Shockwave Therapy

What is Extracorporeal Shockwave Therapy ?

Extracorporeal Shockwave Therapy (ESWT) more commonly known as Shockwave therapy is the application of shockwaves in medicine.  The word extracorporeal means "outside of the body" which refers to the way the therapy is applied.  Shockwave therapy is a non surgical treatment which works by delivering high energy sound waves to damaged or injured soft tissue to stimulate a healing response.

How does Shockwave Therapy work ?

An applicator probe is pressed on to the affected area and the shockwaves are delivered through the skin using a specific contact gel to assist in penetration.  The impulses are delivered through the skin as a shockwave that spreads inside the injured tissue.  These shockwaves initiate an inflammation like response in the injured tissue that is being treated.  This prompts the body to respond naturally by increasing blood circulation, the number of blood vessels and therefore metabolism in the injured tissue and reduction in pain felt by nerve fibers.

What can it be used for ?

Shockwave therapy is used to treat chronic conditions (conditions which have been ongoing for more than 3 months).  It can even be used after other conservative treatment modalities have failed.

The governments National Institute of Clinical Excellence (NICE) guidelines have found ESWT to be effective in the treatment of the following conditions:

• Shoulder Pain - Sub acromial Pain Syndrome
• Elbow Pain - Tennis Elbow
• Hip Pain - Trochanteric Bursitis
• Hamstring Pain - Proximal Hamstring Tendonopathy
• Knee Pain - Patella Tendonopathy
• Achilles Tendon Pain Achilles Tendonopathy - (aka Achilles Tendonitis)
• Heel Pain - Plantarfasciitis

What will I feel during the treatment ?

ESWT is uncomfortable.  Typically your first treatment will start with a lower level of intensity, this will be increased to a point where you feel comfortable.  The procedure does not require any type of sedation or anaesthetic.  We work to your pain levels, but generally the higher the power setting the better the result, after all "no pain no gain".

How successful is the treatment and why choose us ?

The clinical trials done on ESWT show favourable results with NICE and the guidelines provided are highly recommended.  Here at Back2Fitness Physiotherapy we use the most evidence based Shockwave Therapy machine on the market, the EMS Swiss DolorClast Master System.  Out of the 20 clinical trials performed which have studied the effects of Shockwave Therapy, 15 of those studies used the EMS unit, therefore we can be confident our machine delivers the best possible shockwave treatment you can get.  We at Back2Fitness have also undertaken specific training in the use of Shockwave therapy and have certification in the use of the Swiss DolorClast method.  Success rates are encouraging, we constantly audit our outcomes and we are achieving around an 80% success rate for our patients.

How many treatments will I need ?

Typically we would perform 3-weekly treatment sessions if the patient is able to tolerate the desired power dosage at each session.  We have found that this is normally enough to cure most complaints. If after 6 weeks of your last session you still have pain then an additional 2-3 sessions may be administered.

How long is the treatment session ?

We allocate 30 minutes for each shockwave session.  The actual shockwave treatment administers 2000-3000 shocks which typically last between 4-7 minutes.  The remainder of the time will be allocated to ensuring you have the correct rehabilitation protocol for the stage of the treatment you are on.  There will also be time for you to ask any questions as well as our physiotherapist give out specific advice of your treatment.  If you are unable to attend one of your consecutive shockwave appointments, you may have to start the treatment process again from the beginning.  This may delay your overall treatment and have a greater financial cost.

What will I feel after the treatment ?

Many patients experience an improvement in symptoms almost immediately whilst others can take a few weeks to respond.  You will most likely notice increase heat from the treated area.  You will also see reddening or swelling of the treatment area.  In a minority of cases some patients may feel a brief increase in pain.  It may take several weeks to see an overall benefit.  We suggest that you book a review 6 weeks after your last session of shockwave therapy to assess your progress.

Are there any precautions I should take with this treatment ?

Yes, before and during treatment you should try and stop anti inflammatory drugs (ibuprofen, naproxen, diclofenac).  Discuss this first with your physiotherapist.  After each treatment you should try and rest the affected area for about 24 hours.  If Shockwave therapy is applied to the foot it is best to avoid any impact sports such as running or long walks for at least 24-48 hours.  If its applied to the shoulder avoid lifting weights also.  You shouldn't do any stretches for 24-48 hours after the treatment.  You are allowed to carry out day to day activities such as light walking.

Can anyone have Extracorporeal Shockwave Therapy ?

Most people can have this treatment, however Extracorporeal Shockwave Therapy may be contra-indicated if you :

• Are under 18 years old (exception with Osgood Schlatter's Syndrome)
• Are using blood thinners (such as Warfarin)
•  Have a history of cancer/malignancies in the area being treated
• Have a cardiac/heart pacemaker
• Are currently pregnant
• Have an infection
• Have a substantial tear in the tendon or ligament area being treated
• Have had a recent steroid injection in the last 6 weeks in the same area of the body that is being treated.

Back2Fitness Physiotherapy has provided shockwave therapy and treatment to patients from all over the West Midlands including Birmingham and Wolverhampton.  Our practice has also seen patients throughout England due to our central location and easy access off the M6 motorway.  Contact us today to discuss shockwave therapy.