Shockwave Therapy (SWT)
Also known as Extracorproreal Shockwave Therapy (ESWT)
Shockwave therapy involves the use of a machine to deliver energy pulses generated by compressed air that is converted into acoustic energy, delivering a 'shockwave' at the point of contact. The intensity of treatment is adapted by the Physiotherapist according to the individual and condition being treated.
Triggers a pro-inflammatory response (this is how tissue heals)
Increases blood-flow, leading to tissue healing and regeneration
Common conditions treated with SWT
Who should have SWT?
If you have long-standing tendon pain, or are considering a steroid injection for a chronic tendinopathy, it is worth discussing the option of SWT first. SWT works best on chronic tendinopathy conditions - particularly those that have failed other conservative management. Evidence shows that it works best when used in conjunction with a strengthening/loading programme alongside usual Physiotherapy. Interestingly, recent studies promote the use of SWT for long-term recovery when compared with injection therapy.
What does SWT involve?
The procedure is performed by the Physiotherapist and will be adapted to suit your particular condition. Firstly, ultrasound gel is applied to the treatment area (this ensures good conduction of the shockwave). A small hand-held device is used to deliver the treatment to the symptomatic area. Treatment will usually last less than 5 minutes. Following the assessment of your condition, the Physiotherapist will give you an idea as to how many sessions may be required. This is usually between 3-6 spaced a week to 10 days apart.
Is it safe?
SWT is considered a safe, non-invasive treatment option. Possible minor after-effects include, transient pain, mild bruising, redness, numbness and swelling in the treated area. There is a small risk of tissue rupture, however the Physiotherapist will assess your suitability for SWT in your initial assessment. If the risk is too great, an alternative treatment will be offered.
Does it hurt?
Some discomfort may be experienced. The Physiotherapist can adapt the treatment dose if it is too uncomfortable. Most people find it is perfectly tolerable for the short duration of the treatment.
What happens after the treatment?
You can return to normal daily activities straight away, but should refrain from strenuous or impact activity for 48 hours. It is normal to feel a reduction in your symptoms soon after treatment, but if any discomfort occurs do not take anti-inflammatories (such as ibuprofen) or use ice as these may interfere with the natural inflammatory response. Paracetamol may be taken if needed and if you are medically able to do so.
Can anyone have SWT?
As with many treatments, there are certain contraindications. The full list will be discussed with you prior to considering SWT. Most notably, those that have had a steroid injection should wait 12 weeks until considering SWT. Also, those with blood clotting disorders, people taking anticoagulant medication and those with a history of tendon/fascia rupture would benefit from other physiotherapy techniques.