the treatment – it can be a bit painful as the pulses hit the sore spot, but it’s a tolerable, “good hurt” and each pulse is very quick. Most people do not need any numbing; the sensation is often described as a strong tapping or pressure, and it stops immediately after the treatment ends. You might have some redness or mild soreness in the foot for a day or two afterward. Serious side effects are exceedingly rare. Overall, shockwave is considered safe when performed by trained providers. (It’s not recommended if you have certain conditions like a bleeding disorder, active infection in the area, or if you are pregnant – see FAQs.) Always have a proper assessment to ensure shockwave is appropriate for you.
In summary, the science suggests shockwave therapy can help heal a chronically injured plantar fascia when other methods fail. It does so by rebooting your body’s healing processes – increasing blood flow, reducing pathological fibrosis, and stimulating repair at the cellular level. And it achieves this without surgery or injections. Let’s look at how we harness this at Unpain Clinic, and why combining shockwave with a holistic approach gets such great results.
At Unpain Clinic, shockwave therapy isn’t just an add-on – it’s often the centerpiece of our plantar fasciitis treatment plans. Our clinic’s founder, Uran Berisha (BSc PT, RMT), has delivered over 40,000 shockwave treatments and is a leading expert in this modality. But equally important is how we apply shockwave: always in the context of a whole-body, root-cause approach. We don’t just ask “Where does it hurt?” — we dig into “Why does it hurt?”
Every patient with heel pain undergoes a thorough initial assessment. We examine not only your foot, but your entire movement chain from your lower back and hips down to your toes. This includes a gait analysis, range-of-motion tests, muscle strength testing, and a review of your medical history and lifestyle. You might be surprised – as many of our patients are – that the evaluation often points to issues beyond the foot. For example, we might find your hip on the affected side is weaker or less stable, or your ankles are extremely stiff, or an old knee injury changed how you walk. By identifying these contributors, we ensure that when we do treat the foot, the results will hold. As one patient noted, the therapist “went above and beyond to figure out what the main problem is” instead of just treating the obvious sore spot.
In plantar fasciitis (and related heel spur cases), our philosophy is to treat the person, not just the pain location. Yes, the plantar fascia is where it hurts, but often that’s the victim of dysfunction elsewhere. Our team of licensed physiotherapists and chiropractors works to release those higher-up issues – for instance, relaxing tight calves or hamstrings, correcting a pelvic tilt, or strengthening a misfiring glute – in parallel with treating the foot. By the time we deploy shockwave on the plantar fascia itself, the tissue is more receptive to healing because we’ve reduced the ongoing strain. This root-cause strategy is a core principle at Unpain Clinic. As we often say, “pain is only a symptom”; we aim to correct the source of the condition as well as relieve the symptom.
Once we’ve mapped out the drivers of your plantar fasciitis, we begin shockwave therapy on the appropriate structures. The shockwave treatment itself is quick and non-invasive. We use state-of-the-art devices that deliver focused acoustic waves into the target tissue. For plantar fasciitis, the primary target is usually the point of maximum tenderness on the heel or arch (where the fascia is most damaged). We often also treat along the course of the fascia and sometimes the Achilles tendon, since the calf-Achilles-plantar system is connected. If our assessment found issues higher up – say, extremely tight calf muscles or trigger points in the glutes – we can apply the shockwave to those areas as well as part of a comprehensive plan (this is a distinctive aspect of our approach; we don’t “just treat the foot” in isolation).
Each shockwave session typically lasts about 10 minutes of actual treatment time. A conducting gel is applied, and then a handheld applicator delivers pulses of acoustic energy. We might do a few thousand pulses per session, but don’t let that number intimidate you – the frequency and depth are adjustable to your tolerance. Patients describe the sensation as a rapid tapping or tingling. It can be uncomfortable, especially over bony areas, but we check in frequently and keep it within your tolerance. No anesthesia is needed; most people handle it well and even find the intensity encouraging (as it “feels like it’s hitting the spot”). Afterwards, you can get up and walk out normally – there’s no downtime, though your heel may feel a bit achy or warm for a short period. We usually space sessions about one week apart to allow the tissue to adapt and regenerate between treatments. Most of our patients receive roughly 3 sessions of shockwave for plantar fasciitis, sometimes up to 5 depending on severity and how they respond. Remember, everyone is different – some feel 80% better after two sessions, others need a couple more to get full relief. We’ll re-assess your progress as we go.
