Regenerative Foot Therapies
in Los Angeles
Medically Reviewed by Dr. Pegah Panirian, DPM, foot and ankle surgeon
Overview
Dr. Pegah Panirian is a top Los Angeles foot and ankle surgeon who treats long-lasting heel and Achilles tendon pain with shockwave therapy, platelet-rich plasma (PRP) injections and amniotic injections at The Feet Institute. All three are non-surgical office treatments for pain that stretching, inserts and physical therapy have not relieved.
Key points
- What they are: Shockwave therapy sends pulses of sound energy into the painful tissue. PRP is an injection of platelets concentrated from a small sample of your own blood. An amniotic injection uses tissue from donated amniotic membrane and umbilical cord.
- Who they help most: Adults whose plantar fasciitis (heel pain under the foot) has lasted six months or more. In trials, about 7 in 10 of these patients had meaningfully less heel pain within 12 weeks of shockwave therapy.
- Recovery: There is no incision. You walk on the treated foot the same day, and the site of a PRP or amniotic injection is sore for a few days.
- Appointments: Next-day appointments are available in Los Angeles, and same-day when the schedule allows.
What are regenerative foot therapies?
Regenerative foot therapies are treatments designed to stimulate your body’s own repair process in an injured tendon or in your plantar fascia, the thick band of tissue under your foot. Dr. Panirian offers three:
- Shockwave therapy (extracorporeal shockwave therapy, ESWT): A handpiece held against your heel sends pulses of sound energy through your skin into the damaged tissue to increase blood flow there. There is no needle and no incision. Several shockwave devices are FDA-approved for chronic plantar fasciitis.
- Platelet-rich plasma (PRP) injection: Dr. Panirian draws a small amount of blood from your arm, spins it in a centrifuge to concentrate the platelets, and injects the concentrate into your damaged fascia or tendon under ultrasound guidance. Platelets carry the growth factors your body uses to repair tissue, and because PRP is made from your own blood, the risk of an allergic reaction is very low.
- Amniotic injection: Dr. Panirian injects a tissue product made from donated amniotic membrane and umbilical cord into your damaged plantar fascia under ultrasound guidance. The tissue comes from screened donors after childbirth and is processed by a tissue bank, and it is one of the newest regenerative options for chronic heel pain.
What conditions do regenerative therapies treat?
Dr. Panirian uses shockwave, PRP and amniotic injections for long-standing overuse injuries of the heel and Achilles tendon, especially if you still have pain after several months of stretching, inserts and physical therapy:
- Plantar fasciitis: Heel pain that is worst with your first steps out of bed or after sitting. Most of the research on shockwave, PRP and amniotic injections is in plantar fasciitis.
- Heel spur pain: Pain under the heel where a bone spur sits alongside an irritated plantar fascia. Dr. Panirian aims the treatment at the fascia, which is usually the source of the pain, rather than at the spur itself.
- Achilles tendinitis: Pain and stiffness at the back of the heel or along the tendon. Dr. Panirian adds shockwave or PRP to calf-strengthening exercises for tendon pain that has lasted several months.
Heel pain has other causes too, including nerve problems and stress fractures, so Dr. Panirian confirms the diagnosis at your first visit as part of her heel pain treatment.
How well do regenerative therapies work?
In the studies reviewed by the American College of Foot and Ankle Surgeons, about 70 percent of patients with chronic plantar fasciitis improved meaningfully within 12 weeks of shockwave therapy, and the college rates it safe and effective (ACFAS, 2018). In a trial of 145 patients, an amniotic tissue injection cut heel pain by 76 percent at three months, compared with 45 percent after a saline injection (Cazzell, 2018).
| Treatment | Compared with | Result | Source |
|---|---|---|---|
| Shockwave therapy | Placebo treatment | More patients had less heel pain, across 22 trials with 2,299 patients | Zhao, 2025 |
| Shockwave therapy | Before and after treatment | About 70 percent improved meaningfully within 12 weeks | ACFAS, 2018 |
| Amniotic tissue injection | Saline injection | Heel pain fell 76 percent at 3 months, compared with 45 percent after saline, in 145 patients at 14 US sites | Cazzell, 2018 |
Amniotic injections are newer than shockwave and PRP, and larger trials have been more mixed, so the research is still building.
Shockwave, PRP or amniotic injection: which is right for you?
Dr. Panirian recommends one based on your diagnosis, how long you have had pain and what you have already tried.
| Feature | Shockwave therapy | PRP injection | Amniotic injection |
|---|---|---|---|
| How it works | Sound-wave pulses delivered through the skin | Your own concentrated platelets, injected into the damaged tissue | Donated amniotic membrane and umbilical cord tissue, injected into the damaged tissue |
| Needles | None | One blood draw and one injection | One injection, with no blood draw |
| Number of visits | 3 to 5 short sessions, one week apart (ACFAS, 2018) | Usually one injection | Usually one injection |
| At the visit | A few minutes of pulses from a handpiece against your heel, which can feel uncomfortable; usually no numbing, since it may weaken the effect | A blood draw from your arm, then an ultrasound-guided injection; Dr. Panirian can numb the skin first | An ultrasound-guided injection; Dr. Panirian can numb the skin first |
| After treatment | Walk normally the same day, and keep up your stretches and supportive shoes. Some soreness for a few days. | Some soreness for a few days, and keep up your stretches and supportive shoes | Some soreness for a few days, and keep up your stretches and supportive shoes |
| Time to results | Over several weeks, with results usually judged at 12 weeks | Over several weeks, with results measured at 3 and 6 months in trials | Over several weeks, with results measured at 3 months in trials |
| Often chosen when | You would rather avoid needles | You prefer a treatment made from your own blood | You would rather not have blood drawn |
How do regenerative treatments compare with surgery?
