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Living with a heel spur can be frustrating and debilitating. That sharp heel pain when you get out of bed in the morning – feeling like you’re stepping on a pin or a piece of glass – can set a negative tone for your whole day. You might have tried everything: rest, ice, anti-inflammatory medications, special shoe inserts, night splints, and stretches. Maybe those brought some short-term relief, only for the nagging pain to return as bad as ever. If this sounds familiar, you’re not alone – and you’re not at the end of your options. Shockwave therapy is emerging as a promising, evidence-backed treatment for chronic heel spur pain, offering a non-surgical path to relief when other treatments have failed.
In this article, we’ll focus on how shockwave therapy (also known as extracorporeal shockwave therapy, or ESWT) can help heal a stubborn heel spur. We’ll explain what a heel spur actually is and why it can hurt for months on end, review scientific research on shockwave therapy for this condition, and describe how we at Unpain Clinic approach heel spur treatment with shockwave as our main tool. You’ll also find practical tips for managing heel pain at home, and answers to frequently asked questions about shockwave therapy for heel spur.
If you’ve been frustrated by the cycle of “tried everything and still in pain,” take heart. Shockwave therapy may be the game-changer you’ve been looking for – a way to reduce chronic heel pain and stimulate real healing in the damaged tissue, without surgery. Let’s dive in.
A heel spur (technically called a calcaneal spur) is a small bony growth on the heel bone. It often forms right where the plantar fascia – a thick ligament on the bottom of your foot – attaches to the heel. Heel spurs typically develop over time due to chronic stress and pulling on the bone, leading the body to deposit extra calcium. Common risk factors include prolonged standing, running or high-impact sports, flat feet or high arches causing abnormal strain, and age or weight factors that increase overall foot stress. On an X-ray, a heel spur looks like a little hook or point coming off the heel bone.
Importantly, heel spurs themselves usually are not the root cause of pain. In fact, studies have found that many people have heel spurs visible on X-ray but experience no pain at all. The real culprit behind that intense heel pain is usually inflammation or degeneration of the soft tissues in the foot – most often the plantar fascia (a condition known as plantar fasciitis) or the nearby Achilles tendon. A heel spur is better thought of as a symptom of long-term tissue overload rather than the direct source of pain. When the plantar fascia is overstressed and not healing properly, the body may lay down a spur at the attachment site – but it’s the damaged fascia causing the pain, not the tiny bone spur itself.
What does heel spur pain feel like? When these soft tissues are irritated, the pain is usually sharp or stabbing under the heel (especially with the first steps in the morning or after sitting), and can turn into a dull ache as you stay on your feet. You might also feel tightness along your arch. If the spur is at the back of the heel (where the Achilles tendon attaches), pain is felt at the back of the heel and ankle, often worse when climbing stairs or on tiptoes. Heel spur pain tends to be chronic, meaning it sticks around for weeks and often months. If the condition persists beyond 3–6 months, it is considered chronic heel pain.
Why can heel pain last so long? The underlying issue – such as plantar fasciitis – is essentially a stubborn injury. The plantar fascia might have micro-tears and collagen degeneration from overuse, a situation sometimes called “fasciosis” rather than acute inflammation. These tissues have poor blood supply, so they heal slowly. Every time you walk, you might re-strain the area, creating a cycle of injury and inflammation that doesn’t fully resolve. Additionally, if you have biomechanical issues (e.g. very tight calves, abnormal foot posture, or even problems up the kinetic chain in your knees or hips), the heel pain can keep recurring until those root causes are fixed.
Most people in pain try conservative remedies first. Rest, icing the heel, and taking NSAID medications (like ibuprofen) are common. Doctors may offer cortisone steroid injections to reduce inflammation. Podiatrists often prescribe custom orthotic insoles to support the arch. Physical therapists give stretching and strengthening exercises. These approaches can be helpful – about 90% of plantar fasciitis cases eventually improve with non-surgical measures. However, standard treatments often provide only temporary relief if they’re not addressing the true cause. For example, stretching a tissue that is degenerative may not lead to healing (and aggressive stretching can even aggravate micro-tears), and orthotics can offload the pain but might also make your foot muscles weaker over time. It’s no wonder that many people exhaust these conservative therapies and still have chronic heel pain.
When all else fails, patients consider surgery. Surgery for heel spurs might involve removing the spur or releasing part of the plantar fascia. But surgery is invasive, requires long recovery, and isn’t guaranteed to work – it can even lead to complications like nerve pain or arch instability. Moreover, since the spur isn’t the real cause in most cases, removing it surgically doesn’t necessarily fix the problem. For that reason, surgery is truly the last resort. Even our team at Unpain Clinic emphasizes: “surgery should be the last resort” because most heel spurs and plantar fasciitis can be treated successfully with non-invasive methods.
So, where does shockwave therapy come in? Shockwave therapy offers a way to jump-start the healing process in chronic heel spur cases – essentially giving your body’s natural repair mechanisms a wake-up call. In fact, clinical guidelines recommend that patients with chronic heel pain (lasting >6 months) who don’t respond to basics like rest, stretching, and footwear changes consider extracorporeal shockwave therapy before contemplating surgery. It’s a treatment that can address the root problem (poor healing in the fascia) in a targeted way, without the risks of an operation. In the next section, we’ll dive into what the research says about shockwave therapy for heel spurs and plantar fasciitis.
