Shockwave therapy is one of the most effective non-invasive solutions to treat stubborn musculoskeletal conditions like tennis elbow and plantar fasciitis, stimulating healing while decreasing pain without incurring additional side effects of more invasive interventions.
Meta-analysis revealed that low-energy ESWT (0.10 mJ/mm2) was more successful in relieving pain and increasing function during chronic LE treatment than high-energy ESWT (0.20 mJ/mm2). Further research with larger sample sizes and randomized controlled trials must confirm these findings.
Benefits
As shockwave therapy can help treat plantar fasciitis, tennis elbow, shoulder pain and other injuries effectively, it may reduce symptoms and restore quality of life. Shockwave therapy (also referred to as extracorporeal shock wave treatment, ESWT or extracorporeal shock wave therapy) is a noninvasive technique which uses acoustic sound waves to promote healing in injured parts of the body – it has even been successfully applied in treating tendinopathies (tendonitis) and fibromyalgia!
At each treatment session, acoustic sound waves are transmitted using a handheld device placed against the affected area. These sound waves penetrate deep into tissue and help stimulate collagen production for healing damaged tissues. Furthermore, blood flow to this area increases significantly as these sound waves deliver vital nutrients necessary for rapid healing.
Shockwaves have been shown to significantly increase cell membrane permeability and circulation within treated areas, helping promote healing while breaking down calcium deposits within tissues. Shockwaves may also stimulate osteoblasts to produce new bone while stimulating fibroblasts to produce collagen which repairs damaged tissues more effectively.
ESWT has been proven to successfully treat various musculoskeletal conditions, including plantar fasciitis, Achilles tendinitis, patellar tendinitis (jumper’s knee), rotator cuff tendinitis, calcific tendinitis fractures/stress fractures of bone stress fractures/hip bursitis as well as bone marrow lesions. Furthermore, ESWT can also speed recovery after surgery such as rotator cuff repair or ankle reconstruction surgeries/surgeries/surgeries/etc.
Important to keep in mind is the distinction between shockwave treatments. Some devices such as EPAT and low energy waves do not qualify as true ESWT and have been termed pressure wave therapy; although they may provide relief in early stages of inflammation, these therapies do not stimulate new tissue formation or healing of damaged areas.
High Energy ESWT with the Dornier Epos Ultra is an FDA Class III-approved treatment that offers real healing and repairs damaged tendons and fascia in one 20 minute treatment, making this an excellent alternative to more invasive procedures that may lead to surgical interventions. Make an appointment now and begin your journey towards pain-free living!
Safety
Shock wave therapy is an effective and minimally invasive solution for musculoskeletal conditions, although its exact mechanism remains unknown. A proposed mechanism is mechanotransduction; which describes how mechanical stimuli cause biological responses such as migration, proliferation, differentiation and apoptosis in response to mechanical stimulation. Another proposed mechanism of action includes pain modulation via changes in neurotransmitter concentrations activating pain-killing systems.
Clinical research has established the safety and effectiveness of shockwave therapy when administered under the direction of a certified physician. A variety of factors affect its success and safety; among these are energy type/intensity used, application technique (focused or radial), number of treatment sessions/frequency and use of analgesia during therapy.
ESWT has been found safe for patients suffering from various musculoskeletal conditions, including acute and chronic injuries to shoulders, elbows, wrists, knees, hips, ankles, and feet. Furthermore, this therapy has proven itself effective against degenerative diseases like arthritis, osteoporosis bone fractures and delayed or nonunion wounds.
Numerous studies demonstrate the safety and effectiveness of ESWT as a treatment for calcifying tendinitis of the rotator cuff, including single-blind, randomized clinical trials.
Studies comparing high energy shockwave therapy (HESWT) against low energy ESWT or placebo concluded that higher energy ESWT provided significantly greater pain relief and functional outcomes than its low energy counterpart.
