Extracorporeal shockwave therapy (ESWT)
Shockwave therapy is a modern and highly effective non-surgical treatment option in muscle, bone, joint or tendon issues. It works by delivering impulses of energy, targeted to specific damaged tissues within the painful region. This increases the blood flow within the affected area, stimulating cell regeneration and healing, and decreasing local factors which can cause pain.
Shockwave therapy offers a safe and often effective alternative to surgery or medication for managing these and other musculoskeletal conditions.
Current research reports success rates between 65 and 91% in reducing patient’s pain and symptoms after a course of 3 to 6 sessions.
Common Conditions Treated
Shockwave therapy is used to manage a variety of conditions, especially those involving connective tissues like tendons and ligaments:
- Shoulder Pain (Calcifying tendinitis of the shoulder, subacrominal pain syndrome (bursitis), frozen shoulder)
- Elbow Pain (Tennis Elbow / Golfer’s Elbow)
- Hand Pain (Dupuytrens disease, De Quervain tenosynovitis, trigger finger and Carpal tunnel syndrome)
- Hip Pain (Greater Trochanteric Pain Syndrome, Hip Bursitis)
- Hamstring Pain (Hamstring tendinopathy, insertional)
- Knee Pain (Osteoarthritis, patella pain syndrome, Jumpers knee)
- Achilles Pain (Achilles tendinopathy, insertional and mid body)
Heel Pain (Plantar fasciitis, Heel Spurs)
How does it work?
Shockwave therapy offers a unique and patient-centred approach to treating chronic musculoskeletal conditions.
Non-Invasive Nature
One of the standout benefits of Shockwave Therapy is that it's non-invasive
Targeted Delivery
The electrohydraulic probe is a lightweight and portable device that utilizes three distinct frequency settings to deliver targeted treatment to the problematic area only. The device is used with ultrasound gel, which acts as a coupling agent to optimize wave transmission between the device and your skin.
Triggering the Body's Healing Response
The shockwaves stimulate various cellular processes within the injured tissue, which include:
New Blood Vessel Formation
Nutrient blood flow is necessary to start and maintain the repair processes of damaged tissue. The application of the shockwave creates ‘capillary microruptures’ in tendon and bone so increases blood flow and nutrients to the area for healing
Dissolution of Calcified Fibroblasts
Calcium build-up (scar tissue or ‘knots’) is most often the result of micro-tears or other trauma to a tendon. Acoustic waves break up the existing calcifications-which therefore reduces pain.
Release of Trigger Points
Trigger points are one of the principal cause of pain in the back, neck, shoulder and limbs. Shockwave can be used to release these trigger points.
Stimulation of Collagen Production
The production of a sufficient amount of collagen is a necessary precondition for the repair processes of the damaged musculoskeletal and ligamentous structures. Shockwave therapy accelerates ‘procollagen synthesis’.
Reversal of Chronic Inflammation
Shockwave works to enhance the inflammatory process and this then helps restore normal healing and regenerative processes.
Reduced pain perception
The shockwaves may also have a pain-modulating effect, potentially helping to alleviate discomfort associated with the injury.
By promoting these cellular processes, shockwave therapy aims to accelerate the body's natural healing response and improve the function of the affected tissue.
What happens during shockwave therapy?
Your therapist will work with you to identify the exact area of pain and apply a gel-like substance to the area to promote the process.
A probe is pressed at the affected area and the shockwaves are delivered through the skin that spreads inside to the injured tissues. These initiate an inflammation-like response in the injured tissue being treated and prompts the body to respond naturally by increasing blood circulation, the number of blood vessels and therefore metabolism in the injured tissue.
The shockwaves are felt as pulses which are a little uncomfortable but not painful. Typically, your first treatment will start with a low level of intensity and increases as you feel more comfortable.
Shock-wave therapy treatments are usually performed at weekly intervals.
After shockwave therapy
Many patients experience an improvement in symptoms almost immediately while others take several weeks to respond. You may notice a reddening or swelling of the area with some patients experiencing a brief increase in pain. It may take several weeks to see an overall benefit.
Potential Side Effects of Shockwave Therapy
Like any medical treatment, shockwave therapy comes with minor, short-lived side effects.
- Short-term discomfort / pain
- Local inflammation
- Bruising
- Paraesthesia
- Erythema
- Fascia/Tendon rupture or soft tissue damage
These potential side effects will resolve quickly, if present at all, prior to the following treatment session.
Are there any reasons I can’t have Shortwave therapy?
Contraindications to ESWT in Physiotherapy
- Pregnancy
- Painful area over major blood vessels and nerves
- Pacemakers or other implanted devices
- Open wounds
- Joint replacements
- Epiphysis
- Blood clotting disorders including thrombosis
- Infection
- Cancerous tissues
- A compromised mental status of the patient and/or the inability to cooperate.
FAQs
How Should I Prepare for A Shockwave Therapy Session?
Preparing for a Shockwave Therapy session is straightforward. It's recommended that you:
- Avoid taking anti-inflammatory medications for at least 48 hours before the session, as these can interfere with the body's natural healing process.
- Wear comfortable clothing that allows easy access to the area being treated.
- Have a light meal a few hours before your appointment to ensure you're comfortable and not distracted by hunger during the session.
Additionally, it's important to discuss any concerns or questions you may have with your healthcare provider before the treatment. This will help you go into the session feeling prepared and at ease.
How Long Does It Take for Shockwave Therapy to Work?
Most patients are eager to know how quickly they can expect results from shockwave therapy. While some may feel improvement immediately after the first session, the majority will notice significant benefits after three to six sessions, spaced out over several weeks. Complete healing and the full effects of the treatment may take even longer, depending on the severity of the condition being treated.
Timeline for Treatment Effectiveness
Generally, patients may begin to experience pain relief and improved mobility within a few weeks after starting treatment. However, the full extent of healing can take several months. It's important to have realistic expectations and to follow all the healthcare provider's advice for the best outcomes alongside the shockwave therapy treatment.
Can Shockwave Therapy be Repeated?
Yes, Shockwave Therapy can be repeated if necessary. The number of sessions you may need depends on the severity and duration of your condition. Typically, a course of treatment involves 3 to 6 sessions, but some patients may require additional sessions for optimal results. It's important to follow the guidance of your healthcare provider and to allow sufficient time between sessions for the body to respond to the treatment.
Moreover, some patients may find that they experience continued improvement over time and may choose to have another round of therapy later on if symptoms reoccur. As with any medical treatment, it's essential to discuss the frequency and number of treatments with your healthcare provider to ensure the best care plan for your specific needs.
Will Shockwave therapy help me?
Most patients with chronic pain problems have been through multiple treatments with varying success. Up to 80% of the same patients worldwide report that Shockwave therapy has helped them eliminate their problem. Current research reports success rates between 65% and 91% in reducing patient's pain and symptoms after a course of 3 to 6 sessions.
How many treatments will I need?
The number of treatments varies depending on the indication and tissue response. The effect of the treatment is cumulative, so you will typically need 3-6 sessions. Very often though, you will experience a change right after the first treatment.
How often will I need the treatment?
Most indications require 3-6 treatments which are done 7–10 days apart, depending on the patient’s tolerance and their tissue response.
Are there any restrictions after the treatment?
It is recommended that patients refrain from physical activity, especially one that would involve the treated region, for about 48 hours following each treatment session.
We are always happy to answer any other questions you may have - please call us directly