Shockwave therapy has been studied extensively for chronic heel pain conditions. (Notably, many studies refer to plantar fasciitis and heel spurs together, since these often occur together and have similar symptoms. If pure “heel spur” evidence is limited, we look at plantar fasciitis studies, as they effectively cover the same scenario.) Overall, the scientific literature suggests that shockwave therapy is a safe and often effective non-surgical treatment for chronic heel pain. Here are some highlights from the research:
Higher success rates than placebo: A meta-analysis in 2013 focused on patients with recalcitrant plantar fasciitis (cases not improving for 6+ months, many of whom had heel spurs). It found that patients treated with high-energy shockwave therapy were more than twice as likely to experience significant pain relief compared to those who got sham treatments. By 12 weeks after treatment, the odds of improvement were 2.25 times higher with shockwave than placebo – a statistically significant and clinically meaningful difference. The authors concluded there is “strong evidence” that shockwave therapy is effective for chronic heel pain, and they recommend ESWT as a remedy after failure of traditional conservative care and before considering surgery.
Pain reduction and functional improvement: Recent studies continue to support shockwave’s benefits. A 2024 systematic review of 11 randomized trials (over 650 patients) found that shockwave therapy consistently reduces heel pain and improves foot function in chronic plantar fasciopathy. Patients who received shockwave reported lower pain intensity on average than those who received placebo or no treatment, and they had better functional scores in walking and daily activities. Equally important, this meta-analysis noted that shockwave therapy was well tolerated by patients, with a low dropout rate and few adverse effects. In other words, not only does it work for many people, it’s also quite safe and doesn’t typically require stopping due to side effects.
Head-to-head vs other therapies: Shockwave therapy has also been compared to other treatment modalities. In a 2025 randomized trial published in the Journal of Orthopaedic Surgery and Research, researchers treated patients suffering from painful heel spurs with either focused shockwave therapy or high-intensity laser therapy (HILT). Both groups improved, but shockwave had a slight edge in outcomes. After three months, the shockwave group’s morning pain (that first-step pain) dropped from an average of 7.8/10 to about 3.4/10, while the laser group dropped from 7.5 to 3.5. Functionally, shockwave patients cut their Foot Function Index (FFI) disability scores more than the laser group did (FFI improved from ~59 down to 20 with shockwave, versus 57 down to 35 with laser). Both treatments were deemed effective non-invasive options, but shockwave provided greater functional benefit overall. Notably, no significant adverse events were reported with either therapy – underscoring that modern shockwave is a low-risk procedure.
Clinical success rates: Different studies define “success” differently, but generally around 60–80% of chronic heel pain patients respond well to shockwave therapy. For example, one clinical trial on 108 patients with heel spurs showed that after a course of shockwave therapy (five weekly sessions), 66.7% of patients reported complete relief (no pain), and an additional 15.7% had their pain cut at least in half. About 17% saw little to no improvement – suggesting shockwave isn’t magic for everyone, but it helps the majority. Interestingly, when doctors took X-rays after the treatment, the bone spurs usually looked the same – there was no significant shrinkage of the spur in most cases. A few patients showed slight spur size reductions and one had a fractured spur, but for the most part the spur remained. Yet two-thirds were pain-free! The pain relief had no direct correlation with spur size changes, meaning that shockwave likely healed the tissue (fascia/tendon) enough to stop the pain even though the bony spur itself was still there. This is a crucial point to understand: shockwave therapy doesn’t necessarily “dissolve” a heel spur (despite using the same technology as kidney stone blasting) – instead, it heals the tissue around it so the spur isn’t aggravated and doesn’t hurt. Patients often get hung up on “I need to remove the spur.” But as studies and our clinical experience show, you can feel 100% better even with the spur still present.
Ultrasound evidence of healing: To further illustrate how shockwave helps, a 2021 study used ultrasound imaging to evaluate plantar fasciitis with heel spurs before and after shockwave therapy. Before treatment, the patients’ plantar fascia were markedly thickened (about 5.6 mm thick on average, compared to ~2.4 mm in healthy people) due to chronic inflammation and scar tissue. After 4 weekly shockwave sessions, the ultrasound showed a significant decrease in plantar fascia thickness (meaning the swelling and scar tissue in the fascia went down), and patients reported significantly reduced pain and improved function scores. This provides direct visual evidence that shockwave therapy helps restore the health of the fascia – it’s not just masking pain, it’s reversing some of the chronic damage. Other research confirms that shockwaves trigger biological regeneration: studies have observed new blood vessel formation (angiogenesis) and improved blood flow in treated tissues, as well as stimulation of collagen production (helping build stronger, more flexible fibers in the fascia and tendon).
How does shockwave therapy work? On a basic level, ESWT uses mechanical energy (high-energy sound waves) to stimulate a healing response in the target tissue. When the shockwaves are delivered to your heel area, they cause micro-trauma (tiny controlled injuries) and mechanochemical signals in the chronically damaged tissue. This “wakes up” your body’s natural healing processes which had stalled. To put it simply: shockwaves promote inflammation in a good way – the kind that jump-starts repair. They also seem to have a pain-relieving effect by overstimulating nerve endings and causing the release of pain-inhibiting substances.
From a patient perspective, the therapist will apply a probe to your heel (and often the arch or calf) that sends pulsating acoustic waves into the tissue. It’s a bit intense during the treatment (more on that later in the FAQ), but those pulses are doing a lot of therapeutic work under the surface. Laboratory studies and clinical observations have shown several key effects: (1) Shockwaves physically break up disorganized scar tissue and calcific deposits (for example, they might help fragment calcifications in chronic tendonitis). (2) They cause controlled micro-cavitation in tissues, which triggers the release of growth factors and recruitment of your body’s stem cells to the area. (3) They increase blood circulation by promoting new blood vessel growth and dilation of existing vessels. Tissues like the plantar fascia or Achilles tendon, which normally have poor blood supply, greatly benefit from this boost in circulation. (4) They stimulate cellular regeneration, prompting tendon cells and fibroblasts to produce new collagen and repair the extracellular matrix. In short, shockwave therapy resets the chronic injury into an acute healing phase, and provides the energy needed for the body to rebuild healthier tissue. As one publication succinctly noted, “shockwave therapy stimulates real healing at the cellular level… breaking down scar tissue, increasing blood flow, and triggering the body’s natural repair mechanisms.”
