Shockwave Therapy
Extracorporeal Shockwave Therapy (ESWT) FOR TENDONITIS, SPURS, CALCIFICATION and more…
- Unique, non-invasive solution for pain associated with the musculoskeletal system
- Just three to five treatments needed at weekly intervals* (for many conditions)
- A therapy session only takes about 10 minutes
- Shockwaves are characterized by a jump change in pressure, a high amplitude and non-periodicity.
- The kinetic energy of the projectile, created by compressed air, is transferred to the transmitter at the end of the applicator.
MOST COMMON INDICATIONS
- Painful shoulder (Calcification, tendonitis, impingement syndrome)shockwave
- Exostoses of small hand joints in case of grade 1 arthrosis
- Tennis elbow, Epicondylitis humeri radialis/ulnaris
- Bursitis trochanterica
- Pain in the groin area
- Pain in the hamstring insertions
- Achillodynia
- Heel spur, Calcar calcanei
- Plantar fasciitis
- Tibialis anterior syndrome
- Jumper’s knee, Patella tip syndrome
- Pain in palmar side of the wrist
- Trigger points
- Chronic enthesopathies
- Diabetic ulcers, lesions, skin conditions (non-healing), burns
HOW DOES SHOCKWAVE WORK?
A shockwave is an acoustic wave which carries high energy to painful spots and fibrous or myoskeletal tissues with subacute, subchronic and chronic conditions.
This energy promotes healing, regenerating and reparative processes of the tendons and soft tissue.
During Radial Extracorporeal Shock Wave Therapy, a high-intensity sound wave is transmitted from a probe through the skin where it interacts with the tissues of the body. This leads to a cascade of beneficial effects such as increased blood flow and metabolic activity to the area, reversal of chronic inflammation, stimulation of collagen and dissolution of calcium build-up. Stimulation of these biological mechanisms creates an optimal healing environment. As the injured area is returned to normal, functionality is restored and pain is relieved. (see below)
This form of treatment was developed from other medical indications such as treating kidney stones and is widely used in Europe and North America for treatment soft tissue conditions such as Plantar Fasciitis and Achilles Tendonitis. There are numerous published scientific studies, which you are free to request, the majority of which demonstrate positive outcomes. Most importantly it has been demonstrated as a safe treatment option.
Clinical studies report success rate above 75%.
The Beneficial Effects Of Extracorporeal Shock Wave Therapy Are Widely Known.
Scientists Recognize That Shock Waves Can Trigger a Variety of Effective Actions :
- INHIBITS SUBSTANCE P – One of the bodies messenger substances is substance P, a pain mediator and growth factor. On the one hand, the inhibition of the release of substance P by shockwaves has an analgesic effect. Its secondary effect is to dilate the blood vessels and stimulate blood circulation as well as contributing to the formation of new bone tissue. NO (nitric oxide) also has a vasodilatory effect and plays an important role in angiogenesis (Formation of new blood vessels)
- INHIBITS THE COX II ENZYME – By inhibiting inflammatory mediators such as COX II, shockwaves produce an anti-inflammatory effect. This weakens any inflammatory process.
- ACTIVATES CELLULAR DEFENSES – By contributing to the release of free radicals, shockwaves help strengthen the body’s endogenous cellular defence mechanisms to protect it from disease.
- HYPERSTIMULATES NERVE FIBRES – Scientific studies also show that shockwaves act in another way. Overstimulating the nerve fibres blocks an increase in pain stimuli and therefore intensifies the analgesic effect (Gate Control Theory)
In short, when applied where pain occurs, we know why shockwaves produce an analgesic effect, increase blood circulation and to facilitate the repair process.
As well as:
- Metabolism is increased at the application site
- Irritating calcium deposits in and around tendons are reabsorbed
- Fibres are separated to allow for more efficient blood flow and Range of Motion.
- Inflammatory activity and its consequences are reduced
- Tenderness is reduced
- Mechanical loading is increased
After the treatment
You may feel some soreness which can intensify on the night of treatment however this is not common. Simple pain relief and icing may be required to control this pain. There may also be some minor bruising in the treatment area however this also is rare.
About the treatment
After a simple examination of the affected area, shock waves are applied via a hand piece or applicator held against the skin. The initial phase of treatment may cause some deep pain however this indicates correct targeting of the problem area.
This is usually followed by numbness or heaviness in the area and the latter phase of the treatment feels less painful. The treatment sessions are of 10 minutes duration during which you may receive up to 3000 pulses. Many patients get pain relief in just 8-10 days after the first treatment. Depending on the condition and your response you may require from 3 to 10 treatments, although the average is 5.
Side Effects
Post-treatment pain as above. Local bruising, uncommon and minor.
Contraindications
Please inform your Physio if you have a one of the following contra-indications as this form of treatment may not be appropriate for you.
- Pregnancy
- Bleeding and blood coagulation disorders and associated medication consumption.
- Skin wound or acute inflammation in treatment area.
- Tumour in treatment area.
MEDICAL EFFECTS
Analgesic Effect, Elimination of Pain
- Decrease of muscle tension, Inhibition of spasms
- Enhanced dispersion of substance P
Acceleration of Healing
- Increase of collagen production
- Improved metabolism and microcirculation
Mobility Restoration
- Dissolving of calcified fibroblasts
STUDIES / PUBLICATIONS on PLANTAR FASCIITIS (complete list of PAPERS AT ismst.com)
There are more than 100 treatment reports and clinical studies about the treatment available. The following selection of studies were published in acknowledged scientific journals treating Plantar Fasciitis.
Dr. H. Lohrer, Achillodynia and patellar tendinitis, results of the treatment of chronic cases with radial shockwaves. Journal Sportverletzung, Sportschaden No. 16, October 2002.
Dr. P. Magosch, ATOS Clinic Heidelberg (Germany). Radial Shockwave Therapy in Calcific Tendinitis of the Rotator Cuff. 2003
Prof. Dr. Rompe, OrthoTrauma Clinic, Grunstadt. Achillodynia, Results of a comparison study! Orthopadie Report, October 2006.
Dr. L. Gerdesmeyer / Dr. L. Scott Weil et al. Summary of Clinical Study Results / FDA, PMA Approval,
Treatment of painful heel, May 2007
SCIENTIFIC BOOK PUBLICATIONS
Dr. Maier / Gillesberger, Abstractbook, Shockwave foundations 2003, ISBN 3-8330-0423-1
Dr. L. Gerdesmeyer, ExtrakorporaleStosswellentherapie, 2004, ISBN 3-8334-1088-4
Dr. Herisson, Ondes de choc extra-corporelles en medicieorthopedique, 2004, ISBN 2-84023-365-7
Dr. L. Gerdesmeyer / Dr. L. Scott Weil, Extracorporeal Shockwave Therapy, 2007, ISBN 978-1-57400-115-0
Conclusion
The results of the clinical studies provide reasonable assurance that the ESWT is safe and effective when used in accordance with the device labelling. The results of the multi-center, randomized, placebo-controlled, double-blinded clinical study demonstrate that treatment with the ESWT provides significant pain relief to patients with symptoms of proximal plantar fasciitis of at least 6 months duration who had failed previously.
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