Crucially, we combine shockwave with other therapies as needed to maximize its effectiveness:
Extracorporeal Magnetotransduction Therapy (EMTT): This is a pulsed electromagnetic field therapy that we may apply alongside shockwave. EMTT is painless; it involves a magnetic coil placed near the area. It can help reduce inflammation and modulate pain signal transmission. Think of it as calming irritated nerves and encouraging cellular repair. It’s a newer modality with growing evidence for musculoskeletal pain. We sometimes include EMTT especially if your plantar fasciitis has a lot of associated swelling or nerve sensitivity. (If you’ve never heard of it, don’t worry – it’s an adjunct to complement shockwave, which remains the main player.)
Neuromodulation techniques: For cases where nerve sensitization is part of the problem (long-term pain can lead nerves to become over-reactive), we incorporate gentle neuromodulation. This might involve low-level laser therapy, TENS (electrical stimulation), or nerve “flossing” exercises. These approaches aim to “reset” hyperactive pain pathways so normal movement isn’t perceived as painful. In practice, these feel like soothing or tingling treatments with little discomfort. They are supportive therapies to ensure your nervous system is on board with the healing process.
Hands-on manual therapy: Our physiotherapists or chiropractors may perform specific soft tissue release and joint mobilization to address any mechanical restrictions. For example, if your ankle is very stiff or your calf and hamstrings are like rock, loosening those with manual techniques can improve your foot mechanics greatly. Gentle chiropractic adjustments might be done if we find misalignment in the foot, pelvis or spine contributing to your gait issues. As one satisfied patient noted, we “treat secondary problem areas” along with providing shockwave, because it’s all connected. Manual therapy and shockwave together can dramatically improve flexibility and function.
Customized exercise program: You won’t leave without homework! We’ll prescribe tailored exercises to do between visits, which might include calf stretches, plantar fascia stretches, toe curls, and foot strengthening drills (like picking up marbles or doing towel scrunches with your toes). But we also go beyond the foot – often including hip strengthening (glute bridges, clamshells) or core stability exercises if those areas were weak. The goal is to reinforce the improvements from shockwave by restoring normal muscle balance. Exercises are introduced at the right time – usually after we’ve reduced pain enough that you can do them correctly. Doing exercises while in severe pain can be counterproductive, so we sequence it smartly. As our team emphasizes, stretching and strengthening are “helpful – once the dysfunction is corrected”. In other words, shockwave and manual therapy correct the issues, then exercise cements the gains and prevents recurrence.
By combining these therapies with shockwave, we tackle plantar fasciitis from all angles – biological healing, mechanical correction, neural reset, and functional strengthening. This comprehensive approach is how we achieve results that often surprise patients who had “tried everything.” Many tell us this integrative method finally got them lasting relief, whereas isolated treatments elsewhere only gave short-term help. For instance, one long-time plantar fasciitis sufferer reported: “I have tried all kinds of treatments for my plantar fascia and shockwave therapy is the only thing that has helped relieve the pain in my foot.” Another patient came in expecting just her heel to be treated, but our exam revealed her hip alignment was a key issue. After treating her hip and foot together (with shockwave on the arch), she experienced significantly better outcomes – much to her amazement. These stories are not guarantees (everyone’s case is unique), but they illustrate the power of looking beyond the foot and using advanced modalities to truly solve plantar fasciitis.
(Name changed for privacy.) “Linda” is a 47-year-old avid hiker who came to Unpain Clinic after 18 months of relentless plantar fasciitis in her right foot. She’d tried the usual recommendations: daily calf stretches, ice bottles, orthotic insoles, and two cortisone shots from a podiatrist. The injections gave her brief relief, but the heel pain roared back within weeks. By the time she saw us, Linda was hobbling every morning and had to stop her beloved weekend hikes. She was growing depressed, feeling like she’d never be active without pain again.
