Extracorporeal Shock Wave Therapy (ESWT)

ESWT has proven itself to be an extremely safe procedure. Other than the discomfort during the session, there are no long-term side effects. Rarely, do some individuals experience a temporary increase in pain which may be reduced by icing or the use of pain medications. Although ESWT may not be effective in some patients, it does not result in any worsening of a condition.

Unlike treatments such as cortisone injections, there is no restriction on the number of times the treatments can be carried out.

ESWT should not be used in areas of tumor, infection, and certain stages of pregnancy. Targeting of ESWT needs to be accurate, especially when close to areas such as the lung, the spine, and any large blood vessels, or complications could arise.

A non-invasive needle-free and drug-free solution for certain injuries.

Shock waves are acoustic pressure waves with unique waveform characteristics- a very rapid rise to the high magnitude and a very rapid fall time, which may result in a temporary vacuum or “cavitation” in the tissues. These waves are generated in the ESWT device and are focused by an acoustic lens at the target area in the body. Research has shown that such waves have biological effects including:

  • Release of certain growth factors in the targeted tissues, which may lead to the formation of new vessels (angiogenesis) and other biological effects associated with tissue healing. This effect occurs over a period of several months and is responsible for facilitating regeneration and repair in certain chronically injured or degenerated tissues.

  • Effects on nerves carrying pain signals, which may result in pain reduction.

  • Interruption of “pain-spasm” cycles occurs in many chronic pain situations.

  • Shoulder:

    Chronic Tendinosis

    Calcification of Rotator Cuff

    Elbow:

    Tennis Elbow/ Golfers Elbow

    Wrist/Hand:

    Tendinitis

    Hip:

    Tendinitis

    Ischial Bursitis

    Knee:

    Jumper’s Knee, ITB

    Syndrome/Tendinitis

    Shin:

    Shin splints

    Stress Fractures

    Ankle/Foot:

    Achilles Tendonitis, Heel Spur, Plantar Fasciitis

    In addition, ESWT has also been used to assist bone healing in a nonunion or delayed union of fractures. More recently, it has been used also in myofascial trigger point treatment for pain management.

  • An ESWT session usually takes 15-20 minutes per site. The injured area is first identified and then precisely targeted by the ESWT device, sometimes by means of real-time ultrasound. Shockwaves are delivered in rapid succession, ramping up from low levels to therapeutic levels. In most cases, 1000-3000 shocks will be used per session.

    Usually, no local anesthetic is given as some studies have indicated that this may be associated with poorer success rates. Treatment may be uncomfortable or slightly painful (usually a “hammering” feeling). Discomfort or pain is temporary and generally tolerable.

  • For most conditions, 3-6 sessions would be recommended. The interval between sessions may vary from 1-3 weeks.

Treatment by ESWT has the following advantages:

1. Totally noninvasive

2. Risk-free

3. Quick outpatient procedure

4. Drug-free

5. Precise targeting when used with ultrasound.

6. No long-term risk or damage, even with repeated sessions.