Extracorporeal Shockwave Therapy (ESWT), although sounding like an experimental form of psychotherapy, is actually the new buzz treatment for those difficult-to-treat, painful overuse or sports injuries. Shockwave therapy has been around for a quarter of a century now, but was originally used for breaking up kidney stones, known as lithotripsy.
Shockwave therapy is used to treat many musculoskeletal injuries, and the most frequent area of use is the foot and leg. This is Performance Podiatry’s specialty.
Conditions treated include:
- Plantar Fasciitis, Heel pain or Arch Pain
- Achilles Tendinitis or Tendonosis
- Muscle Pain and Injury
- Joint Pain and Injury
- Neuroma and other Forefoot Pathology
- Knee or Patella Tendinitis
It also has a healing effect on bone and so has been used to treat stress fractures, avascular necrosis (dead bone) and slow-healing bone.
So, how well does Shockwave Therapy really work?
There have been numerous studies produced to quantify shockwave’s effectiveness, but variations in the studies (including area being treated, methods used, machine being used and sample of patients included in the study) have resulted in varying results.
The most commonly cited effectiveness in studies is approximately 80% but values range between 65-95%.
How quickly will I see results?
At Performance Podiatry Sydney we find that most patients get a small pain reduction and a greater range of movement immediately after the procedure. This is usually temporary and may be due to hyperstimulation of the tissues and a subsequent anaesthetising effect.
The real results begin after a few days where the injuries begin to heal. Depending on your condition, healing can take weeks to months to heal, however pain relief usually precedes full healing.
How does Shockwave Therapy work?
During Shockwave Therapy, a high intensity shockwave is produced and interacts with tissues of the body so that they can begin to heal. It is able to accomplish this even in chronic cases, where the body has previously showed an unwillingness to heal on its own. It is one of the very few modern technologies that assists with healing once and injury has reached this chronic (long-term) state.
Shockwave Therapy also seems to have a direct effect on nerves, resulting in reduced pain.
It works by the following physiologic processes:
- Increasing circulation
- Breaking down calcification deposits
- Stimulating fibroblast (soft tissue cells) production à healing ligaments, tendons, muscles etc.
- Stimulating osteoblast (bone cells) production à healing bone
- Stimulating the “gate-control” mechanism for pain relief
- Inhibiting Cox II Enzyme, producing an anti-inflammatory effect
What does a course of treatments involve?
A course of Shockwave Therapy usually consists of 3-5 weekly treatments. It is performed on the skin and does not require anaesthesia. The procedure provides some discomfort that quickly subsides once the treatment is finished.
Performance Podiatry Sydney considers Extracorporeal Shockwave Therapy to be a promising treatment for tendon and soft tissue injuries. The research is suggesting that ESWT improves treatment outcomes in Achilles Tendinopathy over and above exercise.
For this reason we have incorporated ESWT into our clinic and into our regular treatment plans.