Shockwave therapy is a treatment modality that delivers high energy sound impulses to the target tissue. This technique was first utilised in the 80’s for the ablation of Kidney Stones; however, its clinical application has since evolved to include the management of musculoskeletal disorders, calcification and tissue healing, particularly in chronic conditions.
What’s Involved in Shockwave Therapy?
Extracorporeal shockwave therapy (ESWT) involves the delivery of high energy sound impulses which are transferred to the tissue interface via varying methods. There are three applications of shockwave therapy which include focused, defocused and radial. Radial shockwave utilises a handpiece that propagates a diffuse wave into the tissue via air compression of the projectile within the handpiece. The transfer of sonic energy promotes tissue healing.
During the treatment ultrasound gel is applied to the skin which is cool and jelly like in consistency. The application of the handpiece to the skin will be firm and will generate an oscillating vibratory sensation against the skin. ESWT is used usually for 30 seconds to a few minutes with the machine generating a loud noise during use.
For optimal results, a course of shockwave therapy usually requires 3-5 sessions.
Does Shockwave treatment actually work?
Shockwave has been shown to enhance revascularisation, disruption to fibrous tissue, healing, inflammation control and sensory disruption to pain processing. More specifically, the literature shows improvement in pain scores at 4 weeks – 3 months versus immediate short-term reduction. Importantly, in chronic pain populations, these improvements were maintained at 1- and 3-month time points without regression.
When is Shockwave Therapy appropriate?
Shockwave treatment is most effective in the following conditions:
- Plantar fasciitis
- Achilles tendinopathy
- Elbow tendinopathy
- Rotator cuff tendinopathy
- Calcific shoulder
- Low back pain
If you have one of these conditions and it has not responded to other forms of treatment, shockwave therapy is likely an appropriate intervention to assist your recovery.
This form of treatment is not suitable for all patients; it will be recommended by your Physiotherapist if appropriate.
Walewicz, K., Taradaj, J., Rajfur, K., Ptaszkowski, K., Kuszewski, M. T., Sopel, M., & Dymarek, R. (2019). The Effectiveness Of Radial Extracorporeal Shock Wave Therapy In Patients With Chronic Low Back Pain: A Prospective, Randomized, Single-Blinded Pilot Study. Clinical interventions in aging, 14, 1859–1869.
Malliaropoulos, N., Thompson, D., Meke, M., Pyne, D., Alaseirlis, D., Atkinson, H., Korakakis, V., & Lohrer, H. (2017). Individualised radial extracorporeal shock wave therapy (rESWT) for symptomatic calcific shoulder tendinopathy: a retrospective clinical study. BMC musculoskeletal disorders, 18(1), 513.
Dedes, V., Stergioulas, A., Kipreos, G., Dede, A. M., Mitseas, A., & Panoutsopoulos, G. I. (2018). Effectiveness and Safety of Shockwave Therapy in Tendinopathies. Materia socio-medica, 30(2), 131–146.