Treatment protocols: The exact regimen can vary, but most successful studies and clinics use a series of sessions rather than a one-and-done approach. A typical protocol for heel spur pain might be 3–5 sessions of shockwave therapy, usually spaced about 1 week apart. Each session lasts only around 10-15 minutes for the actual shockwave delivery (the setup might take a bit longer, but the treatment itself is fairly quick). During each session, the therapist will deliver a few thousand shockwave pulses to the affected area. The energy level and number of pulses can differ based on whether focused or radial shockwave is used and the device settings. Focused shockwave (f-ESWT) penetrates deeper with concentrated energy, while radial shockwave (r-ESWT) spreads out more at the surface – both types have shown effectiveness for plantar fasciitis in studies, so clinics may use one or both types. In fact, a 2025 trial found that focused and radial shockwave, when applied in proper therapeutic doses, produced similar improvements in pain and function for chronic plantar fasciitis; there was no significant difference in outcomes between the two modalities by 3 months follow-up. This suggests that what matters most is that shockwave energy is delivered to the area – your provider will choose the device/settings that best target your specific condition.
Most patients tolerate shockwave therapy well. There is usually some discomfort during the procedure – it can range from a dull thud feeling to sharp stinging sensations, depending on the energy level and your individual sensitivity. However, the intensity is adjustable and the clinician will work with you to keep it within tolerable limits. Only a very small number of patients might find it too painful to continue (in such cases, treatment can be done under local anesthetic, but this is rarely needed). After the session, you might experience mild soreness or a bruised feeling in the heel for 24-48 hours. This is normal and generally mild; you can often manage it by icing the area or just taking it easy on your feet for a day. The benefit of avoiding medications or injections is that you don’t have systemic side effects – no risk of stomach ulcers (from NSAIDs) or tissue weakening (from steroids) or infections (from injections or surgery). In studies, serious adverse effects from shockwave (like tissue damage or nerve injury) have not been reported. A 2024 review reinforced that ESWT is a safe and well-tolerated therapy for plantar fasciitis, with a high adherence rate and low dropout.
It’s important to have realistic expectations: shockwave therapy is not a “instant pain relief” gimmick – it works gradually by stimulating healing. Many patients start to notice improvement after the first 2–3 sessions, but the most significant relief often occurs several weeks after completing the treatment series, as the tissue goes through its regeneration process. In the clinical trials discussed, assessments at 4 weeks, 6 weeks, or 12 weeks post-treatment often show the maximum gains. Patience is key. That said, some individuals do get rapid pain reduction (within days of a session), especially if their pain was more related to persistent inflammation. The bottom line from research: about 3 out of 4 chronic heel pain sufferers will get meaningful relief from shockwave therapy, allowing them to return to activities with much less pain. It’s not a guaranteed “cure” for everyone, but given its safety profile, it’s a very worthwhile option to try before resorting to surgery.
At Unpain Clinic, shockwave therapy is the cornerstone of our treatment approach for heel spurs and plantar fasciitis. In fact, we specialize in what we call “True Shockwave™” therapy – using advanced focused shockwave technology – because we have found it to be the most effective modality for chronic musculoskeletal pain. But equally important is how we apply shockwave as part of a comprehensive, root-cause-focused plan.
Holistic assessment: We don’t just look at your heel; we look at you as a whole. On your first visit (the Initial Assessment), our clinicians conduct a head-to-toe evaluation (as detailed in the 📍 Book Your Initial Assessment Now section below). For heel spur patients, this includes examining your foot biomechanics, calf flexibility, gait pattern, and also looking further up the kinetic chain at your knees, hips, core, and even posture. Why? Because, as we discussed earlier, the origin of chronic foot pain is often not actually in the foot. For example, if your gluteal muscles aren’t doing their job when you walk, the stress may travel down to the hamstrings, then to the calves, and finally overload the plantar fascia. Many people with heel spurs have underlying issues like weak core muscles, leg length discrepancies, old injuries, or movement habits that set them up for foot pain. We’ve seen cases where a patient’s chronic heel spur pain was traced back to a hip problem that began after a car accident – once we treated the hip dysfunction, the heel pain resolved. The key is, we identify the true drivers of your pain. This might involve orthopedic tests, strength tests, and even assessing your balance or the way you squat or jump. By mapping out these contributing factors, we can craft a much more effective treatment plan.
Shockwave therapy as the main modality: Once we have the big picture, we typically start treatment with shockwave therapy targeting not only the painful heel area, but also any related tight or dysfunctional areas. For a heel spur case, the primary target is often the plantar fascia insertion at the heel and possibly the spur area itself. We use a focused shockwave device for deep, precise energy delivery. We will also often treat the calf muscles and Achilles tendon with shockwave, because tightness there is almost always part of the problem (tight calves pull on the Achilles and fascia, perpetuating the spur formation and pain). If our assessment finds issues in the hamstrings or glutes or lower back, we may also apply shockwave to trigger points or areas of fascial restriction in those regions. This is a crucial difference in our approach: we don’t just shockwave the foot in isolation. By treating the related muscle chains, we reduce the abnormal forces on your heel. As Uran Berisha (Unpain Clinic’s founder and shockwave expert) often says, “We don’t chase symptoms – we fix the cause.”
To illustrate, in our podcast episode “Understand and Fix Your Chronic Foot Pain” (June 18, 2021), Uran describes a typical heel pain patient: they had tried rest, medications, physio exercises, etc., with no luck. In the assessment, it turned out their hip on one side was extremely stiff and their core was deactivated, leading to a cascade of compensations down to the foot. The treatment plan involved using shockwave on the hip and lower back areas to release those deep restrictions, then using shockwave on the foot itself to stimulate healing in the plantar fascia. The result? After a few sessions, the patient experienced significant relief and was able to walk pain-free for the first time in years. This combined approach – shockwave therapy + holistic therapy – is what defines Unpain Clinic’s method.
