Shockwave Therapy for Plantar Fasciitis: What to Expect

Shockwave therapy is one of the most effective treatments for chronic plantar fasciitis, with clinical trials reporting 70–80% success rates in patients who have not responded to physiotherapy, orthotics, or steroid injections. If you've been dealing with persistent heel pain for more than 3 months, this article explains whether shockwave therapy might be the right next step — and what treatment looks like at our Notting Hill Gate clinic.

What is Plantar Fasciitis?

The plantar fascia is a thick band of tissue running along the sole of your foot. When it becomes inflamed — usually through overuse, poor footwear, or biomechanical issues — it causes the characteristic stabbing pain at the heel, worst with the first steps in the morning or after sitting for a long time.

Acute cases often resolve with rest, stretching, and orthotics. Chronic plantar fasciitis (persisting beyond 3 months) is significantly harder to treat because the tissue becomes degenerative rather than purely inflamed — and this is precisely where shockwave therapy excels.

How Shockwave Therapy Treats Plantar Fasciitis

In chronic tendinopathy, the tissue has undergone degenerative changes rather than active inflammation. Traditional anti-inflammatory treatments (such as steroid injections) are therefore less effective at this stage. Shockwave therapy works differently: it uses acoustic waves to stimulate the body's own healing response — increasing blood flow, promoting collagen synthesis, and breaking down calcific deposits.

The clinical guideline from the NICE guidance on ESWT for plantar fasciitis (IPG311) supports shockwave therapy as an option when other treatments have failed.

What Does Treatment Involve?

At our musculoskeletal pain clinic in Notting Hill Gate, a typical course for plantar fasciitis is 3 sessions, spaced one week apart. Each session takes around 15–20 minutes. The shockwave probe is applied directly to the heel, targeting the attachment point of the plantar fascia. Most patients find the treatment tolerable — you may feel a pulsing sensation or mild discomfort during the session, but this passes quickly.

You can walk out of the clinic and resume normal activities. There is no downtime, no injections, and no anaesthesia required.

When Will I Feel Better?

Many patients notice an initial improvement in the weeks following their first session, with the full benefit developing over 6–12 weeks after the treatment course completes. The regenerative process continues even after the sessions end. Results are typically durable — studies show maintained improvement at 12 months in the majority of responders.

Shockwave vs Steroid Injections for Plantar Fasciitis

Steroid injections can provide fast short-term relief but often have diminishing returns with repeated use and carry a risk of plantar fascia rupture. Shockwave therapy is slower to take effect but produces longer-lasting results without the tissue-weakening side effects of corticosteroids. Most specialists now recommend shockwave therapy as the preferred intervention once conservative treatment has failed.