Shockwave therapy is a non-invasive medical procedure that utilizes high-energy acoustic waves to promote regeneration and repair in musculoskeletal tissues. These pressure waves trigger mechanotransduction, a cellular response that translates the mechanical stimulus into biochemical signals. This process encourages the formation of new blood vessels and stimulates the body’s natural healing mechanisms. Understanding the operational steps and necessary precautions is essential for ensuring safe and effective application.
Preparing for the Session and Patient Safety
Before initiating treatment, review patient safety and machine readiness. The treatment area must be precisely identified, often through physical palpation, to ensure acoustic waves are directed to the specific source of pain or injury. Proper skin preparation involves cleaning the site to remove lotions, oils, or residue that could interfere with acoustic transmission.
The appropriate applicator head, known as the transmitter, is selected based on the depth of the target tissue. For superficial conditions, a radial or broad-focused transmitter is often used. Deeper structures require a focused shockwave applicator to concentrate the energy at a specific depth. Screening for absolute contraindications is necessary before proceeding with therapy.
Patients who are pregnant should not receive treatment. Therapy must be avoided over areas near a pacemaker, known tumors, the head, spine, or air-filled tissues like the lungs or intestines. Caution is necessary for individuals with blood clotting disorders or those taking anticoagulant medications, as therapy increases the risk of bruising or hematoma formation. Treatment is generally deferred for six weeks following a corticosteroid injection in the target area to allow the body’s natural healing response to function optimally.
Step-by-Step Machine Operation
Once safety checks are confirmed, power on the machine and allow the system to complete its internal diagnostic checks. Apply the acoustically conductive coupling gel generously to the skin over the treatment zone. This gel acts as an interface, eliminating air pockets between the skin and the applicator to ensure efficient transfer of acoustic energy into the tissue.
Configure initial parameter settings on the device console, starting with the frequency (typically 1 to 15 Hz) and the intensity. Intensity is measured as energy flux density (mJ/mm²) for focused waves or pressure (Bar) for radial waves. Start treatment at the lowest clinically appropriate energy level (often 1.5 to 2.0 Bar for radial devices) to gauge patient tolerance. Intensity should be gradually increased only as the patient confirms the treatment remains tolerable, a process known as bio-feedback.
The application technique requires maintaining the handpiece perpendicular to the skin surface, ensuring consistent and full contact throughout the session. Activate the device and begin moving the applicator slowly and steadily over the designated treatment area. This slow movement ensures acoustic energy is distributed across the entire injured site, maximizing the therapeutic effect.
Patient feedback is constant during the procedure; if pain increases sharply, immediately reduce the energy level. A typical session involves delivering 1000 to 4000 impulses, depending on the machine, the condition, and the energy level used. Monitor the pulse count carefully to prevent over-treating the area, as excessive energy can lead to adverse tissue reactions.
Post-Treatment Care and Device Maintenance
After the final impulse is delivered, instruct the patient on proper aftercare to maximize therapeutic benefits. Temporary sensations such as mild soreness, achiness, or slight redness are normal and typically resolve within 48 to 72 hours. Patients should avoid strenuous physical activity that heavily loads the treated area for at least 48 hours, allowing the stimulated healing processes to begin undisturbed.
Hydration is encouraged post-treatment. Patients should strictly avoid anti-inflammatory medications, such as Ibuprofen or Naproxen, for at least two days. These drugs interfere with the beneficial inflammatory response that shockwave therapy is designed to elicit for tissue repair. Over-the-counter analgesics like acetaminophen are acceptable for managing temporary discomfort.
Device maintenance begins with the immediate removal of all coupling gel from the applicator and handpiece, as residual gel can harden and damage components. Wipe down the exterior of the handpiece and the main console daily with a mild, non-abrasive disinfectant solution. Thoroughly clean the transmitter heads after each use, often requiring disassembly for cleaning with running water or an alcohol-based wipe to ensure consistent energy output. Proper storage in a protective case, away from extreme temperatures, preserves the machine’s longevity until the next treatment session, which is usually scheduled one to two weeks later.