Innovative Treatments

Extracorporeal Shockwave Therapy (ESWT)

Extracorporeal shockwave therapy (ESWT) is an advanced new technology used to treat several different conditions within the foot, such as plantar fasciitis and heel spurs. Originally used to treat kidney stones and other urologic conditions, ESWT is now offered as an alternative treatment for orthopedic conditions in patients who do not want surgery.

Candidates for ESWT

Surgery for plantar fasciitis comes with certain risks and is often not successful in relieving symptoms, leaving many patients seeking alternative treatment when conservative methods such as icing, anti-inflammatory medications and stretching have failed. ESWT is now considered a less invasive option that patients may consider before turning to surgery.

Dr. Zarate will discuss this option with you to determine whether or not you are a good candidate, based on an evaluation of your individual condition.

ESWT Procedure

ESWT delivers intense waves of energy through the skin to stimulate the healing process. This is done by inducing microtrauma to the area that will then initiate a healing response. Shockwave therapy can be delivered in both high-energy and low-energy forms. High-energy treatments are given in one session, but can be painful, while low-energy treatments are given over a series of three or more sessions and cause little to no pain. Improvement can be noticed within a few days, and full results are usually experienced after just a few weeks.

The shockwave therapy is performed as an outpatient procedure and only takes minutes. Local anesthesia may be used, but is not always necessary. ESWT is considered a safe and effective alternative to more invasive surgical procedures. Dr. Zarate is experienced in successfully treating a variety of podiatric conditions through shockwave therapy.



Fluoroscopy is a medical imaging procedure that produces moving real-time images of the internal structures within the foot and ankle to help diagnose and treat a wide range of conditions affecting the joints, ligaments and many other conditions. A fluoroscopy exam can produce up to 25-30 images per second for fluid images similar to those that appear on live television.

Some of the most common uses for fluoroscopy exams include:

  • Locating foreign bodies
  • Guiding anesthetic injections
  • Viscosupplementation injections
  • Evaluation of the bones, muscles and joints

As the only type of imaging procedure to show blood flow through the vessels, fluoroscopy is often used to assist in complex surgeries or the placement of a catheter or needle. Without fluoroscopy, many of these procedures may not be able to achieve such accurate and effective results.

Fluoroscopy Procedure

During the fluoroscopy procedure, a dye or contrast material may be administered intravenously in order to provide clearer, more detailed moving images of the blood vessels. The patient will then be positioned on the exam table so that the foot is exposed, and a special X-ray scanner will capture images of the targeted area. This exam may be performed on an in-patient or outpatient basis depending on the type of procedure being performed.

Fluoroscopy is considered safe for most patients and carries very few risks. Some patients may experience radiation-induced injuries or burns to the skin or underlying tissue, but this is considered rare.

Podiatric Laser Treatments

Dr. Zarate's advanced laser procedures can effectively treat a wide range of podiatric conditions, including toenail infections, peripheral neuropathy, and more with less pain and side effects than other treatment options.

Laser treatments are safer and less invasive than surgery, and offer comparable results with many benefits for both patient and doctor. The advanced laser technology allows for more precise treatment and greater control, as well as less discomfort, less scarring and shorter recovery times.

Toenail Fungus Treatment

Toenail fungal infections, also known as onychomycosis, affect an estimated 40 million people in the US as a result of genetics, aging, trauma or poor foot care. Patients with toenail fungus may experience thick, brittle and discolored nails that may split. If left untreated, an infection may lead to difficulty wearing shoes and walking.

While many other treatments are available to treat toenail fungus, many are not as effective, safe or minimally invasive as laser treatments. Medications often do not fully remove all traces of fungus and frequently result in recurrence, while surgery must be combined with oral therapy in order to thoroughly treat and remove the infection.

Laser Treatment Procedure

During the laser procedure, the laser energy is delivered directly to the affected toe to remove the germs embedded in the nail bed that cause toenail fungus and other types of infections. There is no pain associated with this procedure, which usually takes about 10 minutes to perform for each toe that needs treatment.

Patients will be able to walk and resume their regular activities immediately after treatment. Results will usually appear as a new toenail grows within three months after treatment. Most patients achieve successful results from this procedure and do not need any additional treatment.

Laser procedures performed to treat toenail infections are considered safe for most patients, with no major risks or side effects currently known. To learn more about Dr. Zarate's laser procedures, please call the office to schedule an appointment and find out how you can benefit from this procedure.

To learn more about our Podiatry Services, please contact us at (847) 475-0200 today to schedule an appointment.

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