During Linda’s assessment, our physiotherapist noticed a couple of key things: her right calf was significantly tighter than her left, and she had weakness in her right hip stabilizer muscles. Digging into her history, we discovered she’d had a right ankle sprain years ago and even some low back pain on that side. It became clear that her heel pain was being driven by a chain of issues – the old ankle injury and back discomfort had altered how she walked, overloading the plantar fascia. We explained to Linda that to fix her foot, we needed to also address those higher-up problems.
We started a multi-modal treatment plan. Shockwave therapy was applied not just to her painful heel and arch, but also lightly to her calf muscle (to help release the tension). We also did hands-on calf and hamstring stretches and gave her a couple of gentle glute strengthening exercises. After the first session, Linda was surprised that her foot actually felt sorer that evening – which we had warned might happen as the tissue was being stimulated. However, by the next morning she noticed she could walk a little more easily. Over the next three weekly shockwave sessions, she saw steady improvements: her first-step pain reduced from an 8/10 to about 3/10, and she could stand longer at work without burning pain. By the end of her fourth session, Linda was essentially pain-free during normal daily activities. We gradually re-introduced her to hiking over the following month, coaching her on proper footwear and pacing. She sent us a thrilled update after a successful 5 km trail hike with only minor soreness afterward (which is normal as the foot adapts). Six months later, Linda remains able to do the activities she loves. She says the difference was finally finding a clinic that looked at her “whole body instead of just my foot” and utilized shockwave to “jumpstart the healing.”
This example is for illustrative purposes only. Every patient is unique, and not everyone’s results or timeline will be the same. But it shows that even years-long plantar fasciitis pain can often improve with the right approach. Linda had nearly given up hope – then shockwave therapy, applied in a holistic plan, helped give her life back. If you’ve been struggling with similar heel pain, don’t lose hope. With evidence-based treatments and a fresh perspective, there’s a good chance we can make a difference for you too.
While in-clinic treatments like shockwave therapy can accelerate healing, what you do between sessions also matters. We empower our patients with at-home strategies to support their recovery and prevent re-injury. Here are some general tips that may help if you have plantar fasciitis:
Activity Modification: You don’t have to stop all activity, but be smart about it. Relative rest is important – avoid high-impact activities (running, jumping) while your heel is extremely painful. Opt for low-impact exercise like cycling or swimming if you want to stay active. Try to limit long periods of standing or walking on hard surfaces. If your job requires standing, use anti-fatigue mats or cushioned shoes. Listen to your pain: if an activity sharply increases your heel pain, ease off for now.
Footwear and Orthotics: Wear supportive, well-cushioned shoes as much as possible, even at home. Going barefoot or wearing flimsy flip-flops puts extra strain on the plantar fascia. A good shoe with arch support or a quality insole can reduce stress on your heel. Some people benefit from temporary use of custom or over-the-counter orthotic inserts – they can provide short-term support while your fascia heals. (Just remember, as we noted earlier, orthotics alone won’t fix the underlying issue, but they can make you more comfortable during the healing process.)
Stretching & Mobility: Gentle stretching of your calves and plantar fascia can be helpful, especially in the mornings or after prolonged sitting. Before getting out of bed, try doing a simple foot stretch: loop a towel or band around the ball of your foot and pull your toes toward you, or simply flex your ankle up and down to get the blood flowing. Wall calf stretches (both with a straight knee to target the gastrocnemius and bent knee to target the soleus) done a few times a day can improve calf flexibility, which in turn reduces heel pressure. Rolling a tennis ball or a frozen water bottle under your arch for a few minutes can massage the fascia (just don’t press to the point of sharp pain). Consistency is key – gentle stretches every day can over time increase your range of motion and reduce tissue tightness.
Strengthening: Once acute pain subsides a bit, incorporate some foot and hip strengthening as advised by your therapist. Simple exercises like toe curls (gripping a towel with your toes), picking up marbles with your toes, or doing calf raises (if tolerable) can begin to rebuild the foot’s support system. Equally important, strengthen your core and glutes (e.g., bridges, clamshells, planks) because a stable core and strong hips lessen the load on your feet with each step. Proper exercise guidance is ideal – doing these exercises incorrectly can lead to other issues, so ask your provider for a personalized program.