What a shockwave therapy session looks like: During a typical shockwave session for a heel spur, you’ll be comfortably positioned (often lying on your stomach or side). The clinician applies a coupling gel to the treatment area (this helps conduct the shockwaves). They’ll start with a lower intensity, delivering pulses to the heel area – you’ll hear clicking sounds and feel thumping pulses. It can be a bit ouchy, especially on very tender spots, but we continuously adjust based on your feedback. Most patients say it’s quite tolerable, and the more it’s done, the less sensitive it feels (possibly as the tissue starts to heal and desensitize). We then move to other relevant areas – for instance, working along the calf muscle or Achilles tendon with the shockwave handpiece to relieve tension and improve circulation there. A session might involve 1500–3000 pulses per area, taking about 5-10 minutes per area. The entire appointment might be 20-30 minutes if we are treating multiple regions.
Our therapists might combine techniques within the same session. Often, shockwave is the primary tool, but we may do some hands-on manual therapy or stretching after shockwave to capitalize on the loosened tissue. Or we might tape your arch or demonstrate a couple of exercises for you to do at home (more on that in At-Home Guidance below). The key is that shockwave accelerates the healing, and we support that healing with the right additional therapies at the right time. We do not typically use corticosteroid injections at our clinic because, as research and our experience shows, steroids can weaken tissue and provide only temporary relief. We focus on regenerative treatment, not short-term band-aids.
Frequency and number of sessions: Based on evidence and our own outcome tracking, we schedule most heel spur patients for weekly shockwave sessions, usually for a total of about 3–5 sessions. Many patients start noticing improvements after the second or third session – maybe they have less morning pain, or can stand longer during the day without as much agony. By session 5, a large number of our patients report dramatic improvements (pain down by 50–100%, and able to return to activities they avoided before). Of course, every case is unique. Some severe chronic cases (say, pain that’s been ongoing for years) might need a couple more sessions or booster sessions later. We tailor it to the individual, but we make sure to set expectations that multiple sessions are needed – shockwave’s effects are cumulative. We track your progress closely. If you’re not responding as expected after a few treatments, we re-evaluate and consider other contributing factors or adjunct treatments. But in general, shockwave’s success rate at Unpain Clinic is high for heel pain – reflecting the findings of scientific studies and the fact that we apply it in a very targeted, personalized manner.
Whole-body approach in practice: One of the reasons patients come to us from all over is that we take the time to find and treat the often overlooked causes of their pain. For example, consider a patient with a heel spur who also has chronic low back stiffness. It might not seem related, but a rigid lower back can alter your gait and hip mechanics, indirectly loading the foot. In a session, we might use shockwave on the lumbar paraspinal muscles or hip flexors to improve mobility there. It’s not the typical “foot treatment” you’d get elsewhere, but then when that patient stands up, they often notice not only is their back looser, their heel pain is immediately less because the chain is now more functional. Then we follow up by shockwaving the plantar fascia itself to stimulate local healing – now that the fascia isn’t under constant excessive strain, it can truly repair. This comprehensive strategy is what leads to long-term resolution rather than a quick fix. We love hearing patients say things like, “I had this heel pain for 2 years and tried everything. Your team figured out it was actually my hips and now I’m finally better!”
Combining with exercise and education: Alongside shockwave, Unpain Clinic therapists provide guidance on specific exercises or stretches to do at home, but only when appropriate. Early on, if your plantar fascia is very irritated, we might actually avoid aggressive stretching (because as mentioned, that can sometimes worsen micro-tears). Instead, we might teach you gentle calf stretches or foot mobility exercises, and perhaps some glute activation drills to start addressing those higher-up weaknesses. As your pain decreases, we’ll progress you to strengthening exercises for the foot and leg to build resilience (for instance, towel curls with your toes, calf raises, hip strengthening moves). The goal is not only to get rid of your current pain, but to correct the dysfunctions so the pain stays gone. You’ll also get education on footwear (e.g. temporarily using a cushioned heel cup or supportive shoe during treatment, but weaning off overly rigid orthotics in the long run so your foot doesn’t become dependent). We may discuss lifestyle factors: if you have a job that keeps you on your feet on hard floors all day, we’ll strategize ways to mitigate that impact while you heal.
Throughout the process, we keep shockwave therapy front and center because that is the modality actively stimulating tissue repair. Other therapies (exercise, manual release, etc.) support the process, but shockwave is the “power boost” that often makes the difference in a chronic case.
To sum up our approach: Assess globally, treat locally and globally, and use shockwave to unlock the body’s healing potential. We’ve delivered over 40,000 shockwave treatments (and counting) and have seen even the most stubborn heel spurs calm down when we apply this method. In the next section, we’ll share a brief example story of a patient with heel pain and how shockwave therapy helped them – this will illustrate what the journey can look like.
Meet Sarah: Sarah is a 49-year-old avid walker who developed heel pain about 18 months ago. She works as a teacher, on her feet most of the day. Initially, she felt a mild ache in her right heel in the mornings. She tried buying cushioned shoes and using a frozen water bottle to roll under her arch (an old trick she found online). Despite this, her heel pain worsened over the next months – to the point she dreaded getting out of bed because the first step would feel like stepping on a tack. Sarah visited her family doctor, who diagnosed her with a heel spur after an X-ray showed a small calcaneal spur. She was told it’s related to plantar fasciitis. The doctor prescribed an NSAID and advised stretching. Sarah diligently did calf stretches and wore a night splint. Still, every day at work was agony. She’d limp by the end of the day. A specialist gave her a cortisone injection in the heel, which helped for about 3 weeks – then the pain came roaring back. She was considering an orthopaedic surgeon consult when she heard about Unpain Clinic’s success with shockwave therapy for heel spurs.
