Tips from Achilles

3rd September 2018

What is shockwave therapy?

Shockwave therapy or as it is better known in the trade, Extracorporeal Shockwave Therapy (ESWT), is a non-invasive treatment used in physical therapy and orthopaedics to treat musculoskeletal conditions that have resulted in persistent pain (> 3 months) and loss of range of motion, and which have not responded adequately to conventional treatments. It is a safe and effective treatment and was first used in Urology and the treatment of kidney stones.

Mechanism of action

Shockwave therapy uses mechanical energy in the form of audible, low energy waves that increase blood flow in the area treated and initiates the body’s healing process. Treatment is targeted on the damaged tissue through the hand -piece used by the practitioner to deliver the waves and can enhance breakdown of adhesions, scar tissue and calcification.

There are two types of Shockwave therapy devices used in the medicine today, focused and radial waves. Both are based on the wave of energy generated outside the body but they are different in the way the waves are delivered to the affected area.

Indications/conditions treated

It is described as “Gold standard for lower limb pathologies” by practitioners and in accordance with most scientific evidence The International Society for Medical Shockwave Treatment (ISMST) recommends it for:

  • Plantar fasciitis
  • Achilles tendinopathy
  • Patella tendinopathy
  • ITB Syndrome
  • Proximal hamstrings tendinopathy
  • Myofascial Pain Syndrome-trigger point pain syndrome
  • GTPS (Trochanteric bursitis)
  • Piriformis syndrome
  • Low back/thoracic pain
  • Calcified shoulder tendinopathy
  • Lateral/medial epicondylitis
  • Carpal Tunnel Syndrome
  • Bone formation

Medical effects

  • New blood vessel formation
  • Reversal of chronic inflammation
  • Stimulation of collagen production
  • Dissolution of calcific deposits
  • Release of trigger points

Benefits

  • Reduces pain, improves function and quality of life
  • Increases mobility
  • Non-invasive, non-surgical, no side effects
  • Recognised by most insurance companies
  • Affordable
  • Treatment provided by chartered physiotherapists

FAQ

  • Therapy session duration between 5 and 10 minutes
  • 80% success rate for patients with chronic pain reported worldwide
  • Pain relief after 72 h
  • Minor discomfort during treatment
  • Cumulative effect of the treatment requiring between 3 and 5 sessions provided every 3 to 10 days depending on the tissue response

Scientific support

91% improvement for calcific tendonitis (Journal of American Association 2003)
87,5% improvement for patellar tendonitis( 17th International Congress of ISMST 2014)
90% improvement for plantar fasciitis (Journal of Orthopaedics Research 2005
77% improvement for tennis elbow (The Journal of Orthopaedics 2005)

The National Institute for Health and Care Excellence (NICE) have deemed this procedure to be safe and effective for plantar fasciitis, Achilles tendinopathy,  shoulder tendinopathies, tennis elbow and greater trochanteric pain syndrome.

The British Medical Bulletin (2015) also state that ESWT is an effective and safe non-invasive treatment option for tendon and other pathologies of the MSK system.