What is Shockwave therapy or EWST?
Extracorporeal shockwave therapy is a non-invasive treatment that uses high energy sound waves to stimulate and accelerate the healing process and give pain relief to soft tissue conditions. Extracorporeal means 'outside the body' and refers to the way this therapy is applied.
Shockwave therapy is not only used in Physiotherapy clinics for musculoskeletal conditions but also in other areas of medicine such as urology, men's sexual health, dementia and sports medicine.
How does shockwave therapy work?
The shockwave machine passes short and intense sound waves (not an electrical pulse) through to the affected tissue. This activates an acute inflammatory reaction in the tissue which stimulates a healing response in the body. Evidence has shown this happens by triggering the body's anti-inflammatory response, increasing blood flow to the area and increasing cell metabolism, which leads to the break down of any scar tissue and tissue repair. It is an effective treatment to stimulate healing of a tissue that has not spontaneously healed or has failed to respond to conservative treatments.
How is shockwave therapy applied?
The practitioner will first apply some gel to the affected area. Shockwave therapy is then applied directly to the skin through a probe. The practitioner will ensure you are in a comfortable position throughout the duration of the treatment.
What conditions can be treated with shockwave therapy?
Shockwave therapy can be an effective treatment for the following conditions:
- Shoulder pain caused by tendinopathy or calcification
- Tennis or golfers elbow
- Tension headaches
- Chronic muscle pain
- Gluteal tendinopathy
- Hamstring or quadricep tendinopathy
- Knee pain due to patellar tendinopathy
- Achilles tendon pain
- Tibialis posterior tendinopathy
- Shin splints
- Heel pain
The National Institute for Health and Care Excellence (NICE) offers evidence based recommendations for NHS users and healthcare professionals on the treatment of musculoskeletal conditions. NICE guidelines support the use of shockwave therapy for plantar fasciitis, Achilles tendon pain, trochanteric pain syndrome, tennis elbow and calcific tendinopathy. You can read more about these recommendations and the NICE guidelines here.
Can anyone be treated?
This form of treatment is suitable for most people however, there are some exceptions where shockwave therapy cannot be applied such as, pregnant women, some pre-existing health conditions and people taking certain medications. Suitability for this treatment will always be discussed with your Physiotherapist.
How many sessions are needed?
The number of sessions needed will depend on several factors including how long the condition has been present, compliance to complimentary exercises, previous treatments tried and the individual's health. We recommend a minimum of three sessions initially to ensure any kind of marked improvement for symptoms that have been present for under a year. You may need more sessions if your symptoms have been present for a long time. It is recommended that treatment is carried out every 7 - 10 days. Studies show that the greatest amount of improvement is typically seen between 3 - 6 weeks.
Are there any side-effects?
Some people do experience some short-term side-effects which may include redness, soreness, numbness, swelling and petachiae (red spots) following treatment, however research reports that shockwave therapy is very safe and there are no long term side-effects.
This treatment is recognised and covered by all major private medical insurers including BUPA, AXA, AVIVA, Vitality, Cigna and WPA. Pre-authorisation will be needed prior to starting treatment.