Shockwave therapy is a non-invasive treatment used across various medical disciplines, particularly for musculoskeletal conditions. This approach applies acoustic waves to affected areas, offering a non-surgical option for individuals seeking relief from persistent pain and impaired function. It promotes the body’s natural healing processes.
Understanding Shockwave Therapy
Shockwave therapy uses acoustic waves with a rapid rise to high peak pressure, followed by a tensile wave. These waves carry energy that propagates through tissues, inducing biological responses. They are generated using electrohydraulic, electromagnetic, and piezoelectric systems.
There are two primary forms: focused shockwave therapy (FSWT) and radial shockwave therapy (RSWT). FSWT generates acoustic waves that converge at a specific depth, allowing precise targeting of deeper tissues, up to 12 cm. This method is used for acute cases or deep-seated issues like calcific tendinopathies.
RSWT produces acoustic waves that spread radially, covering a broader, more superficial area, reaching depths of 3-4 cm. This makes RSWT suitable for widespread or surface-level conditions and soft tissue issues. Both therapies stimulate blood flow, promote cell regeneration, and reduce pain through mechanisms like growth factor release and calcification breakdown.
Conditions Treated with Shockwave Therapy
Shockwave therapy is commonly applied to a range of musculoskeletal conditions, stimulating healing and reducing pain.
For plantar fasciitis, an inflammation of the tissue connecting the heel bone to the toes, shockwave therapy delivers acoustic pulses that create microtrauma. This promotes blood circulation and activates natural healing, leading to reduced inflammation and enhanced collagen synthesis, which helps decrease the thickness of the plantar fascia.
Achilles tendinopathy, characterized by pain and stiffness in the Achilles tendon, also benefits. The treatment increases blood flow and stimulates growth factor release, accelerating the tendon’s natural healing. This improves revascularization and reduces pain by overstimulating pain-transmitting nerves.
For tennis elbow (lateral epicondylitis), shockwave therapy delivers high-energy sound waves to affected tendons, promoting blood flow and stimulating collagen production for tissue repair. It also helps break down scar tissue and calcium deposits, reducing pain signals. The therapy alleviates pain and functional impairment, such as grip strength loss.
Calcific shoulder tendinopathy, involving calcium deposits within the rotator cuff tendons, is another treated condition. Acoustic waves help break down these calcium buildups, allowing for their natural removal. This process reduces inflammation, increases blood flow, and stimulates cell regeneration, leading to pain relief and improved shoulder function.
Shockwave therapy also treats non-union fractures, where a broken bone fails to heal. The mechanical energy from the shockwaves causes microfractures in old callus, stimulating bioactive factors and new blood vessel formation. This reactivates the body’s natural healing, balancing osteoblast and osteoclast activities to accelerate bone healing.
Administering Shockwave Therapy
Administering shockwave therapy involves specific protocols and patient considerations for effective and safe treatment. Treatment protocols vary depending on the condition and patient, but generally involve multiple sessions. For example, 3 to 6 weekly sessions are suggested for plantar fasciitis, and 3 treatments, 1 to 2 weeks apart, are common for Achilles tendinopathy. Impulses per session typically range from 800 to 3,000, with frequencies between 8 Hz and 15 Hz. Intensity levels can also vary, with higher energy levels sometimes used for bone disorders and calcific tendinopathy, while lower to medium energy levels may be preferred for tendinopathies.
Patient selection involves a thorough assessment by a healthcare professional, including an analysis of the patient’s condition and medical history. Shockwave therapy is for patients whose conditions have not responded adequately to other conservative treatments, such as physical therapy or medication.
Specific contraindications for shockwave therapy include:
- Pregnancy, due to unknown effects on the fetus.
- Presence of pacemakers, as shockwaves may interfere with their function.
- Bleeding disorders or taking anticoagulant medication, due to increased risk of bleeding or hematoma.
- Active infections, malignant tumors at the treatment site, and acute inflammation.
- Treatment over air-filled areas like the lungs or intestines.
- Corticosteroid injections in the treatment area within the previous six weeks.
During a session, a conductive gel is applied to the treatment area, and a handheld applicator delivers the shockwaves to the skin. Sessions are brief, lasting 4 to 18 minutes. Patients may experience mild discomfort or pain, which is often manageable.
Temporary side effects can include redness, swelling, bruising, or numbness in the treated area. These side effects are generally minor and resolve within a few days to a week. Patients are usually able to return to daily activities immediately after a session, though strenuous activities may need to be avoided for 48 hours. Avoid anti-inflammatory medications and ice packs on the treated area immediately after therapy, as these can hinder healing.