Extracorporeal ShockWave Therapy (ESWT) is a procedure where shock waves are passed through the skin to the injured part of the body, using a special device. Extracorporeal means outside of the body. The shockwaves are mechanical and not electric. They are audible, low-energy sound waves, which work by increasing blood flow to the injured area. This speeds up your body’s healing process. You will usually require a course of three treatments, one to two weeks apart.
It is a minimally invasive treatment, which means that you can go home the same day. ESWT can offer relief from pain and other symptoms.
You will experience some pain/discomfort during the treatment, but you should be able to cope with this. Following the treatment, you may initially experience more pain, redness, bruising, swelling and numbness to the area. These side effects should resolve within a week, before your next treatment. There is a small risk of tendon rupture or ligament rupture and damage to the soft tissue, but studies have shown that five to seven out of ten patients have found it to be effective. You will be asked to complete a questionnaire before your treatment starts, after three months and again one year after your treatment.
We will not offer you Shockwave Therapy for Achilles tendinopathy or plantar fasciitis if you:
- are pregnant
- are taking antiplatelets excluding aspirin 75mgs (for example, clopidogrel) or anticoagulants (such as warfarin or rivaroxaban), were recently on ibuprofen, naproxen or other blood thinning anti inflammatory medicines
- have a blood clotting disorder
- are under the age of 18
- have been diagnosed with bone cancer
- have an infection in treated area of your body
- have a history of tendon or ligament rupture
- have had a steroid injection into the affected area in the previous 12 weeks
You will need to be available for the full course of treatment. You should not take any non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, for two weeks before your first procedure, and throughout your treatment. If you are unsure if any of your medicines contain NSAIDs then please check with your doctor, nurse or pharmacist. Wear comfortable clothing as you will be lying on your front for the treatment.
You will be asked to lie on your front with your legs supported by a pillow. The clinician will put some ultrasound gel on the injured area and then place the hand piece of the device on the gel. The ESWT is delivered using this hand piece – it delivers compressed air pulses through the ultrasound gel. Each treatment will take approximately five minutes.
Most patients do experience some pain or discomfort during the procedure. You will be asked how much pain you are experiencing during the treatment, and we will attempt to adjust the treatment to help manage this.
After the treatment you will be able to get up and walk straight away. If you do experience discomfort following the shockwave treatment you can take over the counter painkillers (such as paracetamol) but don’t take anti-inflammatory medication (such as ibuprofen) and ice therapy, as these can interfere with the body’s healing process.
You will be able to return to your usual activities straight away and can return to work immediately. However we advise you not to undertake any strenuous, pain-provoking activity or high-impact exercise for 48 hours following the procedure. If you experience a sudden onset of pain to the area or any loss of function, please contact your GP or go to your nearest Emergency Department (A&E).
We will propose combining this treatment with acupuncture and other physical therapy modalities depending on your condition and state of your injury.