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Shockwave Therapy – is it for me?
Extracorporeal Shockwave Therapy (ESWT) is an effective, evidence-based, non-surgical treatment for chronic musculoskeletal conditions (longer than 3 months). If conservative treatment (i.e. steroid injections, anti-inflammatory medications, splints, braces, orthotics, or physiotherapy) has not proven effective, then ESWT may be a good option for you
How does Shockwave Therapy work?
Shockwave speeds up healing and recovery times. Using a handpiece device, a wave of energy is applied outside the body, directly over the affected area. The “shockwave” energy creates microscopic injuries which stimulates a cellular response inside the body to repair the damaged tissues and regenerate healthy ones.
What conditions can be treated with Shockwave Therapy?
- Plantar fasciopathy ( heel pain)
- Achilles tendinopathy
- Patellar and hamstring tendinopathy
- Hip bursitis and gluteal tendinopathy
- Calcific tendinopathy of the shoulder
- Tennis and golfer`s elbow
What are the benefits?
- Reduces pain
- Increases joint mobility
- Stimulates the natural body healing process
- Can be an alternative to surgery
How many treatments do you need?
While significant benefits can be achieved in some patients after the first visit, other patients may require additional treatments, especially if the damage is extensive or very deep. In those cases, multiple treatments can be administered at about a week apart to promote and continue the healing processes over time. Studies recommend between 3 and 5 sessions. Most patients experience maximum healing benefits within about two months of treatment. Shockwave therapy doesn’t require any downtime, so patients are able to enjoy their normal activities throughout their course of treatment.
Is shockwave therapy a good choice for all patients?
Because it’s non-invasive, has a success rate of 70-80%for most musculoskeletal conditions and promotes natural healing, shockwave therapy can be ideal for most patients. Prior to therapy, a thorough assessment will be performed to determine if a different course of care might be a better option.
Is there clinical evidence supporting use of shockwave?
There is a significant body of evidence supporting the use of shockwave therapy in many common conditions.
The use of shockwave therapy for tendon issues is well supported by the National Institute for Health and Care Excellence (NICE). NICE provides national guidance and advice to improve health and social care in both NHS and private practice.
It provides evidence based recommendations to guide best practice within healthcare. NICE have produced guidelines for the use of shockwave in the treatment of Achilles tendinopathy, plantarfascitis and calcific tendinopathy.
More about Shockwave Therapy
A method of increasing popularity and availability, shock wave therapy is used to treat musculoskeletal pain. It can be particularly useful in cases of pain that lasts for over three months.
In my practice, I apply it particularly to treat heel spurs or tendon issues.
Historical events were crucial to the discovery of the impact of shock waves on human body. Underwater bomb explosions during World War II generated waves capable of traveling over distance and damaging lung tissue in those within their range of impact.
The first medical application of shock waves dates back to the 1950s. Between 1968 and 1971 animal-based studies were conducted in Germany and led to shock waves being utilized to treat kidney stones. Then, in 1985, they were also used in cases of cholelithiasis (gallstones). Around the same time, data started emerging on the benefits of shock wave therapy in bone fractures (through its impact on osteoblast activation). The first device (called Ossatron) that allowed for SWT application in orthopedic cases was introduced in 1993. Soon after, more research was published confirming the advantages of SWT in tennis elbow and heel spurs.
Shock wave is an acoustic wave produced as a result of a significant increase in pressure. In physiotherapy it is typically applied onto the site of chronic pain. Shock wave therapy precipitates healing by increasing blood flow, activating metabolism, stimulating removal of calcified fibroblasts (cells of the connective tissue) and promoting collagen production. It also reduces muscle tension.
The benefits of SWT include short duration of treatment and a relatively low number of appointments – in most cases just three to five treatments yield results. Patients quickly regain mobility without experiencing side effects, their pain subsides and blood vessels around the targeted area are stimulated to grow.
SWT is currently used in tendinitis, heel spur, tennis elbow, golfer’s elbow, jumper’s knee, hip and shoulder pain, muscle strains, post-injury recovery, enthesopathies, tendinopathies, and rotator cuff injuries. It is important to mention that the number of shock wave therapy applications continuously grows, especially in sports medicine. Sometimes SWT can be considered as an interesting alternative to surgery.
As stated before, the most satisfactory outcomes of SWT are seen in tennis elbow, golfer’s elbow, heel spur and shoulder pain. What’s more, these treatments are minimally invasive in nature, relieve pain and stimulate soft tissue regeneration.
What is the treatment like? A specialized device generates shock waves and appropriate pressure within approximately 10 nanoseconds. After the transducer is placed over the targeted site, the waves penetrate up to a few centimetres into the surrounding tissues. Different transducers can be used based on the character and severity of the patient’s condition. A single treatment lasts approximately five to ten minutes. Five of those treatments are typically performed in four- to seven-day intervals but this number can be adjusted individually based on the assessment of the patient.
Depending on the type of condition being treated, modifications can be made to the type of waves, impulse frequency and penetration depth.