New Treatments Stop Heel Pain - DOC

New Treatments Stop Heel Pain

Because we see so many athletes and just plain active folks, we always seek biologic treatments first.  A “biologic” treatment is one that preserves your normal anatomy with surgical destruction. Biologic treatments include advanced treatment injections for tendons and ligaments, shock-wave therapy for chronic heel pain or cartilage repair and joint preservation for arthritis.  A number of cutting edge non-surgical treatments for chronic heel pain are being offered by Dr. Segler. These treatments can get rid of heel pain fast! And best of all… without surgery. A speedy recover, no incision and permanent relief are just what the doctor ordered fro chronic heel pain.

Extracorporeal Shock Wave Therapy treatments use high-power sound waves to end chronic heel pain without painful surgery. This treatment is now being offered by our office as an alternative to heel surgery. The discovery of ESWT came about somewhat by accident. Shock wave therapy is used regularly by urologists to break up and disperse kidney stones. Urologists began reporting that patients who had kidney stones treated showed increased bone density and new tissue growth. This led to studies for using shock wave therapy for soft tissue injuries and the results were amazing—75%-80% of patients with soft tissue injuries were reported to be healed or greatly improved following ESWT.   

Shock wave therapy works by purposely targeting trauma at the painful site. This stimulates the diseased tissue and activates your body’s own healing process. Blood and oxygen rush to the site, activating a metabolic response that fosters healing by the growth of new connective tissue. This is what is damaged and torn when you have plantar fasciitis or heel spur pain. The most important and exciting aspects of ESWT are that it in most cases it ends the pain, the procedure is not painful, there isn’t a lengthy recovery period, and there are no side effects. 

Autologous Platelet Concentrate (APC) Therapy is another new treatment for chronic plantar fasciitis.  This is not for everybody with heel pain. It is a new cutting edge treatment and is only for those who have been diagnosed with plantar fasciitis that has not responded to other treatments.  

This is not surgery.  Is a minimally invasive treatment that utilizes your body’s own cells and healing potential to dramatically reverse the chronic inflammation that causes plantar fasciitis.  

APC Therapy (also called PRP for “Platelet Rich Plasma”) is an advanced procedure that is performed to stimulate healing. A small sample of blood is drawn from the patient, spun in a centrifuge, and the platelets (the growth and healing factors of the blood) are drawn out afterwords. After the platelets are drawn out, they are re-injected into the damaged tissue in the plantar fascia where it attaches to the heel bone. This stimulates healing at a rate of 5,000 times more quickly than the healing rate of normal blood vessels.  

This breaks up the cycle of chronic inflammation.  The injured tissue then repairs itself and prevents the need for surgery. 

When this procedure is done there are no stitches and no significant risks like those in surgery.  There is no need to travel to or wait in the hospital to have this performed. This procedure is performed right in your home or office at a time that is convenient for you.  

FAQ’s About Non-Surgical Heel Pain Treatment

What is the cost for shock wave therapy to treat heel pain in a Hospital?

Dr. Segler hasn’t performed shock wave therpay treatments for heel pain in a hospital setting in several years. It is possible to arrange in the San Francisco Bay Area, but costly. The last facility where Dr. Segler received a quote for a cash-paying patient to have ESWT in the hospital was $3,500 for the “facility fee” alone. The hospitals charge you the patient a “facility fee,” and “anesthesia fee,” and many other hidden costs. Because of all of the Hospital charges (that are IN ADDITION to the surgeon’s fee), the out-of pocket expense for ESWT (Extra-Corporeal Shockwave Therapy) treatment (provided in a hospital setting) for plantar fasciitis can easily exceeds $5,000. As a more cost-effective alternative, we can make arrangements to bring the foot doctor and shock-wave equipment to your home or office. By bringing the physician and equipment to you, we can offer this treatment for less than 1/4 of the cost in a hospital.

What is the cost for shock wave therapy to treat heel pain at Home?

The total out-of pocket expense for ESWT (Extra-Corporeal Shockwave Therapy) treatment (provided at your home or office) for plantar fasciitis is only $1200.  This includes the use of the shock-wave equipment, podiatric physician administered local anesthesia, and the procedure.

What is the cost for PRP therapy to treat heel pain?

The total out-of pocket expense for  single PRP (also known as APC or “autologous platelet concentrate”) injection (provided at your home or office) to treat chronic plantar fasciitis is only $1100 plus the $250 house call fee. This includes the sterile single-use PRP kit, physician administered local anesthesia, and the procedure.

If I try one of these non-surgical treatments for chronic heel pain, can I still have the surgery later if it doesn’t work?

Yes. One of the biggest advantages with these treatments is that you haven’t “burned any bridges” so to speak. Non-surgical treatments alone have a high success in the right patient. If for some reason the heel pain does not fully respond to PRP or ESWT, you can always think about surgery later. You haven’t “burned any bridges” so to speak. This is not true of surgery. If you have surgery, you no longer have as many treatment options available to you.

Are there any guarantees with Heel Surgery for Plantar Fasciitis?

There are only two guarantees with heel surgery. 1) You will get a bill. 2) You will get a scar. Although we always hope for the best in any surgery patient, there is simply no way to guarantee that you will be completely free of heel pain if you have heel surgery for plantar fasciitis.

Will my insurance reimburse me for PRP or ESWT?

At this time there are very few Insurance companies that will reimburse policy holders for these services. If you happen to have a policy which will cover either of these treatments, we provide you will a “superbill” containing the appropriate billing codes required by insurance carriers to process the claim. In spite of the fact that most insurance companies don’t pay for these procedures, many people think that it is well worth it to pay-out-of-pocket to receive them. These non-invasive treatments are both much lower risk than surgery. It would be beneficial to look at your MRI films and/or report together if you can obtain them to determine the likelihood that you would respond to one of these treatments and hopefully be able to avoid foot surgery.


Dr. Christopher Segler is a Sports Medicine Podiatrist in San Francisco. He has a unique podiatry practice that caters to the demands of athletes and other busy active people in the Bay Area. He offers time-saving house calls, email follow-up consultations and direct physician access to answer questions. He decided to incorporate concierge-level care into his practice. This allows him to spend up to 5 times as much time with patients to ensure that they get all of their conditions treated and all of their questions answered. Because he doesn’t maintain a standard brick-and-mortar doctor’s office, he is able to provide unparalleled care and service at extremely cost-effective rates.  If you have a question about shock wave therapy or platelet concentrate therapy for chronic heel pain, you can speak with Dr. Segler directly by calling (415) 308-0833.