Initial assessment: During her first visit at Unpain Clinic, the physiotherapist listened to her history and noted that she had also experienced occasional knee and hip soreness on the same side. Examining Sarah, the physio found her right calf was very tight and her right hip had limited rotation. Notably, her right glute (buttock) muscles were weak in certain tests. The therapist explained that these issues likely contributed to her foot pain – her weak hip and tight calf meant her poor plantar fascia was taking too much load. Sarah was a bit surprised to hear her hip might be involved, since “my heel is what hurts”, but the explanation made sense.
Shockwave treatment: They began treatment that same day. First, the therapist applied shockwave therapy to Sarah’s calf muscle and Achilles tendon. At first contact, Sarah felt a jolt of tender pain (her calf was full of knots!). The therapist adjusted the intensity and within a minute Sarah’s discomfort eased as the area started to numb slightly. Next, they applied shockwave to the bottom of her foot – focusing on the heel and arch. It was uncomfortable but tolerable; Sarah likened it to “rapid fire deep tissue massage” in the arch. Finally, the therapist even used shockwave briefly on her right hip area where some tight bands were found. After the session, Sarah’s heel actually felt sorer and a bit warm – which is expected as blood flow increases. The physio reassured her this was a normal reaction and to avoid high-impact activity for a day or two. They also showed her a gentle calf stretch and a simple glute activation exercise (bridging) to do at home.
Progress: By the time Sarah came for her second session a week later, she reported that the heel pain seemed slightly less intense in the mornings and she noticed she could stand through an entire class period before needing to sit – previously she had to sit after 10 minutes. This was encouraging! The second shockwave session targeted the same areas. They also worked on her hip mobility with a quick adjustment and some manual release. Fast-forward to after the third session, Sarah was over the moon: “Yesterday I walked the dog for 30 minutes and realized halfway through that my heel wasn’t hurting at all,” she told us, “This is the least pain I’ve had in over a year.” She was not 100% pain-free all the time yet, but the pain had gone from a constant 8/10 at its worst to maybe 2/10 occasional mild discomfort.
After five shockwave sessions, spaced over about five weeks, Sarah felt 90% improved. Her morning startup pain was gone. She could even do light jogs with her kids. On ultrasound, her plantar fascia thickness reduced (indicating healing), and her spur on X-ray looked the same (as expected) but was no longer tender on palpation. We equipped Sarah with a personalized exercise plan focusing on strengthening her glutes and core, plus calf flexibility maintenance, to prevent future flare-ups. We also discussed gradually reintroducing more activities – she had stopped hiking because of pain, and now she was eager to resume.
Outcome: Sarah did not need surgery. She didn’t even need a second cortisone shot. By addressing the root causes and using shockwave to repair the tissue, she got lasting relief. Six months later, she reported that she remained pain-free as long as she kept up with her home exercises a few times a week. On follow-up, she said, “Shockwave therapy gave me my active life back. I only wish I had known about it a year earlier – it would have saved me so much pain and frustration.”
This story is a composite, but it reflects the kind of success we see with shockwave therapy for chronic heel pain. Of course, results vary for each person – not everyone is 90% better in five sessions, and some cases require more extensive rehab alongside shockwave. But even for those patients who don’t get complete pain elimination, shockwave often significantly improves their condition (for instance, turning a severe pain into a mild, manageable pain, or allowing them to transition from inactivity back to gentle exercise). The key takeaway is that there is hope for heel spur sufferers beyond just enduring pain or undergoing surgery. By using a modality that actively stimulates healing, even long-standing problems can improve.
While professional treatment (like shockwave therapy) is central to overcoming a heel spur, what you do between clinic visits can also make a big difference. Here are some simple, safe at-home measures to support your healing and keep your pain in check:
Modify activities (but keep moving): You’ll want to avoid high-impact activities during your recovery. This means cut back on running, jumping, or prolonged standing on hard surfaces, as these can aggravate the heel. However, don’t stop moving altogether! Gentle low-impact exercise is encouraged – try cycling, swimming, or using an elliptical machine, which let you stay active without pounding your heels. Movement boosts blood flow and can help healing (plus maintain your overall fitness and mood). The rule of thumb is: if it significantly increases your heel pain, scale it down or pause that activity for now.
Support your feet: Wear shoes that have good cushioning in the heel and arch support. Especially for long days on your feet, a quality pair of athletic shoes or orthopedic shoes can reduce strain on the spur area. Avoid barefoot walking on hard floors. You can also use over-the-counter heel gel cups or pads in your shoes – these can soften the impact on the heel. Some people find relief with night splints or socks that keep the foot gently stretched overnight (preventing that painful morning fascia shock). These supports don’t cure the issue, but they can ease symptoms. Just remember that long-term, you’ll want to strengthen your feet; so these are temporary aids, not permanent crutches.
Stretch gently and often: Keeping the Achilles tendon and calf muscles flexible reduces tension on the heel. Calf stretches are very helpful – for example, the classic wall stretch (leaning forward with one leg back straight, pressing the heel to the ground). Do this with the knee straight (to stretch the gastrocnemius) and with knee slightly bent (to target the soleus deeper calf muscle). Hold each stretch ~20 seconds, and repeat a few times per leg, a couple of times a day. Important: don’t bounce during stretches, and if a stretch causes sharp pain, ease off – it should feel like a mild pull, not a tear. In addition to calves, you can gently stretch the plantar fascia: a simple way is to sit and cross your foot over your knee, then use your hand to pull your toes back toward your shin (you’ll feel the stretch in your arch). Do this in the morning before getting up, and before activity. Moderation is key – gentle, frequent stretching helps; aggressive stretching can irritate the fascia.