Most heel pain settles with stretching, supportive shoes and inserts. If yours has not, regenerative therapy is the next step: shockwave, PRP and amniotic injections are all done in the office without an incision, and none needs the weeks of recovery that surgery does.
| Feature | Shockwave or PRP | Amniotic injection | Surgery |
|---|---|---|---|
| What it does | Sound pulses or your own platelets aimed at the damaged tissue | Donated birth tissue injected into the damaged tissue | Releases or repairs the damaged tissue |
| Incision | None | None | Yes |
| Where it is done | Office | Office | Surgery center |
| Time off your feet | None after shockwave; a few days of soreness after PRP | A few days of soreness | Several weeks |
| How long relief lasts | Builds over several weeks; judged at about 12 weeks | Builds over several weeks; measured at 3 months in trials | Intended to be permanent |
Dr. Panirian also performs heel and Achilles surgery, including plantar fascia release and calf tightness release (gastrocnemius recession), for patients who need it.
Are regenerative treatments safe?
Complications are uncommon, and side effects are usually mild and gone within days:
- Soreness: Shockwave can feel uncomfortable during the session, and the site of a PRP or amniotic injection is often sore for a few days.
- Redness, swelling or bruising: Up to 12 percent of patients have temporary skin reddening after shockwave (NICE, 2009).
- Donated tissue: The amniotic tissue comes from screened donors and is processed by a tissue bank before it reaches the office.
- Tendon or fascia rupture: A rare complication. Dr. Panirian tells you when you can start running and sports again so the healing tissue is not overloaded.
Shockwave is not recommended if you have a significant bleeding disorder, an infection or tumor in your foot, or heel pain that began only in the last few weeks (ISMST, 2023; ACFAS, 2018).
Why choose Dr. Panirian for regenerative foot therapy in Los Angeles?
- Cedars-Sinai trained: Surgical residency and chief resident at Cedars-Sinai Medical Center, where she is now a teaching attending.
- Board certified by the American Board of Podiatric Medicine and board qualified by the American Board of Foot and Ankle Surgery.
- Non-surgical and surgical care in one practice: From custom orthotics to heel and Achilles surgery.
- Ultrasound-guided injections: PRP and amniotic injections go into the damaged tissue that the ultrasound image shows.
- Two offices: Los Angeles/Beverly Hills and Westchester/Marina Del Rey.
- Speaks English, Spanish and Farsi.
Dr. Pegah Panirian is a leading Los Angeles foot and ankle surgeon who examines your heel, gives the shockwave, PRP or amniotic injection, and performs heel or Achilles surgery herself if you later need it. For plantar fasciitis that has lasted for months, that means a course of shockwave therapy, an ultrasound-guided PRP injection or an amniotic injection in her office, with no incision and no hospital visit. The goal is that your first steps out of bed no longer hurt, and that you can walk and stand through a full working day again.
Common questions about regenerative foot therapies
Is shockwave therapy FDA-approved?
Yes. The FDA has approved several shockwave devices for chronic plantar fasciitis in adults whose heel pain has lasted six months or more despite other treatment.
How long does shockwave therapy take to work on plantar fasciitis?
Most people notice their heel pain easing over several weeks. The International Society for Medical Shockwave Treatment recommends a check at 4 and 8 weeks, and trials measure the full result at about 12 weeks.
Are amniotic injections FDA-approved?
No. The FDA has not approved amniotic or other birth-tissue injections for plantar fasciitis or tendon conditions. Before you decide, Dr. Panirian explains how the tissue she uses is made and screened, and whether an amniotic injection suits your heel.
Sources
- Schneider HP, Baca J, Carpenter B, et al. American College of Foot and Ankle Surgeons Clinical Consensus Statement: Diagnosis and Treatment of Adult Acquired Infracalcaneal Heel Pain. J Foot Ankle Surg. 2018;57(2):370–381. Accessed September 24, 2026.
- Zhao P, He Y, Li M, et al. Comparative efficacy and acceptability of different intensity levels of extracorporeal shock wave therapy in adults with plantar heel pain: a systematic review and network meta-analysis. PM R. 2025;17(12):1481–1493. Accessed September 24, 2026.
- Cazzell S, Stewart J, Agnew PS, et al. Randomized Controlled Trial of Micronized Dehydrated Human Amnion/Chorion Membrane (dHACM) Injection Compared to Placebo for the Treatment of Plantar Fasciitis. Foot Ankle Int. 2018;39(10):1151–1161. Accessed October 29, 2026.
- U.S. Food and Drug Administration. Premarket Approval database: OssaTron (P990086), Epos Ultra (P000048), Swiss DolorClast (P050004), Duolith SD1 (P080028). Accessed September 24, 2026.
- American Academy of Orthopaedic Surgeons. Plantar Fasciitis and Bone Spurs. OrthoInfo. Accessed September 24, 2026.
- National Institute for Health and Care Excellence. Extracorporeal shockwave therapy for refractory plantar fasciitis (IPG311). 2009. Accessed September 24, 2026.
- International Society for Medical Shockwave Treatment. ISMST Guidelines for ESWT. 2023. Accessed September 24, 2026.
- U.S. Food and Drug Administration. Important Patient and Consumer Information About Regenerative Medicine Therapies. Updated April 8, 2024. Accessed October 29, 2026.