What is shockwave therapy?
Extracorporeal shockwave therapy uses high-powered sound waves to stimulate the healing of chronically injured tissues. Shockwave therapy has been used in medicine for over 20 years and has a large body of evidence proving its effectiveness at treating many chronic tendinopathies. Shockwave therapy has been adapted from lithotripsy treatment that is still used today as a treatment to break down kidney stones. Shockwave therapy is very different from ultrasound therapy and can mechanically stimulate tissues deep within the body unlike other types of sound wave therapies.
How does shockwave therapy work?
Shockwave therapy works through a variety of biological mechanisms. The powerful sound waves created by the therapy have been shown to cause a cellular level vibration within injured tissues that have a number of beneficial effects:
- Increased blood flow to tissues that promotes healing of chronic injuries.
- Stimulates the production of fibroblast cells. Fibroblasts are the cells that promote tendon health through collagen production.
- Induces a controlled inflammatory reaction within tissues that re-stimulates the healing of injuries that are failing to heal.
- Improves the health of bones through direct mechanical stimulation and has been shown to be very effective at healing non-union fractures.
Highly effective at relieving pain in tissues that have been painful for a long period of time, typically over 12 weeks. The shockwaves do this through reducing the chemical substance P and decreasing the sensitivity of tissues permanently.
When should you consider shockwave therapy?
- If you have been suffering with a tendon problem for over 12 weeks.
- If you have tried normal stretching and physiotherapy treatment for 3 months and your pain does not seem to be improving.
- If you have been diagnosed with one of the following conditions:
- Plantar fasciitis
- Achilles tendinitis
- Patella Tendinitis
- Hamstring Tendinitis
- Trochanteric Bursitis
- Frozen Shoulder
- Calcific Rotator cuff tendinitis
- Biceps Tendinitis
- Tennis Elbow
- Golfers Elbow.
What are the success rates of shockwave therapy?
Shockwave therapy has been shown to provide a 70-80% success rate in reducing chronic tendinitis pain within 12 weeks of starting treatment.
What are the contra-indications?
Times when shockwave therapy can not be used:
- If you are pregnant
- Over open growth plates
- Over the lungs
- Over major blood vessels
- Over infected areas
- If you have had a recent steroid injection
- If you are on anti-coagulant medication
- If you have an active cancer.
Is shockwave therapy safe?
Yes. Shockwave therapy is extremely safe having been used on millions of patients around the world with virtually no negative side effects. Recent NICE guidelines recommend the use of shockwave therapy and emphasise the safety of the therapy.
Side-effects include:
- A temporary reddening of the area treated.
- A temporary increase in pain for 24 hours after treatment.
- Mild to moderate pain during treatment.
- Low level bruising of the treated area.
What to expect during shockwave therapy treatment?
Prior to engaging in shockwave therapy your diagnosis will need to be confirmed by a diagnostic ultrasound scan. This is to ensure you are a good candidate for the therapy and to optimise results.
Once diagnosis has been confirmed your therapist will apply the shockwaves to the injured tissue. Typically this will correlate with some tender areas located around your injury. The treatment is non-invasive so no needles are used. There is also no need for local anaesthetic. The treatments itself lasts no longer than 8-10 minutes. During the treatment you should expect to feel some mild to moderate discomfort, this is required in order to achieve maximum benefits. The energy levels applied during treatment can be adapted to suit each individual patient.
What do I need to do after treatment?
One of the main advantages of shockwave therapy is there are no major restrictions on patients after treatments. It is recommended that heavy impact activity is restricted for 24 hours after treatment but patients will be fine to drive and return to work after treatments.
Many athletes and elite sports teams use shockwave therapy over injections to manage injuries as it allows them to continue training and playing throughout the season.
Do I need to do any other treatments with shockwave therapy?
Yes. In order to maximally benefit from shockwave therapy it must be combined with a specific stretching or strengthening home exercise programme. The exercises required will be demonstrated and progressed by your therapist during each session.
When will I notice improvements?
Most people will notice an almost instant decrease in pain after treatment. This will be a temporary decrease as the tissue has been desensitised. Over time the pain relief becomes more permanent. Typically most people notice a significant improvement in symptoms 3-6 weeks after their first session. The optimal results of shockwave therapy are realised at 12 weeks after the first treatment.
How many treatments will I need?
Every patient will require a minimum dose of 3 treatments performed at weekly intervals. After the 3rd treatment patients will be reviewed at 6 weeks to assess response to treatment – at that point a decision on further treatment can be made. If an injury has been present for a long-time then a further 3 treatments may be required. Typically patients do not require more than 6 sessions.
What device do CoreBodyClinic use?
At core body clinics we only use the highest-grade medical shockwave therapy equipment. The devices used are the original Swiss made shockwave therapy machines as used in the NICE guideline recommendation trials.
We are also very proud to announce that both focused and radial shockwave therapy are available for use – one of only 6 clinics in the UK to offer this. The advantage of utilising both radial and focused shockwave therapy is that more energy can be used and therefore superior results achieved.
Resources for more information:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3844425/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4674007/
https://www.nice.org.uk/Guidance/IPG571
https://www.nice.org.uk/Guidance/IPG311
https://www.nice.org.uk/Guidance/IPG313
https://www.ncbi.nlm.nih.gov/pubmed/26612525
https://www.ncbi.nlm.nih.gov/pubmed/19088057