What is ESWT?
Extracorporeal Shock Wave Therapy, or ESWT, is a non-invasive method of treating certain soft tissue injuries. It has been used in Germany and other parts of the world since the early 1990s. ESWT evolved from Extracorporeal Shock Wave Lithotripsy (ESWL), where shock waves are used to break down kidney stones. In ESWT, lower energy levels are used in Sports Medicine and Orthopaedic conditions to trigger an individual’s own repair mechanisms.
The most common indication for ESWT is plantar fasciitis (heel spur). Other indications include tennis elbow and golfer’s elbow, patellar tendinitis (jumper’s knee), supraspinatus tendinitis (occurring in the shoulder), and Achilles tendon enthesopathy (pain where the Achilles tendon attaches to the back of the heel).
What is a ‘Shock Wave’?
A ‘Shock wave’ is a pulsed acoustic wave that delivers a sudden high pressure to a targeted area, followed by a negative pressure. ‘Extracorporeal’ means that the shock wave is delivered from outside the body.
How do Shock Waves Heal an Injury?
Based on current knowledge, it is thought that the shock waves:
- Over-stimulate pain transmission nerves. This leads to an immediate reduction in pain and sensitivity.
- Trigger the body’s repair mechanism. One of the manifestations of this is the gradual formation of new blood vessels in the targeted area. As a result, the recovery and pain relief is felt progressively by patients over the next 3 to 6 months.
What does the Treatment Involve?
The course of treatment involves 3-5 sessions that are spaced I week apart. Before each session, avoid heavy meals (light meals are fine). Wear clothes that will allow the injured area to be exposed easily. Inform your doctor of your medical conditions or pregnancy.
During each session, you will be positioned comfortably on an examination table. About 2000 shock waves will then be ‘fired’ over a ‘tapping’ sensation accompanying each shock wave.
You can resume your normal daily activities immediately after each treatment. Aggravating activities (e.g. running in the case of heel spurs) should be avoided until a week or more after the second ESWT session.
Are there any Adverse Effects?
The shock waves may be painful but, on the whole, it is tolerable. energy levels of the shock waves are usually increased progressively and adjusted to the individual’s pain tolerance levels. Rarely, minor bruising may develop, but this is transient and harmless.
Is this treatment new?
ESWT has been successfully utilised in the high profile sporting world for many years. Physicians at Olympic Park and the ATP Tennis Tournament use ESWT regularly in the management of player injures.
The key advantages are:
- no anaesthesia required
- no injections
- no surgery and
- no negative side effects
Osteopaths can treat many other problems by using ECSW – Shockwave Therapy
Randomised Clinical Trials (RCT) have been proven and documented for treating the following complaints with a success rate of 70% – 80%
- 1. Epicondylitis Humeri Radials
- Painful inflammation of the tendon attachment on the medial elbow
- 2. Tendinosis Calcarea
- Painful limitation of shoulder movement due to calcification
- 3. Epicondylitis Humeri Ulnaris
- Painful inflammation of the tendon attachment on the lateral elbow (golfer’s elbow)
- 4. Bursitis Trochanterica
- Painful periostitis of the outer femur
- 5. Patela Tip Syndromer
- Inflammation of the point of attachment of the patellar ligament
- 6. Tibialis Anterior Syndrome
- Inflammation of the tibial edge due to excessive strain
- 7. Achillodynia
- Painful irritation of the Achilles tendon
- 8. Fasciitis Plantaris
- Painful, mostly chronic inflammation of the plantar fascia
- 9. Chronic Enthesopathies
- Painful irritation of tendon attachments due to overexertion or improper strain, or due to degenerative processes
- 10. Acupuncture Points
- Pain therapy via treatment of acupuncture points
- 11. Painful Trigger Points
- Acute and chronic pain in the back, shoulder, neck, etc. due to permanently shortened and thickened muscles