Pain Management: To manage pain flare-ups at home, ice can be used (roll that frozen bottle under foot for 5-10 minutes, or use an ice pack on the heel). Some people prefer contrast baths (alternating warm and cold water foot soaks) to stimulate circulation. Over-the-counter pain relievers (NSAIDs like ibuprofen) might help temporarily on bad days, but be cautious using them long-term – and avoid taking anti-inflammatories right before or after shockwave sessions unless your provider says it’s okay (the inflammatory response is part of shockwave’s healing mechanism). If the heel is very sore at the end of the day, elevating your foot and doing gentle ankle pumps can reduce swelling.
Night splints: If your morning pain is severe, a night splint (a brace that keeps your foot in a gentle stretch overnight) might help some by preventing the fascia from tightening up overnight. Not everyone tolerates these, but it’s something to discuss with your therapist or doctor if mornings are a huge struggle.
When to seek urgent care: Plantar fasciitis, though painful, is generally not dangerous. However, you should seek prompt medical attention if you experience sudden, severe heel pain and can’t bear weight at all, especially after an injury – this could indicate a fracture or acute tear that needs different management. Also, if your heel is red, very warm, or swollen, or if you have numbness/tingling in your foot, see a healthcare provider to rule out other conditions (like a nerve issue or blood clot). And of course, if your symptoms are worsening despite treatment, check back with your clinician; occasionally what seems like plantar fasciitis can be something else.
Important: The above tips are general educational information for plantar fasciitis. They may or may not be appropriate for your specific situation. Always consult with your healthcare provider before trying new exercises or stretches, especially if you’re in a lot of pain. Results may vary, and what works for one person might not be right for another.
By combining careful in-clinic therapy (like shockwave) with smart self-care, you’ll give yourself the best shot at beating plantar fasciitis. It’s a team effort – our clinic will do everything we can with advanced treatments and guidance, and your commitment to the at-home plan will help carry you to full recovery.
Yes, shockwave therapy is generally considered very safe for chronic plantar fasciitis. It is non-surgical and non-invasive, meaning it doesn’t require incisions or injections. The most common side effects are temporary and mild – typically some soreness, redness, or bruising in the treated area that resolves in a day or two. Unlike steroid injections, shockwave doesn’t carry risks of tissue degeneration. And unlike surgery, there’s no infection risk and no lengthy recovery. That said, shockwave should be applied by a qualified healthcare professional who can ensure the correct dosage and technique. There are a few contraindications: for example, we avoid using shockwave therapy over areas of active infection, over open wounds, or near any malignant tumor. It’s also not used on pregnant patients in the treatment area purely as a precaution. If you have nerve disorders, circulation issues, or are on blood-thinning medication, let your provider know – caution may be needed. Overall, for most people with plantar fasciitis, shockwave is a safe treatment with a low complication rate. We will discuss your medical history to make sure you’re a good candidate.
The number of sessions can vary, but most plantar fasciitis cases need a series of approximately 3 to 5 shockwave sessions for optimal results. At Unpain Clinic, we typically start with 3 sessions (once per week) and then reevaluate. Many patients experience noticeable improvement after just 2 or 3 sessions – for instance, less morning pain or increased activity tolerance. Some may require a couple more sessions if the condition is very chronic or severe. Research studies often evaluate results at the 12-week mark after treatment, which usually corresponds to about 3-5 sessions in total. It’s important to give the body time to respond; the healing processes stimulated by shockwave continue for weeks after the last session. In recalcitrant cases (pain that has persisted for years), additional sessions or periodic “booster” sessions down the line might be recommended. We will tailor the plan to your progress. The good news is shockwave has a cumulative effect – each treatment builds on the last, driving further healing. Most people do not need endless sessions; if shockwave is going to help, you should know within a few treatments. And if you’re not responding as hoped, we’ll reassess and explore other options rather than continuing something that’s not working.