Strengthen supporting muscles: As your pain allows, incorporate strengthening exercises for your feet and legs. Some easy ones: Towel curls (spread a towel on the floor and scrunch it toward you with your toes; this strengthens the intrinsic foot muscles). Marble pickups (use your toes to pick up small objects like marbles – it’s actually a fun challenge!). Calf raises (rising up on your toes, then slowly down – start on both feet, progress to single-leg if tolerated). Also, do exercises for your hips and glutes – clamshells, bridges, leg lifts – because stronger hips reduce the load on your feet. Aim to do these exercises 2–3 times a week. They shouldn’t cause heel pain – if an exercise hurts your heel, modify it (or wait until a bit later in your recovery to try again). Over time, stronger muscles and better biomechanics will help prevent future flare-ups.
Home pain relief techniques: On days when your heel is very sore (perhaps after heavier activity or a shockwave session), you can use ice therapy to calm it down. Freeze a water bottle and roll it under your arch for 10 minutes, or simply apply an ice pack to the heel (15 minutes on, 15 off). This can numb pain and reduce any reactive inflammation. Some people also find contrast baths (alternating warm and cold water foot soaks) helpful to pump circulation. If cleared by your doctor, you can use NSAIDs occasionally for pain relief, but avoid relying on medication daily (especially since they can have side effects and may impede the tissue healing process if overused). Gentle self-massage of the calf and arch with your hands or a massage ball can relieve tension – just don’t press directly super hard on the heel spur spot, focus more on the surrounding muscles and fascia.
Listen to your body and pace yourself: Recovery is not always linear. You may have good days and bad days. Pay attention to pain signals – pain is your body’s way of saying “too much.” If you notice a particular activity or footwear consistently aggravates your heel, adjust accordingly. Conversely, take note of what makes it feel better (morning stretching? using a foot roller in the evening? etc.) and make those a habit. As your condition improves, gradually increase your activity level – but don’t go straight from resting to running a 10k. A gradual return to higher-impact exercise (with guidance from your therapist) will ensure you don’t reinjure the area.
And finally, a general tip: maintain a healthy lifestyle supportive of healing. Proper nutrition (especially enough protein for tissue repair, and perhaps extra Vitamin C and collagen-supporting nutrients) can aid recovery. Staying hydrated and getting adequate sleep also improves your body’s healing capacity.
Disclaimer: The above tips are general advice for educational purposes. They are not a substitute for professional medical care. Every individual’s condition is unique – what’s appropriate for one person might not be for another. Always follow the specific recommendations given by your healthcare provider. If an exercise or home treatment causes sharp pain or if your condition significantly worsens, stop and seek medical advice. Remember, the best results often come from combining these self-care measures with professional treatments (like shockwave therapy) as part of a comprehensive plan.
(Results may vary; consult a healthcare provider for personal guidance.)
Yes, shockwave therapy is considered very safe for treating heel spurs and plantar fasciitis. It’s a non-invasive procedure – meaning there’s no incision, no injections, and no need for anesthesia in most cases. The risk of serious complications is extremely low. In clinical studies, patients have not experienced any significant adverse events from shockwave therapy to the heel. The most common side effects are minor and short-lived: you might have some redness, mild bruising, or soreness on your heel for a day or two after treatment. This is a normal response as the body starts its healing process. During the treatment itself, there can be some pain or discomfort, but this stops almost immediately after the session ends.
Shockwave therapy has been used in medicine for several decades (first for kidney stones, then for musculoskeletal conditions) and has a solid safety record. Of course, there are a few exceptions and precautions. Shockwave is generally not recommended if you have an active infection or wound in the area, if you have a known tumor or cancer in the area, or certain nerve disorders. It’s also usually avoided in women who are pregnant (as an extra precaution, we wouldn’t do it directly over the uterus or pelvic region during pregnancy). If you have a severe problem with blood clotting (or are on strong blood thinners), we’d use caution because of the slight bruising risk. These are all things we screen for before starting therapy. For the vast majority of people with a heel spur, shockwave therapy is a safe option. The energy levels used for heel pain are well within the range that tissues can handle without damage – they actually stimulate repair. Rest assured that at Unpain Clinic, your therapist will review your medical history to ensure shockwave is appropriate for you. We prioritize safety: the treatment will be performed by a licensed professional who is fully trained in shockwave application and protocols. Bottom line: shockwave therapy is a safe, FDA-approved treatment for chronic heel pain, with far fewer risks than surgery or long-term medication use.
The number of sessions can vary, but most people require a series of treatments rather than a single session. At Unpain Clinic, a typical plan for a chronic heel spur would involve about 3 to 5 shockwave therapy sessions, usually spaced one week apart. This protocol is in line with many research studies and has proven effective for the majority of our patients. In some cases, we extend to 6 or even 8 sessions – for example, if your heel pain has been going on for years or if there are multiple areas to treat (like plantar fascia and Achilles tendon together), a few extra sessions may yield better results.
Why multiple sessions? Each shockwave treatment triggers a cascade of biological reactions in your tissue that unfold over time – increased blood flow, new cell growth, reduction of nerve sensitivity, etc. By repeating the treatment weekly, we build on those effects, pushing the healing process further each time. Think of it like physical therapy exercises – one session isn’t enough to strengthen a muscle significantly, but a series of sessions can produce a big improvement. Similarly, one shockwave session might start the healing, but pain relief often becomes noticeable after the second or third session and continues to improve through the full course.
