WHAT IS SHOCK WAVE THERAPY?

Therapeutic shock waves were introduced as medical treatment for eliminating kidney stones 20 years ago.
During these treatments one of the side affects
noted was an accelerated tissue healing response in the area. This led to the development of radial shock wave
therapy.
The radial shock wave is generated using compressed air. This is used to drive a projectile in a cylinder, located
in the hand piece to a shock transmitter.
The pulses you can hear and feel spread into your underlying tissue to a depth of up to 6cm.
HOW DOES IT HELP ME?
There are several potential benefits using radial shock wave.
1) Pain reduction - by changing the way the nerves signal pain (interferes with the pain signals in a positive way).
2) Increased tissue healing - radial shock waves cause the release of chemicals in the cells which can reduce
inflammation and pain.
3) Improved blood flow - repeated shock waves create new blood flow promoting tissue healing and
regeneration.
4) Reduced muscle tone - shock waves act on trigger points. These are the painful tender spots in muscles which
often generate pain and dysfunction.
HOW MANY SESSIONS?
We recommend 6-8 sessions with approximately 4 days in between to see good benefits and results. Many
patients notice a difference after just one session.
DOES IT WORK FOR EVERYONE?
Quite simply, no. We find improvements in approximately 60-70% of patients, but still a percentage of people do
not respond. We will only offer this treatment
when other treatment avenues have been tried first. Most patients will still have a degree of "home work" to
continue with regards to stretching, self mobilisation
and strengthening which should be continued.
ARE THERE ANY SIDE EFFECTS?
Normally radial shock wave therapy is well tolerated and has few side effects. Bony areas can be reasonably
tender with the application of radial shock wave
therapy, but this stops as soon as treatment stops and we will try to take steps to make this comfortable. Other
side effects (which usually disappear after a
few days) include redness of the skin, slight swelling and discomfort over the treatment area.
If you have any other questions regarding radial shock wave therapy, please ask your physiotherapist or the
radial shock wave technician who will be pleased
to answer these for you.
HOW DOES SHOCKWAVE THERAPY WORK?
The basic principles behind shockwave therapy are the high pressured acoustic shockwaves that travel through
the skin to stimulate pain relief and tissue repair.
WHAT CONDITIONS DOES SHOCKWAVE THERAPY TREAT?
Shockwave Therapy has attracted several clinical research trials which have supported its use in the treatment of
patients with the following conditions:

Plantar Fasciitis/heel spur (calcaneal spur)

Achilles tendinopathy

Gluteal tendinopathy

Proximal hamstring tendinopathy

Calcific tendonitis of the shoulder

Patella tendinopathy

Tennis elbow (lateral epicondylitis)

Other forms of insertional tendinopathy

Other musculoskeletal problems:

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Muscle strains

Calcified Haematomas (corkies)

Shin splints

Osteitis pubis

Recalcitrant trigger points

Osgood Schlatter Disease

WHAT IS THE EVIDENCE?

There are a number of trials, including randomized controlled trials, which support the use of Shockwave
Therapy:

Rompe et al 2008, Eccentric Loading Compared with Shockwave treatment for Chronic Insertional
Achilles Tendinopathy, Journal of Bone and Joint Surgery (America) 2008; 90: 52-61

Han et al 2009, Effect of Extracorporeal Shockwave Therapy on Cultured Tenocytes, Foot and Ankle
International, 30: 93-98

Furia et al 2007, Extracorporeal Shockwave therapy in the treatment of chronic plantar fasciitis and
Achilles tendinopathy, Current Opinion in Orthopaedics 2007; 18: 101- 111

Rompe, JD; Radial Shockwave Therapy- Where do we stand today?; Translation from Medical Special,
Apr 2006

Contraindications (reasons why ESWT should NOT be used)

Coagulation disorders i.e. Hemophilia
Anticoagulant use i.e. Marcumar
Thrombosis
Tumor disease, Carcinomas
Pregnancy
Polyneuropathy
Acute inflammations
Growing children
Cortisone injections less than 6 weeks prior to first ESWT treatment
Potential Side Effects
Swelling
Reddening
Hematomas (bruising)

Petechiae
Pain
Skin lesions after previous cortisone therapy
Side effects last for approximately 3-7 days after treatment.
CAUTION: Only light activities and training should be performed immediately after treatment(s).