Where to See Dr. Tortland in Connecticut
Dr. Paul Tortland, DO provides comprehensive orthopedic evaluations for patients at his Glastonbury, CT office. The practice sees patients from Glastonbury, Hartford, West Hartford, Farmington, Simsbury, South Windsor, and other Connecticut and New England communities.
📍 59 Sycamore Street, Suite 301, Glastonbury, CT 06033 — Get directions
📞 (860) 430-2821
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What Is ESWT and How Does It Treat Plantar Fasciitis?
Extracorporeal shockwave therapy (ESWT) is a non-invasive treatment that delivers focused acoustic pulse waves through the skin to the affected area of the heel and plantar fascia. The mechanical energy from these pulses is thought to stimulate a localized healing response in chronically irritated tissue — essentially prompting the body to treat a stubborn, stalled injury as a fresh one worth repairing. Unlike surgery, ESWT requires no incision, no anesthesia beyond the treatment sensation itself, and no meaningful recovery period.
Plantar fasciitis is one of the most common causes of heel pain, and for most patients it responds well to conservative treatment: activity modification, night splints, supportive orthotics, and a structured physical therapy program. ESWT is typically introduced when heel pain has persisted for several months despite these more basic measures — it is a second-line option, not a replacement for trying conservative care first.
What Does the Research Say About ESWT's Effectiveness?
A comprehensive narrative review examining ESWT across a range of chronic pain conditions, including plantar fasciitis, found consistent evidence supporting its use as an effective, low-risk option once simpler treatments have been exhausted. The review highlighted that ESWT's mechanism — stimulating neovascularization and modulating pain signaling in chronically inflamed tissue — is reasonably well understood, even though outcomes can vary based on the specific protocol, equipment, and patient selection used.
It's worth being direct about the limits of this evidence: not every study of ESWT shows dramatic results, and some research on shockwave therapy for other conditions has found it performs similarly to, rather than clearly better than, other non-surgical treatments. The honest summary is that ESWT is a legitimate, well-supported option for plantar fasciitis specifically, not a guaranteed fix for every type of chronic tendon or fascia pain.
How Many ESWT Sessions Are Typically Needed?
Most treatment protocols call for 6 or more sessions, typically given once or twice a week. A single session takes about 15 minutes, during which the patient feels a rapid tapping sensation as the device is applied to the skin. Some patients notice improvement after just one or two sessions, but the fuller benefit generally develops over the course of the complete protocol.
Am I a Good Candidate for ESWT?
The best candidates for ESWT are patients who have already given conservative care — stretching, orthotics, night splints, physical therapy — a genuine trial of at least several weeks to months without adequate relief. Patients with very acute, recent-onset heel pain are typically better served by continuing conservative measures first, since plantar fasciitis often improves on its own within this window. ESWT tends to be most useful for the subset of patients whose pain has become chronic and treatment-resistant.
What Are the Risks of ESWT?
ESWT is considered a low-risk procedure. The most common side effects are temporary soreness, mild bruising, or redness at the treatment site, which typically resolve within a few days. Because no anesthesia or incision is involved, the risk profile is substantially lower than that of surgical treatment for plantar fasciitis, such as plantar fascia release.
Is ESWT Only Used for Plantar Fasciitis?
No. ESWT is also used for a range of other chronic tendon and soft-tissue conditions, including Achilles tendinitis, tennis and golfer's elbow, shoulder tendinitis, and hamstring strains — essentially any chronic, treatment-resistant tendon injury where the goal is to restart a stalled healing process without surgery.
Limitations: What the Evidence Does Not Show
ESWT is well-supported for plantar fasciitis specifically, but the evidence has real boundaries.
- Not every study of ESWT shows dramatic results, and in some other conditions shockwave therapy has performed similarly to, rather than clearly better than, other non-surgical treatments.
- ESWT is a second-line option after conservative care has had a genuine trial — it is not shown to outperform stretching, orthotics, and physical therapy as a first step for most patients.
- Outcomes vary with protocol, equipment, and patient selection, and some patients do not respond even after a full course of sessions.
- This article cannot determine whether ESWT is appropriate for your specific heel pain — that requires an evaluation and, usually, a documented trial of conservative care first.
Dr. Tortland's Perspective
"Plantar fasciitis is one of those conditions where patients show up frustrated because they've already tried the basics and nothing's worked," says Dr. Tortland. "What I see most often is heel pain that's been treated the same generic way for months — some stretches, maybe an orthotic — without anyone stepping back to confirm the diagnosis with imaging or considering a second-line option like shockwave therapy." He points to ultrasound as central to that step: having been among the first physicians in the U.S. registered in musculoskeletal ultrasound through the AIUM, he uses same-visit imaging to confirm the fascia itself, not just the general area, is the actual source of pain before recommending ESWT. "ESWT isn't a miracle cure, and I tell patients that upfront," he says. "But for the person who's already given conservative care a real trial and is still hurting, it's a legitimate way to try to restart the healing process before surgery becomes the conversation."
Reference
According to PubMed: Ufondu W, Ogunsola O, Williams A, Valenti K, Herbert G, Ezenekwe E, Bufano J, Suleiman T, Esiso F, Jevotovsky D, Hasoon J, Orhurhu V. Extracorporeal Shockwave Therapy in Pain Management: An In-Depth Narrative Review. Orthop Rev (Pavia). 2026. DOI: 10.52965/001c.154361
Related condition guide: See our Plantar Fasciitis page for symptom patterns, conservative care and when additional treatment may be considered.