It’s normal to be a bit nervous about potential pain, especially when your heel is already hurting. Shockwave therapy can cause some discomfort, but it is generally tolerable for most patients. During the treatment, you’ll feel rapid percussion or tapping sensations on your heel. When the pulses hit a very tender spot or bone, you might feel a sharp jolt of pain – but the practitioner can adjust the intensity to keep it within your comfort zone. We often start at a lower intensity and increase as you acclimate. Patients commonly describe the feeling as “uncomfortable but not unbearable,” and it’s a kind of pain that often reassures them something therapeutic is happening. The treatment itself lasts only about 5-10 minutes, and any intense sensations are very brief bursts. If needed, we can pause to give you a break. No anesthesia is required (in fact, studies show doing shockwave with local anesthetic can reduce its effectiveness, so we avoid numbing the area). After the session, your heel might feel a bit sore or achy, similar to having done a deep massage – this is a normal response and usually fades within 24-48 hours. Over-the-counter pain relievers or icing can be used if needed, but many patients don’t find it necessary. It’s worth noting that as your plantar fasciitis improves over the course of treatments, the shockwave sensation often becomes less painful because there’s less inflammation and tenderness in the tissue. Our team will work closely with you to ensure you’re as comfortable as possible during the process. In short, shockwave therapy does involve some pain, but it’s temporary and a sign that the treatment is stimulating the area. Most people find the results – reduced chronic pain – well worth this brief discomfort.
Absolutely – in fact, shockwave therapy is specifically indicated for chronic cases that haven’t healed with standard treatments. If you’ve been suffering for years, you likely have a lot of scar tissue or degeneration in the plantar fascia, and your body’s natural healing has essentially stalled. Shockwave excels at “restarting” the healing process in such chronic situations. Studies have shown positive outcomes with shockwave even in people who had heel pain for 12+ months and had tried things like physiotherapy, injections, etc. without success. It’s not uncommon for our long-term plantar fasciitis patients to experience significant relief after shockwave treatment when they had assumed nothing would ever help. That said, the longer a condition has been present, the more factors may be at play. Years of altered movement can lead to secondary problems (tight muscles, joint compensation) that also need addressing. That’s why at Unpain Clinic we assess the whole body and often combine shockwave with other therapies for chronic sufferers. But to answer the question: yes, even if you’ve “had plantar fasciitis forever,” shockwave therapy can still be effective – in fact, you’re the kind of case it was designed for (chronic, stubborn musculoskeletal pain). Many patients who had heel pain for years achieved improvement with shockwave where conventional therapies failed. Keep in mind, chronic cases might require the full course of treatment (and diligent follow-through with exercises) to get maximal benefit. And results can vary – a handful of people might not respond, but the majority do get meaningful pain reduction and function improvement. If you’re unsure, consider getting an evaluation to see if you’re a good candidate for shockwave at this stage.
While shockwave therapy is safe for most people, there are a few contraindications and situations where we either postpone or avoid treatment. You should not have shockwave therapy on the heel if:
You are pregnant – as a precaution, we don’t apply shockwave in the pelvic or heel area of pregnant patients (though there’s no specific evidence of harm, it’s a standard safety practice).
You have a known tumor or cancer in the area – we avoid any strong stimulation over a malignancy.
You have an active infection or open wound on the heel – we would wait until it clears, since shockwave can increase circulation and might spread an infection.
You have a severe bleeding disorder (or are on heavy blood thinners) – shockwave causes microtrauma and small blood vessel rupture, which is usually harmless, but in bleeding disorders it could theoretically cause more bruising or bleeding. We evaluate this on a case-by-case basis.
You have had a corticosteroid injection in the heel very recently – generally we wait a few weeks after an injection before doing shockwave on the same area to avoid any risk of tissue damage, as steroids can temporarily weaken tissues.
Also, shockwave is not typically used in children or adolescents with open growth plates near the heel (like Sever’s disease), since the effect on growing bone isn’t well studied. If you have peripheral neuropathy or poor sensation in your feet (for example, due to diabetes), we’d use caution because you might not feel pain normally – we’d start very gently to ensure we don’t over-treat a numb area. Pacemakers or other electronic implants are not usually an issue with shockwave (since it’s a mechanical sound wave, not an electrical current), but we still like to know about them. During your assessment, we will review your medical history to screen for any contraindications. Rest assured, if shockwave isn’t appropriate for you, we’ll discuss alternative treatments. Patient safety is our top priority.