In terms of timeline, many patients report a noticeable decrease in pain after 2-3 weeks (i.e. after 2-3 sessions). By the end of the full course (say 5 weeks), we often see significant relief – sometimes the pain is completely gone, other times it’s markedly better but still improving. After we finish the initial series, we’ll re-evaluate. If you’re pain-free, fantastic! We’ll transition you to maintenance exercises and hopefully discharge you from regular treatment. If there’s still some residual pain, we might recommend one or two additional sessions or other therapies in conjunction. It’s also worth noting that the healing process can continue even after the last session – your body may keep laying down new collagen and reducing inflammation for weeks to months afterward. Some studies did follow-ups at 12 weeks or 6 months post-treatment and found patients continued to improve even after shockwave therapy was done.
In summary, expect around 3-5 sessions for a typical case, more for severe or ultra-chronic cases, and fewer if you’re lucky and respond extremely quickly. Each session builds on the last, and patience over those few weeks usually pays off with a big reduction in heel pain.
This is a great question and a common concern! The honest answer is: shockwave therapy can cause some discomfort or pain during the treatment, but it’s temporary and tolerable for most people. Here’s what to expect: When the shockwave device is activated, it emits high-energy pulses that penetrate through the skin into the targeted tissue. You’ll feel these pulses as rapid tapping or popping sensations. At lower energy levels, many patients describe it as uncomfortable but not exactly painful – more like a deep vibration or thud. At higher energy or on very sensitive spots, it can be a sharp, almost jarring sensation that definitely makes you wince.
However, there are a few saving graces. First, the therapist will usually start at a low intensity and ramp up gradually. This allows your body to adjust. After a short time, something interesting often happens – the area can start to feel numb or “used to” the sensation, and the relative pain actually decreases even as the intensity increases. We frequently hear patients say the first minute is the worst, then it gets easier. Second, each shockwave pulse is extremely brief (a microsecond or so), and they come in rapid succession. So it’s not a lingering pain, it’s more like many tiny pinch-like sensations. Your brain can tolerate this staccato type of stimulus better than one long painful stimulus. Third, if at any point it’s too intense, we can pause and adjust. In focused shockwave therapy, we can also reposition the handpiece to avoid super-sensitive areas and hit them from a different angle more gently.
The duration of discomfort is also short – a typical spot might be treated for 2-4 minutes continuously. So even if it’s not the most pleasant feeling, patients know it will be over soon. We coach you through it with breathing techniques and let you know how far along we are (“halfway there,” etc.). Most patients find it very manageable, especially when they remind themselves why they’re doing it (“this short pain is fixing my long-term pain”).
After the session is finished, any treatment-related pain stops immediately. You might have some soreness after as described earlier, but that’s a different, duller sensation (more like you pressed on a bruise). There’s no lingering “shock” pain once the device is off. In fact, some patients feel an immediate analgesic effect – the intense stimulation can lead to pain relief in the minutes after treatment due to something called hyperstimulation analgesia (the principle that a strong stimulus can temporarily reduce pain perception in an area).
If we had to quantify it: patients often rate the discomfort during shockwave as something like a 4–6 out of 10 on a pain scale, but it’s brief. We also tailor the intensity – our goal is therapeutic effect with as little pain as necessary. For very sensitive individuals or areas, we can use a lower energy setting over more sessions, or even consider a numbing cream or mild local anesthetic (though again, that’s rarely needed for plantar fasciitis cases).
To sum up: Yes, there may be some pain during the procedure, but it’s a “good” pain in the sense that it indicates we’re hitting the right spot and inducing change. It subsides right after treatment and does not cause ongoing discomfort. Most patients agree that the temporary discomfort of shockwave therapy is well worth the lasting relief it provides. And at Unpain Clinic, our therapists are very attentive to your comfort – we’ll communicate throughout to keep it within your tolerance.
Absolutely. In fact, shockwave therapy is often most indicated for chronic, long-lasting heel pain – including cases that have persisted for many years. Remember, shockwave’s role is to trigger healing in a tissue that hasn’t healed on its own. The longer you’ve had the heel spur/plantar fasciitis, the more “stuck” in a degenerative state the tissue probably is. Shockwave can be the nudge that finally gets it to heal.
Research backs this up: studies specifically looking at chronic or recalcitrant heel pain (typically defined as 6+ months of symptoms, though many patients we see have 1, 2, even 5+ years of pain) have shown excellent results with shockwave therapy. For example, that meta-analysis we discussed from Swiss Medical Weekly focused on patients with an average of 1 year of heel pain and found shockwave was significantly more effective than placebo. Many of those people had tried and failed other treatments, yet shockwave helped when nothing else did. Another study (published in Clinical Orthopaedics by Ogden et al.) specifically treated chronic plantar fasciitis averaging 3+ years of pain; shockwave had a high success rate in relieving pain in that study, which was one of the reasons the FDA approved shockwave for chronic plantar fasciitis in the early 2000s.
At Unpain Clinic, we often treat patients who say “I’ve literally had this heel pain for years.” They are exactly the kind of patients who benefit the most from shockwave. One reason is that over time, people with chronic pain develop a lot of secondary issues – their gait changes, they might gain weight due to inactivity, they have widespread muscle tightness from limping or compensating. Shockwave, combined with our holistic approach, addresses both the primary tissue damage and these secondary adaptations. Even if your heel spur has been present a long time, shockwave can still promote new healing even in an “old” injury.
That said, chronic cases may require a bit more patience and possibly more treatment sessions. A fascia that’s been painful for 5 years might need a full 5+ session course and a couple of months of rehab to really turn the corner. But we’ve had many patients who had resigned themselves to “I guess I’ll have this pain forever” who were pleasantly surprised at how much better they got with shockwave therapy.
It’s also worth noting that chronic pain sometimes has a centralized component (meaning your nervous system becomes more sensitive over time). Shockwave can help “reset” that by the intense sensory input it provides, kind of like hitting a reset button on nerve sensitivity. As a result, it can break the cycle of chronic pain, even if the physical spur and thickened fascia have been there for ages.
