What are shock waves?

Shock waves are audible high-energy sound waves. In the medical world, shock waves have been used since 1980 to disintegrate kidney stones. In modern pain therapy, low-energy shock waves are applied to painful body regions to exert their curative action. Shock waves can accelerate the body’s healing process; they stimulate metabolism and improve blood circulation, and help damaged tissue to regenerate and fully heal. Many years of experience have confirmed that specific pathological alterations of tendons, ligaments, capsules, muscles and bones – in other words, the root causes of your pain – can be eliminated systematically with this therapy approach. If performed by qualified therapists, extracorporeal shock wave therapy of musculoskeletal pain has minimal risks and side effects.

How is shock wave treatment performed?

The therapist takes your medical history in an in-depth consultation, localizes the pain region by palpation, and discusses the findings with you. A skin gel is then applied to the treatment area to allow the shock waves to be introduced into the body without any loss of energy. After these preparations, shock waves are applied as the machine head is moved over the pain region in a circular motion.

How many treatments are necessary, and how long does each treatment take?

Each therapy session takes between 20 to 45 minutes, depending on the disorder to be treated. In general, an average of 3 to 6 treatments is necessary at weekly intervals.

How successful is the therapy?

After only 1 to 2 sessions, many patients report complete pain relief or significant pain reduction. The therapy eliminates pain or restores full mobility, thus improving your quality of life.

Conditions and symptoms we can treat with shock wave therapy: 

Elbow

Tennis or golfer’s elbow

Knee and shin

Patellar tendinitis (jumper’s knee) 

 Shin pain/tibial stress syndrome

Achilles tendon and heel

Achilles tendon pain

 Heel pain

Shoulder and neck

Chronic neck

Shoulder pain

Trigger points

Back and fascia

Back pain 

Fascial pain

How can shockwave therapy help with Tennis or golfer’s elbow?

Tennis elbow, also known as lateral epicondylitis, is a condition that occurs when tendons in the elbow are weakened. This happens when certain motions that put a strain on the elbow, are repetitively performed.

Tennis players rely heavily on arm movements to maneuver their rackets and may end up damaging their tendons. Anyone whose job features repetitive motions of the arm can develop tennis elbow.

Shockwave therapy can help in treating this condition. Studies also show that shockwave therapy for tennis elbow has led to an improvement in pain, function, and grip strength.

How can shockwave therapy help with Patellar tendinitis (jumper’s knee) and shin pain/tibial stress syndrome?

When there is constant stress, tiny tears are being created in the tendon. If corrective action is not taken, the tendon becomes inflamed.

Patellar tendonitis is also referred to as jumper’s knee, because athletes, whose sports involve frequent jumping, such as basketball players, are often the ones who are diagnosed with this condition.

Shockwave therapy is a safe and effective form of treatment for patellar tendonitis and helps in fast pain relief and mobility restoration. As it is non-surgical in nature, the recovery time is faster as well.

How can shockwave therapy help with Chronic neck, shoulder pain and trigger points?

One of the main causes of chronic neck pain are Myofascial trigger points, these are localised segments of muscle that have been subjected to acute injury and micro trauma from repetitive stress. Statistically MFTP is most common in the neck and can be responsible for cervical headaches. Shockwave can be very helpful for chronic tension headaches, chronic pain in the neck, shoulder or back. Symptoms include temporal pain, eye pain and pain at the back of the neck and can mimic migraines. Manual treatment would be a first port of call, acupuncture and possibly stress management and ergonomics in the workplace.

Shockwave can be employed when the above simply has not worked and usually at a period of not less than 6 months.

Rotator cuff disease is the most common cause of shoulder pain, especially at night and when lifting the arm above the head. Calcium deposits may form on the tendons in the shoulder joint. Shock wave therapy passes sound or shock waves through the skin to the affected area, and may break up calcium depositsMyofascial trigger points, or just “trigger points” are small muscle spasms within the muscle belly.  The smallest units of muscle contraction (the sarcomeres) are stuck in extreme contraction.  This causes the blood supply to be cut off to the muscle, waste products to build up and the trigger point to further contract.  This cycle spirals on itself and trigger points just continue their pattern.

How can shockwave therapy help with Back pain and fascial pain?

If you suffer from back muscle weakness, numbness, tingling and extreme sensitivity, shockwave therapy can help.

