What is Extracorporeal Shockwave Therapy (ESWT)?
In 1997 EMS, patented the first extracorporeal shockwave machine, Swiss Doloclast for the treatment of kidney stones, called Lithotripsy. It was also found to be helpful in treatment of orthopaedic and sports medicine conditions, particularly chronic conditions such as plantar fasciitis and achilles tendonitis. Success in treating these conditions meant that surgical options were avoided.
EMS continued to develop ESWT and produced the current Radial Swiss Dolorclast machine. It delivers high pressurised, low frequency acoustic kinetic energy from a handpiece in a short period of time and is converted into a radial shockwave which travels through gel into tissues, stimulating pain relief and tissue repair. The radial shockwave produces a compressive and tensile phase which creates cavitation bubbles. The cavitation bubbles creates metabolic tissue reactions including the production of substance P. The more energy delivered into the tissues the better the therapeutic outcome.
The Benefits of Shockwave Therapy include:
- Reduced pain and inflammation with depletion of substance P, so neurogenic inflammation declines
- Increased blood flow with the proliferation of new blood vessels – useful in chronic conditions which persist despite physical interventions
- Stimulating the healing process – triggered by Stem Cells
- Proliferation of cells (e.g. tenocytes) in collagen tissue (collagen synthesis) – so creating repair of chronic tendinopathy conditions e.g. achilles tendinopathy and posterior tibialis tendinopathy with improved tendon gliding and tendon re-modelling
- Is non-invasive compared to surgery or injections and is given without anaesthetic
- Dissolves calcium build up
- Only requires 3-4 treatments on average
- New bone formation with the proliferation of osteoblasts
- Relaxation of spastic muscles
Conditions which are treated by ESWT: Shockwave therapy is used to treat superficial musculoskeletal conditions – subacute and chronic affected muscles, tendons, tendon insertions, fascial conditions including:
- Tendinopathies – achilles tendinopathy, de Quervains, dupuytrens contracture, gluteal tendinopathy, tibialis posterior tendinopathy
- Fasciopathies – plantar fasciitis/heel spur/calcaneal spur, iliotibial band runner’s knee
- Myotendinous tears – shoulder rotator cuff injuries, proximal hamstring tendinopathy, quadriceps jumper’s knee, pes anserinus insertion strains
- Muscle strains – hypertonic/spastic muscle tissue, shin splints, calcified haematomas “corkies”
- Shoulder Rotator cuff tendinopathies/impingement, calcific tendinopathy
- Patella tendinopathies
- Back pain
- Tennis elbow (lateral epicondylitis) and golfer’s elbow
- Osteitis pubis
- Trigger points
- Tendon insertion problems – calcaneal/Haglunds, Osgood Schlatter’s Disease
- Sever’s Disease – shockwave therapy can help with bone regeneration at the growth plate achilles tendon junction, with results of 80-90% improvement over 3 treatments
- Osteoarthritic knees
Shockwave therapy is used in conjunction with other physiotherapy management for tendinopathies, fasciopathies and may include:
- Home exercise programs to load the tissue so it can sustain the forces of activities of daily life and sport
- Taping
- Acupuncture/dry needling