Side effects are generally minor. Right after a session, it’s common to have some redness on the skin and the area might feel a bit tender or sore. You might notice a small bruise on the heel the next day, especially if you bruise easily – this comes from the shockwaves improving blood flow and causing tiny blood vessel changes. This bruise or tenderness typically resolves in a few days. Some patients report a tingling or numbness sensation briefly after treatment (from nerve overstimulation), but this is temporary and normal sensation returns shortly. Importantly, shockwave therapy does not damage tissue when applied correctly – it stimulates a healing response without causing actual injury. There’s no risk of burns or cuts (as with lasers or surgery). It also doesn’t involve any medication, so there are none of the systemic side effects you’d get from pills or injections (like stomach issues or blood sugar spikes). During treatment, the main “side effect” is the discomfort we talked about, but we don’t really consider that a side effect so much as part of the treatment process. After the treatment course, there are no lasting adverse effects reported in the literature【32†L327-L334】. You can continue with daily activities – in fact, we encourage staying active (within pain limits) after treatments. Very rarely, someone might feel an increase in pain after the first session – kind of like stirring things up – but this usually subsides and by the next session they begin improving. If needed, you can use ice or a mild pain reliever after sessions, but most people don’t find it necessary. In short, shockwave therapy’s side effect profile is very mild. It’s one of the reasons we’re so enthusiastic about it – you get the benefit of tissue healing without significant downside.
Insurance coverage for shockwave therapy can vary widely. Shockwave therapy for musculoskeletal conditions (like plantar fasciitis) is still a relatively new treatment in the insurance world. Some private insurance plans do cover it, especially if it’s performed by a licensed practitioner such as a physiotherapist or chiropractor and billed under appropriate codes. For example, at Unpain Clinic we often bill shockwave as part of a physiotherapy session – many insurers will cover the physio treatment, which can include modalities like shockwave. There are also cases where insurance considers extracorporeal shockwave therapy an “experimental” or add-on treatment and doesn’t reimburse for it. It really depends on your plan. In Canada, provincial health care (like Alberta Health) typically doesn’t cover shockwave therapy in clinics, but extended health benefits often do to some extent. In the US, some major insurers have started covering ESWT for plantar fasciitis if certain criteria are met (chronic pain, tried other treatments first, etc.), but others still do not. The best approach is to check with your insurance provider. Our clinic staff can add the treatment codes or a letter if needed. Even when not covered, many patients are willing to pay out-of-pocket because shockwave therapy often results in avoiding more costly interventions (like surgery or long-term medications). It’s also a one-time course in most cases – not an indefinite ongoing expense. We provide transparent pricing and will work with you to make it as affordable as possible. In summary: maybe – insurance coverage is hit or miss, so inquire with your specific plan. We’ll help in any way we can.
Chronic heel spur pain can severely impact your quality of life. You’ve learned that a heel spur is often a sign of an underlying plantar fasciitis, and treating the cause – not just the spur itself – is key to lasting relief. Shockwave therapy offers a cutting-edge, evidence-backed way to stimulate healing in the damaged plantar fascia, providing a chance for long-term recovery without surgery. Research and our clinical results show that shockwave therapy may significantly reduce pain and improve function for people with stubborn heel spur pain, even when other treatments haven’t helped. It’s a safe procedure with minimal downtime, making it an attractive option for those who want to stay active during treatment.
At Unpain Clinic, we combine shockwave therapy with a holistic approach, addressing issues like muscle tightness or weakness that contribute to your heel pain. This whole-body, root-cause focus means you’re not just chasing symptoms – you’re fixing the problem at its source. If you’ve been frustrated by more than three months of heel pain, or you find yourself saying “I’ve tried everything,” it may be time to consider shockwave therapy for your heel spur. The journey to pain-free feet begins with a thorough assessment and a personalized plan.
You don’t have to live with chronic heel pain or immediately resort to surgery. There is an effective non-surgical solution that can help get you back on your feet – comfortably. Take the next step toward healing:
At 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., et al. (2013). Meta-analysis of high-energy extracorporeal shock wave therapy in recalcitrant plantar fasciitis. Swiss Medical Weekly, 143:w13825. https://pubmed.ncbi.nlm.nih.gov/24357497
2. Karakuzu-Güngör, Z., et al. (2025). Comparison of extracorporeal shock wave therapy and high-intensity laser therapy in the treatment of calcaneal spur-related symptoms. Journal of Orthopaedic Surgery and Research, 20(1):393. https://pubmed.ncbi.nlm.nih.gov/38645684
3. Lippi, L., et al. (2024). Efficacy and tolerability of extracorporeal shock wave therapy in patients with plantar fasciopathy: a systematic review with meta-analysis. European Journal of Physical and Rehabilitation Medicine, 60(5):832-846.https://pubmed.ncbi.nlm.nih.gov/38388247
4. Yalcin, E., et al. (2012). Effects of extracorporeal shock wave therapy on symptomatic heel spurs: a correlation between clinical outcome and radiologic changes. Rheumatology International, 32(2):343–347.https://link.springer.com/article/10.1007/s00296-010-1581-5
5. Tezén, O., et al. (2025). Radial vs. focused shock-wave therapy in plantar fasciitis: a randomized trial. Journal of Foot and Ankle Surgery, 64(1):36–41. https://pubmed.ncbi.nlm.nih.gov/38678912
6. Podcast: Understand and Fix Your Chronic Foot Pain — Unpain Clinic Podcast, hosted by Uran Berisha. (June 18, 2021) https://unpainclinic.com/podcast/understand-and-fix-your-chronic-foot-pain/
7. Blog: Shockwave Therapy for Heel Spurs & Plantar Fasciitis in Edmonton — Unpain Clinic (2025). https://unpainclinic.com/shockwave-therapy-for-heel-spurs-and-plantar-fasciitis-edmonton/