The authors of the study suggest that clinicians adhere to ESWT usage guidelines. They advise against applying it at sites with significant vascularity or bone metastases as these could increase risks of complications and complicate care plans. Clinical focusing, the application of shockwaves over areas of maximal pain, should also be used as a way of optimizing results and application.
The therapist will apply a probe to the affected area after applying a gel that conducts waves. As shockwaves travel throughout their bodies, patients will feel some mild pressure. Throughout treatment, he or she will ask whether the shockwaves are painful and adjust intensity as necessary; usually however, treatment can be completed without needing anesthetic unless specifically requested by patient.
Patient Education
Shock wave therapy is an innovative non-invasive solution. Your physician may recommend it as part of an overall treatment plan if traditional conservative measures such as physical therapy or medication have failed to provide sufficient pain relief for your condition. Shock wave therapy makes a valuable addition to recovery regimens and may help speed the return of movement and function faster than anticipated.
Your OCC physician will evaluate if you qualify for either focused or radial shock wave therapy, or both, based on your clinical history and diagnosis. ESWT creates pressure waves or shockwaves which trigger your body’s natural healing response in order to decrease pain, increase blood flow, and encourage tissue regeneration.
At each treatment session, shockwaves are administered through a probe attached to your skin after gel has been applied to help conduct them. High energy therapy may cause some discomfort; therefore a local anesthetic may be suggested for added comfort; while low-energy sessions often produce minimal or no pain and are frequently performed without needing anesthetics.
Shockwave therapy sessions typically last 20 minutes. Your physician will likely schedule multiple treatments over three to four weeks in order to achieve maximum effectiveness; some patients experience immediate relief while others don’t notice its benefits until several weeks have gone by. Your physician will monitor your progress and decide when it is time for another visit.
Once the initial series of treatments have concluded, your doctor is likely to suggest continued shockwave sessions on an ongoing basis to maintain maximum pain reduction and rehabilitation progression. Depending on your diagnosis, some level of activity may also be recommended in order to promote bone and tendon healing.
Many different devices exist for shockwave therapy, but not all of them provide equal results. Licensed physicians who have completed specialized training and certification in using focused or radial shockwave therapy are the most effective practitioners, while cheap machines that create only pressure or noise waves should not be considered ESWT treatments.
Procedure
ESWT therapy involves using a hand-held device with a probe that emits shockwaves. It’s then placed over an area of discomfort – usually tendonitis or another muscle issue – where pain exists, with no side effects reported during or after treatment. Sessions generally last less than 30 minutes each and may need to take place over multiple body areas over multiple sessions, possibly weekly depending on severity.
Shockwave therapy is an innovative noninvasive solution to pain management that offers immediate relief for plantar fasciitis, Achilles tendinitis, shoulder (tendinitis or rotator cuff), hip bursitis stress fractures and bone marrow lesions. Shockwave Therapy may also aid recovery after surgery such as rotator cuff repairs.
ESWT offers many advantages; however, more research needs to be conducted regarding its efficacy. One proposed mechanism of action involves mechanotransduction: mechanical stimuli can alter cell behaviors like migration, proliferation, differentiation or apoptosis through mechanical mechanotransduction.
Though numerous studies have demonstrated the efficacy of ESWT, individual results vary. To know whether ESWT will be useful to you, speak to a healthcare provider to assess your condition and create a tailored treatment plan.
One of the keys to successful ESWT treatment lies in its intensity. Low energy shockwave machines generate radial pressure waves that diverge from their source and may not be effective enough at treating chronic conditions such as plantar fasciitis or calcific tendinitis.
Verstraelen et al conducted a recent meta-analysis comparing high and low energy shockwave machines, and discovered that high energy devices consistently delivered more positive results than low energy equipment. This may be attributed to their waves converging more directly onto target tissue resulting in the most efficient use of energy and creating desired effects more rapidly. Furthermore, high energy equipment also allows greater levels of customization which ensure that treatment intensity matches patient need more effectively.
