What is Extracorporeal Shock Wave Therapy (ESWT)?
ESWT is proven to be a safe, highly effective way forward for patients who fail to respond to appropriate physiotherapy treatment. Shockwave therapy works by the Physiotherapist delivering a mechanical pressure wave generated acoustically through a handheld applicator. This involves a small metal bullet travelling via compressed air colliding with an applicator head that causes an impact and the generation of a high-powered pressure wave called a ‘Shockwave’.
The Shockwaves travel nearly unchanged through fluids, including soft tissues of the body, exerting their effects only where there is a change in acoustic deficiencies along their path in the damaged tissue. These radial shockwaves spread in the damaged tissue and initiate an inflammation-like response in the injured tissue that is being treated and prompts the body to respond naturally by increasing blood circulation, the number of blood vessels and metabolism in the injured tissue. The shockwaves help stimulate new blood vessel growth and improve inflammatory, nervous, tissue repair function and cellular regeneration. Healing continues to work 3 -4 months after Treatment.
There are three main ways of using radial shockwave:
- Breakdown of tissue
- Increased healing for example via blood supply
- Reduction in pain (nerve regulation/desensitisation)
Before shockwave therapy is considered you will have a full clinical assessment by one of our Chartered Physiotherapists.
Which conditions can ESWT treat?
There have been many robust Scientific research trials supporting the use of ESWT. It has been recommended as a treatment by NICE ‘The National Institute for Health and Care Excellence’. It is particularly effective for conditions such as:
- Calcified tendons
- Tendinopathies/Tendinitis of the Knee, Shoulder, Ankles, Hips, Hamstrings
- Achilles Tendinopathies
- Plantar Fasciitis
- Tennis/Golfers Elbow
- It may also help Osteoarthritic conditions too.
Is Shockwave suitable for everyone?
- ESWT is contraindicated if you have the following health conditions:
- Malignant tumour in the treatment area (not as underlying disease)
- If you are pregnant- as a local treatment it is considered safe, however you may feel it best to wait until after your pregnancy.
- If you have a blood clotting disorder (including thrombosis)
- If you are taking oral anti-coagulants
- If you have received a Steroid injection within 4-8 weeks depending on who you speak to If you have a Pacemaker fitted you should not receive treatment in the upper body.
- If tumours are present at the treatment site – any patient with a history of malignancy should have their decision to undergo radial shockwave cleared by a medical professional first – it is best to wait until the patient is in remission
- If you have an infection or skin abrasion at the treatment site
- If you are Under 18 (except in the treatment of Osgood-Schlatter disease)?
- In acute large tears or ruptures these should be investigated first as initial line of treatment may be offloading in a walker boot, surgical or conservative management
- Hypersensitivity, allodynia, central sensitisation
- Local infections
- Open wounds, rash, psoriasis or other skin conditions making them unlikely to be able to tolerate the treatment.
What to expect during your ESWT treatment session.
The Physiotherapist will identify the exact area of pain and apply a conduction gel to the area to help the applicator head glide over the painful area.
The Physiotherapist will select the best settings on the machine for your problem. The machine will be switched on and you should expect it to be very noisy as a compressor is used to create the high-pressure shockwaves. The Radial shockwaves are introduced into the body via the applicator to cover the entire pain region. Shockwave therapy is not painful but can be slightly uncomfortable. The Physiotherapist may turn the pressure up if you do not feel any discomfort at all.
Shock-wave therapy treatments are usually performed at weekly intervals, there should be no more than 10 days between treatments. Each treatment session takes about 15 minutes and you will require a block of 4 sessions, some people may require another session a few weeks after their block of 4 sessions.
What to expect after your treatment.
Many patients experience an improvement in symptoms almost immediately while others take several weeks to respond. You may notice a reddening or swelling of the area with some patients experiencing a brief increase in pain. It may take several weeks to see an overall benefit
Common side effects can include reddening, swelling, some pain and bruising.
Cost of ESWT at Blairgowrie Physiotherapy
4 block sessions of SWT – £280
The cost of this treatment is also covered (or partially covered) under various health insurance providers- BUPA, AXA, Vitality, Aviva. Please check with your provider under the terms of you own policy.