Shockwave Treatment In Physiotherapy
Shockwave therapy is an effective treatment for a broad spectrum of musculoskeletal disorders, including:
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Achilles tendinopathy
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Lateral/ medial epicondylitis (Tennis/ Golfer’s elbow)
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Plantar fasciitis
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Carpal tunnel syndrome
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Shin Splints
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Rotator cuff tendinopathy
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​Patellar tendinopathy
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De Quervain’s tenosynovitis
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Shoulder bursitis
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Trochanteric bursitis
Shockwave therapy effectively reduces inflammation, stimulates collagen production, breaks down calcified fibroblasts, and reverses the chronic inflammation process.
What is Shockwave Therapy?
Extracorporeal Shockwave Therapy (ESWT) or Shockwave Therapy generates sound waves which can trigger biological effects. The kinetic energy of the sound wave passes through tissues to promote regenerative and reparative processes of tendon, soft tissues and bone.
The therapeutic effects of Shockwave Therapy include pain relief, accelerated tissue repair and cell growth, as well as restoration of mobility.
There are many high quality (randomised control trial) studies carried out to look into the effect of Shockwave Therapy on a wide range of musculoskeletal conditions. Most of the studies supported good treatment effects ranging from 70 to 90% improvement, even more than 6 months after cessation of the treatment sessions.
How Does Shockwave Therapy Work?
Shockwave Therapy has mechanical and cellular impacts on tissues regeneration and pain management through cavitation bubbles, acoustic micro streaming, and hyper-vascularity that can directly affect tissue calcifications, and modulate cell activity.
Shockwave Therapy generates high energy sound waves and induces neovascularisation at the tendon-bone junction and the release of growth factors such as eNOS (endothelial nitric oxide synthase), VEGF (vascular endothelial growth factor) and PCNA (proliferating cell antinuclear antigen).
As a result, these lead to improved blood supply, an increase in cell proliferation and consequently to the tissue regeneration of tendons and bones for tissue repair.
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The shockwaves reduce pain partly through the creation of substance P and the hyperstimulation of small diameter pain fibres which in turn activate a serotoninergic system that regulates the transmission of pain stimuli and therefore increase the patient’s pain tolerance.
Shockwave therapy treatments are carried out every 5-7 days. Improvements of symptoms can be felt straight after the treatment session or continue to be noticeable a few days later.
Shockwave Therapy Benefits
Shockwave Therapy is non-invasive with proven effectiveness. It is a good treatment option which is convenient, faster and safer to use. Shockwave Therapy was found to have equal or superior treatment effect compared with surgery and steroid injections in some musculoskeletal conditions.
Side effects of Shockwave Therapy is minimal and negligible and it is relatively easy to tolerate. Most treated conditions show noticeable and significant improvements after 6-8 treatment sessions.
Shockwave Therapy can also relieve muscle trigger points without causing much post-treatment soreness. It can be an effective alternative treatment option for dry needling (acupuncture) for people who are afraid of needles and after treatment soreness.
