Shockwave (ESWT) Therapy
WHAT IS SHOCKWAVE THERAPY?
Shockwave therapy, also known as Extracorporeal Shock Wave Therapy (ESWT), is a clinically proven and highly effective treatment for chronic tendon injuries and certain bone conditions.
An extracorporeal shockwave is a non-invasive, non-electrical high energy sound impulse that passes into the body via a hand-held probe.
The shockwaves create an increase in inflammation and blood flow to the target area and can break down fibrous scar tissue which builds up over time, especially with chronic conditions. This helps to stimulate cell regeneration and promote tissue healing resulting in improved pain and function.
Shockwave is best utilised alongside a comprehensive rehabilitation programme that typically begins once the shockwave treatment is completed.
What Does Shockwave Therapy Treat?
Shockwave therapy can be effective on a wide range of chronic tendon problems. Here are some examples of conditions where shockwave has been shown to effectively treat symptoms and improve function:
Plantar fasciitis (medial arch pain)
Lateral Epicondylitis (Tennis Elbow)
Patellar tendinitis (jumper‘s knee)
Achilles tendinitis (heel pain)
Greater Trochanteric Pain Syndrome (lateral hip pain)
Proximal hamstring tendinitis
What Happens During Shockwave Therapy?
Your physiotherapist will work with you to identify the exact area of pain and apply a gel to the area to allow the Shockwave to be delivered effectively. A probe is pressed on to the affected area and the Shockwaves are delivered through the skin.
The impulses are delivered through the skin as a Shockwave that spreads inside the injured tissue as an aspherical ‘radial’ wave. These radial Shockwaves initiate an inflammation-like response in the injured tissue that is 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 can be uncomfortable but should not be acutely painful. Typically your first treatment will start with a low level of intensity and increase this to a point where you feel comfortable.
Shockwave therapy treatments are usually performed at weekly intervals and the best evidence available recommends 3-5 treatments followed by a 2-3 month period of progressive strengthening.
How successful is Shockwave Therapy?
This does somewhat depend on the area being treated but research has demonstrated that, in the lower limb, approximately 80% of patients report a reduction of pain and improvement in function.
Research is steadily growing for this cutting-edge technology and the latest reports are confirming shockwave therapy is an effective treatment of chronic tendon injuries and certain bony conditions like heel spurs and calcific rotator cuff tendinitis.
Shockwave is also now recommended by NICE for the treatment of chronic tendon conditions especially of the lower limbs alongside a progressive strengthening programme.
How Long Do Sessions
The Shockwave treatment itself lasts approximately 10-15 minutes but you will be with your physiotherapist for up to 30 minutes to allow for other normal physiotherapy interventions such as soft tissue work and exercise rehabilitation.
How Much Will It Cost?
Shockwave is normally conducted over 3-5 sessions which costs between £255 and £365 depending on whether you are insured or self-funded. Shockwave works best when backed up by a solid rehabilitation programme and this may last 2-3 months after the shockwave has finished and is not included in this cost.
What Are The Side Effects And Exclusion Criteria?
The physiotherapist providing the treatment will have checked your medical history to ensure that you are at minimal risk of any side effects.
Redness or bruising in the treated area
An increase in pain in the treated area, this can be controlled with paracetamol, please do not take NSAIDs e.g. ibuprofen, naproxen.
Steroid injection in the past 60 days
Tendency to haemorrhage
Patients taking anti-coagulant therapy
Acute inflammation of the treatment area
Tumour or infection at the treatment site
Severe circulatory disorder
Nerve disorder at treatment site
Open wound at the treatment site
Prosthesis( ie. hip replacement)
Shockwave Therapy Aftercare Advice
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. Is likely to take several weeks to see an overall benefit alongside your progressive strengthening plan.
Following Shockwave therapy maintain your “normal” levels of activity but do not do anything you normally would not do. Avoid sports, running, jumping and hopping and any other aggravating activities which may stress the treated area for the next 48 hours. Your physio will give you individual advice as required.
Do not use ice on the treated area or take non-steroidal anti-inflammatory medicines e.g. ibuprofen, naproxen as these may reduce the therapeutic effect of ESWT.
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"I was under the care of Nick suffering from pelvic misalignment, muscle spasm and sciatica. During the time I underwent treatment I was accurately diagnosed with an impingement of the sciatic nerve which was later confirmed with an MRI scan as a bulging lumbar disc.
During the time I received treatment, I experienced relief from the symptoms and was given a series of exercises to carry out for self-care in between appointments. Nick was very practical and pragmatic with the advice he gave me, informing me that surgery is really a last resort and that there are various other options to help recover from the issue.
I have now been given the opportunity of receiving Pilates in a class run at the clinic by a specialist musculoskeletal physiotherapist, which will be bespoke treatment for the spinal issue I am experiencing. I would happily recommend this clinic and their staff to anyone experiencing any issues."
LS, ADMINISTRATOR, NORTH CHEAM
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