Extracorporeal shockwave therapy (ESWT) is a type of electro-therapy utilised by physiotherapists, sports medicine doctors, podiatrists, and other health care professionals to treat a variety of painful musculoskeletal conditions.
The Shockwave Therapy Process
ESWT creates and delivers mechanical waves of high energy acoustic pressure into a specific group of tissues. Each of these waves is termed a ‘shockwave’. These shockwaves have a profound effect on the human body’s healing capacity and there are years of research showing ESWT works to drastically enhance the innate healing response of the body.
Who Can Benefit From Shockwave Therapy?
ESWT began to be used to treat muscle and bone problems in the 1980s and has been extensively researched in the field of musculoskeletal medicine for the last 20 years. There is currently the highest level of clinical evidence available (systematic review and meta-analysis) supporting the use of ESWT in several conditions such as listed below:
- Calcific tendinopathy of the shoulder
- Plantar fasciitis / Achilles tendinopathy
- Knee osteoarthritis
- Post-stroke muscle spasticity
Who Should Not Use Shockwave Therapy?
Shockwave therapy is contraindicated in cases where there is a cancerous tumor near the shock site, within 6 weeks of a steroid injection around the shock site, if the shock site is near an individual’s cardiac pacemaker or stent and if an individual suffers from hemophilia. Caution should also be used if utilising shockwave therapy on acutely inflamed tissues as it can often further irritate the already painful site. It is typically best to allow a painful joint or muscle to settle for a few days if acutely inflamed before going ahead with EWST.
Does Shockwave Therapy Hurt?
EWST can be uncomfortable, especially if being used to breakdown calcified tendon deposits in a condition called calcific tendonitis as higher power levels are used for this. But, in general, we keep the power well within your own personal tolerance level. However, we often find that our patients find the relief they receive after the first round of shockwave so great that they request to turn it up even higher! That said, we abide by a slow ramp of increasing intensity to avoid any adverse reactions.
What Are The Adverse Reaction of Shockwave Therapy?
If the power is turned up too high, too fast. You may experience some mild bruising, swelling, or numbness at the shock site for a few days after. However, this is avoided by a slow and gradual ramp of intensity over the course of a few sessions. Beyond this, there are no further known serious side effects that have been reported in the multitude of studies that have investigated the use of EWST for musculoskeletal health problems.
How Many Sessions Will I Need?
This would depend upon your specific condition but typically we would treat most problems with 3-5 sessions of shockwave therapy. Rarely we would go above 6 sessions and almost never over 8 sessions. We would expect improvement in the condition within the first few sessions and this would continue to improve over the following 2-3 sessions. If you are not seeing improvement within 2-3 sessions it is likely that your condition is not responding to the therapy and it would be redundant to continue with additional sessions.
Can I Do Ala-Carte Shockwave Therapy?
The short answer is no! At Heartland Rehab, we employ ESWT as an adjunct therapy only. Meaning that it only meant to supplement other physiotherapy interventions that you are undergoing. A good example of this would be someone who has been experiencing a long-standing condition such as chronic patella tendinopathy where the front of the knee becomes painful due to an overloaded tendon. Shockwave therapy can be very effective at treating the pain and allowing a quick return to activity in this situation. However, there is likely to be some muscle wasting and changes in the way an individual moves due to the chronicity of the condition. If these underlying issues are not addressed, the problems will quickly return once the irritating activity is undertaken again. As such, we will only use ESTW as part of a holistic physiotherapy management program.
What Should I Do If I Want To Find Out More Information?
If you are keen to learn if shockwave can help with whatever condition you are dealing with, please get in touch with our expert therapists at Heartland Rehab for an unbiased and non-pressured chat about its suitability. It’s important to note that while shockwave therapy can be very effective for many conditions, there has been a lot of clever marketing around its use and it can be seen by some as a cure-all panacea, which it isn’t. A good therapist will assess your need for it, spell out the pro’s and cons of its use, and ultimately place the decision of its use in your hands.