If you have been suffering from tendon pain in your Achilles, knee, elbow, foot or shoulder for a long period of time and haven’t been able to find relief from various forms of treatment, then this innovative type of treatment may be of benefit.
Extracorporeal Shockwave Therapy (ESWT) is a series of energetic shockwaves applied to an area that requires treatment. The shockwaves are mechanical waves, not electrical ones. The treatment initiates an inflammation-like condition (pro-flammatory) in the tissue that is being treated and the body responds by increasing the blood circulation and metabolism in the area, which in turn accelerates the body’s own healing process. Ultimately, the shockwaves break down injured tissue and calcifications.
Applications and benefits
ESWT can be used to treat a wide variety of musculoskeletal conditions – especially chronic conditions, for example:
• Tennis/golfer’s elbow
• Knee ligament sprain
• Shoulder calcific tendinosis
• Patella tendinosis
• Achilles tendinosis
• Plantar fasciitis
And as ESWT encourages bone healing, it has also been used to help treat:
• Stress Fractures
• Avascular Necrosis (a dead portion of bone)
• Slow-healing bone (delayed unions)
• Non-healing bone (non-unions)
As opposed to traditional surgical techniques, ESWT offers two main advantages: fewer potential complications and a faster return to normal activity. Additional benefits include:
• No anaesthesia
• Non invasive
• No medication
• No surgery
• Fast treatment: 30 minutes per session, 3-4 sessions required
• Fewer complications
• Virtually painless after treatment
• Significant clinical benefit often seen 6-8 weeks after treatment
How ESWT works
- The shockwave is delivered to the tissue via a compressed air impulse exerted by the hand piece
- The shockwave radiates out, extending to the entire area where pain occurs
- Usually no more than 3-4 sessions are needed
- Each treatment takes approximately 5-10 minutes to be delivered
- No anaesthetic is required and you can continue usual activities. (It is recommended that pain provoking exercise is avoided for 48 hours following treatment)
- No surgery or other therapy is required and treatment can usually start straight away
The success rate of ESWT
Documented international results show an overall result rate of 77% of chronic conditions that have not been cured with other kinds of treatment. It is important to highlight that we would expect positive clinical outcomes following treatment, however there is a chance that the treatment may not improve your symptoms. A review at 12 weeks is recommended following your final treatment. If at this stage your symptoms persist you will be advised of alternative treatments/surgery by your medical practitioner.
The advantages of ESWT
ESWT is applied without medication, for example Cortisone injections. The treatment stimulates and effectively supports the body’s self healing mechanisms. It is usual to experience immediate pain relief following the treatment and hence improved movement. Reported side effects are minimal. However, there may be some discomfort during treatment, skin reddening, possible bruising.
• Is the shockwave treatment painful?
Sometimes the treatment is a bit painful, but most people can stand these few intense minutes without medication. If pain does become apparent during treatment, there are adjustments that can be made to reduce the discomfort. However, having some pain during the treatment illustrates that shockwaves are having a positive effect.
• Will I be in pain after the treatment?
You will normally experience a reduced level of pain or no pain at all immediately after the treatment, but a mild and diffused pain may occur a few hours later. This dull pain can last for a day or so.
• What shall I do if I am in pain after the treatment?
ESWT initiates a pro-flammatory condition in the tissue that is being treated. If necessary, you may use ordinary prescription-free pain killers. Do not use antiinflammatory medication and do not use ice on the treated area as both will interfere with the body’s selfhealing abilities.
• What if I am painless after the shockwave treatment?
Even if you have no pain we strongly recommend that you refrain from intensive activities that stress the treated area for the next 48 hours after each treatment.
• What if the shockwave treatment doesn’t work for me?
Even though the response to shockwave treatment normally is exceptionally good within a few weeks it may take several months before maximum effect is achieved. If after 3-4 months you still do not experience a pronounced improvement, surgery for example may be an alternative depending on your particular clinical picture.
• Are there any contraindications or precautions that I should be aware of?
Yes. These include:
- Cortisone injections are not to be administered within the last 11 weeks prior to shockwave therapy treatment.
- Sometimes there may be some bruising and haemorrhaging tendencies and coagulation system disturbances. As such if you are on warfarin or other anti-coagulant therapies please notify your clinician.
- If you have a cardiac pacemaker please notify your clinician prior to treatment as shockwave therapy may interfere with this.
- Acute inflammation in the treatment area.
- If you have been diagnosed with cancer you should notify your clinician, as the treatment would not be appropriate in this case.
- If you are pregnant please notify your clinician, as treatment should not be administered.