What is a heel spur and why is it so annoying?

If you feel a sharp kipu in your heel when you get out of bed in the morning, making you momentarily stand on your tiptoes, the culprit might be a heel spur, or plantar fasciitis. This is a condition where the tendon under the sole of the foot (plantar fascia) becomes inflamed, and sometimes a small bony "spur" even forms under the heel. Such a condition can make every step agonizing – especially in the morning or after prolonged sitting, as the inflamed connective tissue has stiffened overnight, and the kipu is particularly severe during the first few steps (Khan et al., 2008) (Wang et al., 2013).

What to do if common methods don't help?

Most people first try insoles, stretching exercises, and kipukillers. These might help in some cases, but often the kipu persists or quickly returns. If common methods don't yield results, you might feel that you just have to endure the heel kipu. Fortunately, there are more modern solutions – one of the most effective is shockwave terapia (ESWT), which has found strong scientific evidence in the hoito of chronic plantar fasciitis (Yalcin et al., 2020); (Babaei-Ghazani et al., 2022).

What is shockwave terapia?

Shockwave terapia is nothing scary – it's not an electric shock or anything kipuful. It's a procedure where a special device sends short and strong "sound waves" to the heel. Imagine someone tapping inside your heel with tiny hammers – these waves cause the body to fight inflammation and kipu itself (Kudo et al., 2006); (Chew et al., 2015).

How does it work?

• Improves blood circulation
• Accelerates tissue healing
• Reduces inflammation
• Helps nerve endings to "calm down," so the kipu subsides (Babaei-Ghazani et al., 2022); (Yalcin et al., 2020)

What do scientific studies say?

1. Does it really work?

Several randomized studies and reviews confirm that shockwave terapia is very effective for chronic heel spurs. For example, Khan et al. (2008) found that after just three sessions, participants' heel kipu was significantly reduced, and the plantar fascia was thinner – indicating a reduction in inflammation and swelling. Pain decreased by 73.2% in the shockwave terapia group, which was 32.7% more than in the placebo group, and no significant side effects occurred.

Kudo et al. (2006) also confirmed that shockwave terapia helps reduce the typical morning "first step" kipu, which is one of the most unpleasant symptoms of plantar fasciitis. After three months, the kipu was significantly less than in those who received placebo hoito.

2. Is the effect lasting?

Yes, studies confirm that the effect of shockwave terapia is not short-term. For example, Yalcin et al. (2020) studied how heel kipu and mobility changed after shockwave terapia not only immediately after hoito but also over a longer period. They assessed patients 3, 6, and 12 weeks after the end of the hoito course and found that the kipu remained significantly lower even several weeks later. Daily movement and foot function also improved.

Long-term studies also confirm that ESWT reduces kipu and improves quality of life for months after hoito ends (Kapusta et al., 2022).

3. Is it better than injections or other methods?

When comparing shockwave terapia with, for example, cortisone injections, several studies have shown that shockwave terapia can offer longer-lasting relief. For instance, a study by Chew et al. (2015) found that although both hoito methods can quickly reduce kipu, the effect of shockwave terapia often lasts longer. This means that the kipu does not tend to return as easily, and patients can enjoy a more lasting result. Also, the need for repeat hoito is less than with injections, and the hoito is safe even with long-term use.

Other studies also confirm that shockwave terapia is more effective than corticosteroid injections or other conservative methods, especially for chronic kipu (Shockwave Canada, 2024); (Sun et al., 2017).

4. Is it safe?

Shockwave terapia is a safe and well-tolerated hoito method, with side effects that are mostly mild and resolve quickly. Babaei-Ghazani et al. (2022) confirm that after the procedure, the treated area may be slightly sensitive or reddened, but these signs usually disappear within a few days. Most people do not require separate palautuminen time and can continue their daily activities.

The procedure itself is simple and quick. Usually, 3–6 sessions are performed, each lasting about 10–20 minutes. During the procedure, mild discomfort may be felt, but most patients find it quite tolerable – the sensation is often described as a strong hieronta. After the procedure, it is recommended to rest the foot a bit, but no special palautuminen time or restrictions are needed. Many people feel that the kipu has reduced and movement becomes easier already after the first sessions (Yalcin et al., 2020). Large reviews also confirm that serious side effects do not occur, and ESWT is safe in the long term (Leão et al., 2020).

Does it help everyone?

Shockwave terapia is particularly suitable for those whose heel kipu has lasted for a long time and for whom conventional hoito methods, such as stretches, insoles, or kipukillers, have not yielded the desired results (Wang et al., 2013). Studies show that for chronic and persistent kipu, shockwave terapia is often the most effective, helping to reduce kipu and improve foot mobility and daily functioning (El Molla et al., 2021).

Yhteenveto: Is it worth trying?

If you have previously encountered a heel spur or plantar fasciitis, you know how stubbornly kipu can persist. In the case of shockwave terapia, it is important to understand that this hoito not only alleviates symptoms but also contributes to the actual palautuminen of the foot's connective tissue (Khan et al., 2008). For example, studies have found that after shockwave terapia, the structure of the plantar fascia becomes more elastic, and signs of inflammation decrease.

Additionally, shockwave terapia is one of the few hoito methods documented to improve foot function – people can return to work and hobbies more quickly (Yalcin et al., 2020). This is particularly important for those whose quality of life has significantly declined due to heel kipu. Because the procedure does not require palautuminen time or surgery, it is well-suited for active individuals who wish to return to their normal life rhythm as quickly as possible (Babaei-Ghazani et al., 2022). Shockwave terapia also does not damage tissues or cause long-term side effects, making it suitable for repeated use if the kipu should return over time (Chew et al., 2015).

Modern hoito centers adapt the shockwave terapia protocol according to the patient's needs – whether it's different kipu intensity, duration of the disease, or lifestyle. It is precisely the individual approach and scientifically proven effectiveness that make this method a reliable choice for those seeking a long-term solution to chronic heel kipu (Kudo et al., 2006).

Cited scientific sources:

1. Khan et al., 2008, DOI: 10.4103/0019-5413.41853
2. Kudo et al., 2006, DOI: 10.1002/jor.20008
3. Yalcin et al., 2020, DOI: 10.1590/1413-785220202801227.190
4. Chew et al., 2015, DOI: 10.1016/j.arthro.2015.05.036
5. Babaei-Ghazani et al., 2022, DOI: 10.3390/medicina58111598
6. Wang et al., 2013, DOI: 10.4103/0019-5413.114932
7. Kapusta et al., 2022, DOI: 10.3390/jcm11236926
8. Sun et al., 2017, DOI: 10.1097/MD.0000000000006621
9. Heide et al., 2020, DOI: 10.1186/s13063-020-04510-z
10. El Molla et al., 2021, DOI: 10.1186/s43166-021-00085-y
11. Leão et al., 2020, DOI: 10.1590/1413-785220202801227402