Extracorporeal shockwave therapy treats common MSK conditions such as Achilles tendonitis, plantar fasciitis, tennis elbow, and stress fractures. Additionally, there is substantial scientific evidence that shockwave therapy reduces pain. But what is shock wave therapy, and how does it work?
What is extracorporeal shockwave therapy?
It’s a simple pressure wave that creates a sudden change in pressure. There are various methods for producing a shockwave. For example, we create radial shock waves by using high-pressure air to force a collision between a ball bearing and a metal tip. This collision creates a sound wave that moves outwards. Alternatively, a focused shock wave produces a sound wave concentrated at a single point with increased energy. We don’t know whether a radial or a focused shock wave is better. However, we suspect that a focused shockwave may be more effective for deeper structures, such as the hamstring tendons.
What does shock wave therapy do?
Surprisingly, we don’t know exactly. However, we believe that shock wave pressures alter the properties of cells, thereby influencing healing and remodelling. Alternatively, we believe that sound waves stun the small nerves that transmit pain messages to the brain. Additionally, shock wave therapy may break up calcium deposits in tendons, thereby reducing pain.
Most people experience immediate pain relief after each session, but the most significant effects are typically felt after 3-5 sessions.
What conditions respond best to extracorporeal shockwave therapy?
Generally, we believe that certain musculoskeletal conditions respond more effectively to shockwave therapy than others.
Common conditions that have shown positive effects in studies on shockwave include Achilles tendonitis, hamstring tendonitis, tennis elbow, plantar fasciitis, shin splints, and stress fractures.
Recent evidence suggests a beneficial effect of shockwave therapy on lower limb tendons. We are unsure whether a radial or focused shockwave is better. However, we suspect that a focused shockwave is better for pathologies that require more energy, such as stress fractures or large, deeper tendons, such as the hamstring or hip tendons.
How long does the treatment take?
Generally, we suggest one session every seven days for up to 5 sessions. Each session directs about 3000 sound waves over 5-10 minutes.
If there is no response after five sessions, we recommend stopping this treatment.
Does shockwave therapy hurt?
Both focused and radial shockwaves are uncomfortable but should not be intensely painful. Power can be adjusted according to the level of pain associated with the procedure. However, we don’t suggest local anaesthetics for patients. Studies indicate that shock wave is more effective without local anaesthetic.
Do you need to modify exercise during shockwave therapy?
Generally no. You do not need to change or stop your exercise program during shockwave treatment. Results are better when shockwave therapy is combined with exercise. However, we advise against using anti-inflammatory medications such as ibuprofen tablets or ice packs, as we believe these treatments can counteract the positive effects of shockwave therapy.
Will private insurance cover the cost of shock wave therapy?
Yes, most insurance plans will cover the cost of a series of shockwave sessions in central London. However, please check with your insurance provider before starting treatment.
Other frequently asked questions about shockwave therapy?
What is the shockwave therapy recovery time?
It takes time to see the benefits of shockwave therapy. Generally, maximal benefit occurs 4-6 weeks after the last session.
Can shock wave therapy cause damage?
If used correctly at the proper settings, it is unlikely to cause damage. It is one of the reasons we use it for tendonitis, as the risks are lower than those associated with other interventions, such as tendon injections.
Shockwave treatment side effects: what are they?
Generally, shock wave therapy is well tolerated. However, possible side effects include increased pain and skin damage.
Does exercise therapy help improve the effects of shockwave?
Yes. Recent studies suggest that exercise can help improve the effects of shockwave therapy. For example, a recent paper reviewing the combination of exercise with shockwave therapy has found excellent results for Achilles tendonitis, tennis elbow, plantar fasciitis, and calcific rotator cuff tendonitis.
Final word from Sportdoctorlondon
Overall, shockwave therapy is an excellent addition to the treatment of tendonitis and stress fractures. In particular, shockwave therapy is helpful for plantar fasciitis, hamstring origin tendinopathy, and problematic tennis elbow. However, we don’t know whether a focused or radial shockwave is better.
On a torn shoulder tendon, that I have anterior and posterior, my second MRI in a year with no surgery shows that the tear is calcifying, so my question is is the calcium buildup superficial? Can it be scraped off upon surgery? And how typically do they repair this type of problem? I heard they can use tendons from a pig is that true? Do they use tendons from a cadaver also I would like to know!!!!
If the tendon needs repair, then it is easier enough to remove the calcification before repair. Surgeons can use cadaver tendons if needed.