People without a good range of motion caused by muscle spasms can also benefit. Shockwave therapy reduces swelling by stimulating infrequently used muscles to improve range of motion. In fact, extracorporeal shockwaves are applied to lesions to help revascularization and stimulate or reactivate the process of connective tissue and bone healing, thereby relieving pain and improving functions.

Shockwave therapy (SWT) is a non-invasive method for treatment of various musculoskeletal disorders. Its effect is based on transduction of mechanical energy, transferred to cascade of various biochemical processes in target tissue. Its efficacy was proved in the treatment of different painful conditions.

What should or shouldn’t I do after a shockwave therapy session?

After shockwave therapy, you should:

  1. Even if you have no pain after treatment it is strongly recommended that you refrain from any activity that stresses the treated area for 48 hours after each treatment.
  2. You will be able to drive immediately after the treatment
  3. No rehabilitation and limitation will apply to you after shockwave therapy.
  4. Patients could apply Heat after shockwave treatment

Radial shockwave therapy initiates a pro-inflammatory condition in the tissue that is being treated. If necessary you can use paracetamol or a codeine-based medication for pain relief after treatment.

After shockwave therapy you shouldn’t:

–   You should avoid high impact exercise such as running or playing tennis for the first 48 hours after treatment.

–    If you feel any discomfort, you can take paracetamol if you’re able, but avoid taking a non-steroidal anti-inflammatory painkiller such as ibuprofen as it will counteract the treatment and render it useless.

– Patients should not apply ice or take anti-inflammatories after shockwave treatment, as this inflammatory healing response shouldn’t be reduced.

We will also advise that you do not carry out your rehabilitation/physiotherapy exercises for 24 hours following your shockwave treatment.- Patients should not apply ice or take anti-inflammatories after shockwave treatment, as this will impact the inflammatory healing response and thus reduce the effectiveness of the Shockwave treatment.

Is shockwave therapy painful?

 Shockwave therapy is a non-invasive, non-surgical treatment, but you might feel a little pain or discomfort in the treatment area during the procedure. Most patients say it feels like small pulses against the skin.

After the treatment, you may experience temporary soreness, tenderness or swelling for a few days following the procedure, as the shockwaves stimulate an inflammatory response. But this is the body healing itself naturally.

What is the shockwave therapy operator’s specialty?

Therapists, Practitioners, who trained to understand how to incorporate SWT in their practice.

What are the potential side effects of shockwave therapy?

Side effects from shockwave therapy are limited to mild bruising, swelling, pain, numbness or tingling in the treated area, and the recovery is minimal compared with that of surgical intervention.

Who shouldn’t use shockwave therapy treatment?

While Shockwave is suitable for a large number of conditions both evidenced and experimental with minimal side effects, there are some conditions, also known as contraindications, that means Shockwave is not an option.

Shockwave is unsuitable in the following circumstances:

●  If you are pregnant

●  If you have a blood clotting disorder (including thrombosis)

●  If you are taking oral anticoagulants

●  If you have received a Steroid/ cortisone injection within 6 weeks

●  If you have a Pacemaker fitted

●  If tumours are present at the treatment site

●  If you have an infection or skin abrasion/ acute inflammations at the treatment site

●  If you are in growth (Under 18)

●  Tumour diseases, carcinoma, cancer patients

How should I know my shockwave therapy is working?

ESWT forces your body to create new tissue cells in the damaged area. Expect gradual healing to take place over days, weeks or months. Though not typical, some have mild soreness or bruising after treatment. Some people experience no more pain from day one. Most will have noticeable to significant improvement by the thirteenth week. A second treatment after sixteen weeks may be necessary in approximately 20% of patients. As it took time to create the injury, healing also takes time. Total healing of the area can take up to one year.

The best thing about ESWT is that unlike surgery, you avoid getting worse before getting better. You do not need to plan lengthy time off from work or your life for painful post-procedure recovery.

Shockwave stimulates the healing process by increasing the blood flow to affected areas, which accelerates healing and often results in quicker relief from pain. It also helps heal chronic inflammation, stimulates collagen, which connects and supports tissue, and also breaks up calcium deposits. Seeing those results you will make sure the shockwave is working for you.

What kinds of support do I need after a shockwave therapy session?

In order to get a good result after your shockwave therapy, it is strongly recommended that you refrain from any activity that stresses the treated area for 48 hours after each treatment. Other than that no specific support will be applicable.

Resources:

www.shockwavetherapy.eu/studies

shockwavecanada.com/

zimmer.de/