Shockwave therapy

What is shockwave therapy?

Shockwave therapy uses high energy sound waves, which pass through the skin to the affected area, increasing the blood flow to help accelerate the healing process.

Shockwave therapy, also called extracorporeal shockwave therapy (ESWT), is a treatment usually offered when symptoms have not responded to other treatments, such as physiotherapy, modifying daily activities, pain relief, and steroid injections.

A course of treatment normally requires one treatment session each week and treatment sessions should not be more than 2 weeks apart. The number of sessions will depend on the underlying problem and the progress made with treatment. Shockwave therapy is best used as part of a rehabilitation programme, including advice on activities and exercises, and other interventions that may be needed such as medicines for pain relief.

The National Institute for Health and Care Excellence (NICE) recommends that there are no major safety concerns but the evidence whether shockwave therapy is an effective treatment is limited in quality and quantity, and therefore does not recommend it as an evidence based therapy to be used as a routine treatment. Therefore the potential benefits of shockwave therapy need to be carefully considered for each person before treatment begins.

Although shockwave therapy is generally safe, it should be avoided for some people including those who:

• Are pregnant, or trying to conceive.

• Have received a steroid injection into the area to be treated within the previous 12 weeks.

• Have any increased risk of bleeding (haemorrhage), such as haemophilia.

• Have a heart pacemaker, any other heart device, or any unstable heart condition.

• Have a fracture, tumour or infection at the site of treatment.

• Currently have a thrombosis.

• Have epilepsy.

• Are taking certain type of antibiotics called fluoroquinolone antibiotics eg, ciprofloxacin.

• Have fragile bones, eg, osteogenesis Imperfecta.

• Have increased sensitivity or decreased sensation over the area to be treated.

Shockwave therapy can be effective for a wide range of problems, such as:

• Plantar fasciitis (heel pain).

• Patellar tendinitis (jumper‘s knee).

• Achilles tendinopathy.

• Tennis elbow.

• Greater trochanteric pain syndrome (lateral hip pain).

• Proximal hamstring tendinitis.

Each shockwave treatment takes around 10 minutes. A gel is applied to the skin over the area to be treated, and the shockwave therapy will then be delivered through a handheld probe. When the therapy is happening, you may feel a little discomfort, but it is not painful.

Potential side effects at the treated area include:

• Bruising.

• Pain.

• Local swelling.

• Skin reddening.

• Numbness or altered sensation.

These side effects should resolve within a week after the treatment. There is also a small risk of tendon rupture (such as rupture of the Achilles tendon) or ligament rupture and damage to the soft tissue.