Coverage for shockwave therapy varies widely. Shockwave is a relatively newer treatment in the physiotherapy and orthopedic realm, and not all insurance plans have caught up to it. In many cases, extended health benefit plans (through employers or private insurance) will cover shockwave therapy when it’s administered by a licensed practitioner (such as a physiotherapist or chiropractor) as part of a treatment session. At Unpain Clinic, shockwave is often billed under physiotherapy or chiropractic services, so if you have coverage for those services, the shockwave treatment can be included. It’s always a good idea to check with your insurance provider: ask if physiotherapy involving shockwave is covered, or if there are any specific limits (some plans might have an extra fee for “modalities”). In Canada, provincial healthcare (like Alberta Health) typically does not cover shockwave therapy, as it’s an “add-on” therapy in private clinics. Some workers’ compensation or motor vehicle accident insurance cases may cover it if deemed medically necessary. Our clinic staff can help by providing any codes or descriptions your insurance company needs. Bottom line: many patients do get reimbursement for shockwave therapy through their health benefits, but you should confirm with your insurer. Even if not covered, consider that shockwave often leads to faster recovery, potentially saving you money in the long run on repeated appointments or more invasive procedures. We also try to keep it cost-effective by not recommending more sessions than needed.
The side effects of shockwave therapy for plantar fasciitis are usually minimal and short-lived. The most common ones include:
Pain during treatment: as discussed, you’ll feel some discomfort while the shockwaves are being delivered. This is expected and stops when the session ends.
Post-treatment soreness: your heel and arch might ache or feel bruised for a day or two afterward. Some patients describe it like “I walked a lot yesterday” soreness. This is actually part of the healing response – shockwave creates a controlled inflammatory response. Usually, it’s mild enough that you can do your normal activities. We typically advise against high-impact sports immediately after a session, just to avoid exacerbating the soreness.
Redness or minor bruising: because shockwaves improve blood flow and can rupture tiny capillaries, you might see some redness on your heel, or occasionally small bruises. This isn’t harmful and will fade. If you have very sensitive skin or took aspirin, bruising is a bit more likely.
Numbness or tingling: rarely, people report a temporary tingling in the foot following treatment, likely due to nerve stimulation. This should resolve in short order.
Temporary increase in pain: in a small subset of patients, pain might actually flare up slightly in the first 24-48 hours as the body’s inflammatory process is activated. This usually is followed by improvement, so don’t be alarmed – but do inform your therapist so they can adjust intensity if needed next time.
Serious adverse events are extremely rare with musculoskeletal shockwave. Unlike surgery, there’s no risk of infection. Unlike medications, there’s no systemic side effect. There have been isolated reports of temporary nerve irritation or tissue calcification with inappropriate use, but in skilled hands these are not a concern. We will provide you with after-care instructions (for example, we usually say “take it easy” on the foot for a day or two – light activity is fine, just no marathon running immediately). Most patients actually feel better in the days after shockwave, as pain levels start trending down. Overall, shockwave therapy is well-tolerated. If during your treatment course you experience anything worrisome, we’re here to support you. But the vast majority of people only experience the mild effects listed above.
Living with plantar fasciitis can be deeply frustrating – but you don’t have to just “live with it.” Shockwave therapy for plantar fasciitis is an evidence-backed treatment that offers new hope for relief when heel pain just won’t quit. This non-surgical modality can stimulate your body’s natural healing processes, helping to reduce pain and improve function in those stubborn cases of chronic plantar fasciitis. By sending focused sound waves into the damaged plantar fascia, shockwave therapy breaks up scar tissue, boosts blood flow, and kickstarts tissue regeneration. The research shows it can be effective even when other treatments have failed, and it avoids the downtime and risks of surgery.
At Unpain Clinic, we’ve seen first-hand how shockwave therapy – used in combination with a whole-body approach – can finally get patients past the pain and back on their feet. By assessing the root causes (often tight calves, weak hips, or past injuries) and tailoring treatment to each individual, we aim for not just short-term relief but lasting resolution of plantar fasciitis. Most patients tolerate the therapy well and start to notice improvements within a few sessions. Of course, results may vary: factors like your overall health, how chronic the condition is, and adherence to the rehab plan all play a role. Shockwave therapy isn’t a guaranteed “cure” (no treatment is), but it has a solid success rate and could be a game-changer for your heel pain.
