So, what is shockwave therapy?
Shockwave therapy (extracorporeal shockwave therapy, ESWT) is a non-surgical treatment clinically proven to treat a range of conditions such as:
- Plantar fasciitis
- Achilles tendinopathy
- Patellar tendinopathy
- Greater trochanteric pain syndrome
- Proximal hamstring tendinopathy
- Tennis elbow
- Golfers elbow
- Rotator cuff tendinopathy
Although these are the most common conditions that shockwave therapy is used, the treatment can also be used for muscular pain and a wider array of indications.
How does shockwave therapy work?
Shockwave therapy involves using a medical device to pass high-energy soundwaves to the target tissue. The soundwaves can either be electrically produced or by a projectile inside the hand-held device. As the shockwaves enter the body, an inflammatory-like response is initiated in the injured tissue. This promotes healing by increasing blood circulation, stimulating the body’s natural healing process.
What are the therapeutic effects of shockwave therapy?
Here comes the science bit (if you’re interested).
The effects of shockwave therapy on the musculoskeletal for pain relief and healing are based on shot cellular and molecular mechanisms. Scientists fully recognise the valuable effects of shockwave treatments and how they trigger direct action adequately. More of the physical principles can be summarised here.
One of the central messenger substances that is released is known as Substance P, which is a growth factor and pain moderator. The discharge of such a substance produces an analgesic effect whilst amplifying the blood vessels, boosting blood circulation and contributing to the design of new bone tissue. In essence, we know that when treating an area of pain, shockwaves directly speed up the repair process.
By committing to the release of free radicals, shockwave treatments help to enhance our endogenous cellular defense mechanisms to protect us from disease. The body’s signal and modulator modules play a crucial role in the activation of these cells.
By suppressing inflammatory mediators such as Cyclooxygenase-2 (COX II), shockwaves create an anti-inflammatory reaction, which decreases any inflammatory process. In short, it is an important stimulant during the healing process.
Studies carried out by scientists have also shown that shockwaves act in another unique way – hyper stimulating the nerve fibres, this blocks any escalation in pain stimulation and therefore strengthens the analgesic effect (also known as Gate Control Theory).
Why should I have this treatment compared to standard physiotherapy?
The good thing here is that shockwave therapy can be a great addition to standard care. Core treatments (such as exercise therapy, load management, and education) can be perfectly complemented by shockwave therapy. When you receive shockwave therapy, it is recommended to have sessions in 1-2 week intervals. These sessions can be worked around your current exercise programmes and physical activity. Both exercise and shockwave come together to elicit the perfect environment for recovery.
Who shouldn't have shockwave therapy?
Shockwave therapy is a very safe treatment. However, we will always screen for patients just in case this therapy is not for you. Just like any treatment, there are some which it is not safe for.
- Absolute contraindications
- malignant tumour in the treatment area
- fetus in the treatment area
- Relative contraindications
- growth plates in the treatment area
- brain or spine in the treatment area
- severe blood clotting disorders (coagulopathy)
Physiotherapists are well-placed to deliver shockwave therapy to patients seeking it. Bradley Rugg has extensive training in shockwave therapy and attends national training courses and conferences. He offers his shockwave practice in Harrow and across north-west London. Bradley offers one-off sessions, as well as 3 and 6-session packages. Private medical insurance providers also typically covers shockwave therapy in their policies.
Click here to see Bradley’s shockwave services.
Click here to see Bradley’s shockwave prices.