Extracorporeal Shockwave Therapy

A guide for clinicians and patients.

What is it?

Extracorporeal Shockwave Therapy (ESWT) is a non-invasive treatment in which a device is used to pass acoustic shockwaves at a set frequency through the skin to the affected area. It is purely a mechanical wave- not an electric one. Shockwave is an accepted intervention in the UK and treatment may provide pain relief for chronic tendinopathies.

How does it work?

The treatment initiates a pro-inflammatory response in the affected tissue that is being treated. The body responds by increasing the blood circulation and metabolism in the affected area which accelerates the body’s own healing processes. The shockwaves can break down injured tissues and calcifications. As a result of cellular tissue micro-trauma, it can provide a temporary analgesic effect on afferent nerves providing immediate pain relief, known as ‘hyper-stimulation anesthesia’.
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How is the shockwave delivered?

The painful area is located by palpation. The treatment is delivered via a compressed air impulse through a handheld piece attached to the shockwave machine. The shockwave radiates out through the head into the affected area. Contact gel will be applied to the skin to improve the transmission of the shockwave.

Why chose ESWT?

Shockwave therapy stimulates and supports the body’s self-healing mechanisms. ESWT is a non-invasive treatment modality- there are no medications such as cortisone or surgery involved. There are no major safety concerns associated with ESWT. It is common to have some immediate pain relief and studies have shown positive outcomes in approx. 70% of cases. It is included in the NICE guidelines for the management of refractory (chronic) tendinopathies involving conditions such as plantar fasciitis, Achilles tendinopathy and tennis elbow but can be used for most common tendinopathies.

How long does the treatment session last?

The ESWT application lasts 5-15 minutes to deliver the set 2500 impulses of shockwave energy and you must attend for 2-3 sessions over 3-4 consecutive weeks.

Conditions That Often Benefits From Shockwave Therapy

• Plantar Fascitis (Heel Spurs)

• Painful Shoulder (Calcific Tendonitis)

• Radial/Ulnar Epicondylitis(Tennis of Golfers)

• Achilles Tendon

• Acute Muscle Spasm

• Knee Pain(Arthrosis) Jumpers Knee (Patellar Tendinopathy)

• Low Back Pain

• SI Joint Pain

• Hip-Trochanteric Bursitis

• Chronic Tendinitis (Anywhere in the body)
  
  

Is Shockwave Therapy Safe?

Yes. This FDA cleared technology was developed in Europe and is currently used around the globe. A wealth of medical experience, state of the art engineering, have been built in the shockwave device. The therapy has virtually no risks or side effects.

Is the Shockwave treatment painful?

The treatment itself can be painful during the application of the ESWT. The treatment is delivered according to patient response, if a patient is unable to tolerate the pain levels the settings will adjusted to reduce the discomfort. A mild ache may occur later that day but should pass after a day. A patient may therefore take analgesic pain relief afterwards if required or before attending their next session.

Are there any Contraindications or Precautions to be aware of?

ESWT is not allowed due to:

• Pregnancy

• DVT (DEEP Vein Thrombosis)

• Malignancies
  
  

What to do following the treatment?

There are no restrictions after the treatment session- you may continue with your normal activities. You may use simple painkillers if still in pain. Do not use anti-inflammatories. Pain relief may be felt immediately but long term effects are normally seen after 2-3 months. All patients should be reviewed after 6-12 weeks.