If you’ve been struggling with plantar fasciitis and feel like you’re at the end of your rope, it may be time to consider shockwave therapy – especially before thinking about invasive measures. The evidence is there, and so are countless patient success stories. Imagine starting your day without that stab in your heel, or finishing a long walk without pain. It’s possible, and you don’t necessarily need surgery or more pills to get there. Shockwave therapy for plantar fasciitis offers a chance to heal your injury by working smarter, not harder – by prompting your body to fix the issue at the source.
Are you a good candidate for shockwave? If you have heel pain persisting over 3 months despite rest and standard care, chances are high that shockwave could help. The best way to know is to have a proper assessment. We’d love to be part of your success story – helping you move from pain to freedom. Don’t let chronic heel pain keep dictating your life. Take the step towards healing (literally, a more comfortable step!) with a proven, cutting-edge treatment and a team dedicated to uncovering why it hurts, not just where.
Ready to find out if shockwave therapy can finally reduce your heel pain? The next section details how you can get started with an initial assessment at Unpain Clinic. We’re here to answer your questions, create a personalized plan, and guide you every step of the way to pain-free feet.
Book Your Initial Assessment NowAt Unpain Clinic, we don’t just ask “Where does it hurt?” — we uncover “Why does it hurt?”
If you’ve been frustrated by the cycle of “try everything, feel nothing,” this assessment is for you. We take a whole-body approach so you leave with clarity, not more questions.
✅ What’s Included
Comprehensive history & goal setting
Orthopedic & muscle testing (head-to-toe)
Motion analysis
Imaging decisions (if needed)
Pain pattern mapping
Personalized treatment roadmap
Benefit guidance
🕑 Important Details
60 minutes, assessment only
No treatment in this visit
👩⚕️ Who You’ll See
A licensed Registered Physiotherapist or Chiropractor
🔜 What Happens Next
If you’re a fit, we schedule your first treatment and start executing your plan.
🌟 Why Choose Unpain Clinic
Whole-body assessment, not symptom-chasing
Root-cause focus, not temporary relief
Non-invasive where possible
No long-term upsells — just honest, effective care
🎯 Outcome
You’ll walk out knowing:
What’s wrong
Why it hurts
The fastest path to fix it
Author: Uran Berisha, BSc PT, RMT, Shockwave Expert
1. Li Z., Jin T., & Shao Z. Meta-analysis of high-energy extracorporeal shock wave therapy in recalcitrant plantar fasciitis. Swiss Med Wkly. 2013;143:w13825. Published June 30, 2013. smw.chsmw.ch
2. Güngör Z.K. et al. Comparison of extracorporeal shock wave therapy and high-intensity laser therapy in the treatment of calcaneal spur-related symptoms: clinical outcomes and functional improvement. J Orthop Surg Res. 2025;20(1):393. pubmed.ncbi.nlm.nih.govpubmed.ncbi.nlm.nih.gov
3. Aqil A. et al. Extracorporeal shock wave therapy is effective in treating chronic plantar fasciitis: a meta-analysis of RCTs. Clin Orthop Relat Res. 2013;471(11):3645-3652. Epub 2013 Jun 28. pubmed.ncbi.nlm.nih.govpubmed.ncbi.nlm.nih.gov
4. Unpain Clinic Podcast Episode #3 – “Understand and Fix Your Chronic Foot Pain”. (Hosted by Uran Berisha, Unpain Clinic, 2021). unpainclinic.comunpainclinic.com
5. Unpain Clinic Blog – “Shock Wave Therapy for Heel Spurs: Differentiating Heel Spurs vs Plantar Fasciitis and Effective Treatments”. (September 29, 2025) unpainclinic.comunpainclinic.com
6. Unpain Clinic – “How to Treat Plantar Fasciitis (Faster and Forever)”. Unpain Clinic website, accessed 2025. unpainclinic.comunpainclinic.com
7. Unpain Clinic – “Shockwave Therapy Edmonton” (Clinic information page). Unpain Clinic website, accessed 2025. unpainclinic.comunpainclinic.com
