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Extracorporeal Shockwave Therapy (ESWT/Shockwave)

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For more info see our dedicated site


WHAT IS SHOCKWAVE?
 

Shockwave therapy is a non-invasive administration of high-intensity sound waves. Also known as Extracorporeal shockwave therapy (or ESWT)

 A shockwave is a form of acoustic energy and although often likened to  ultrasound the two waveforms are very different. From a physics perspective a  shockwave is defined as an acoustic wave with a high positive peak pressure, a  fast rise time and a period of negative pressure all within a very short time  period.  

WHAT CAN IT HELP?
Shockwave can help with many chronic conditions arising from overuse, those that are so often difficult to treat with other methods . Typically it is used for tendinopathy ( for example tennis or golfers elbow, biceps tendonitis, plantar fasciitis and heel pain).  It may also help with myofascial pain syndromes, intractable trigger points and chronic muscle pain.

DOES IT WORK?
The reported rate of clinical success is between 75 and 91 percent worldwide for most conditions, however some respond better than others (e.g. plantar fasciitis and heel spurs). During our assessment, we will also look to identify and address any underlying contributing causes of the problem to prevent a recurrence, if possible. Treatment is cumulative and results are often felt after 3 to 5 sessions, with most benefits usually seen four to six weeks following care.

ARE ALL SHOCKWAVE UNITS THE SAME?

What makes the DolorClast® Radial Shock Waves so unique?
Bench studies1 demonstrate that the DolorClast® Radial Shock Waves delivers up to 200% more energy density than competing devices at frequencies of 15 Hz and above and maximum pressure.
There are other shockwave units on the market that deliver less energy. Treatment often takes 8-10 sessions with other units, but the higher energy delivered by our device means shorter treatment times.

WHAT ARE THE ADVANTAGES? 
Shockwave therapy is a non-invasive treatment  with very few side effects or complications:

  • A safe procedure, confirmed by NICE* guidelines
  • Strong clinical results/evidence-based*
  • May prevent a need to have surgery
  • No need for anaesthesia
  • Short treatment sessions lasting just 10-20 minutes
* National Institute of Clinical Excellence (NICE) Guidelines IPG376 (Greater trochanteric pain syndrome),  IPG312 and IPG571 (Achilles tendinopathy), IPG311 (plantar fascitis), IPG21 (calcific tendonitis) and PG313 (tennis elbow )

WHAT ARE THE RISKS? 
There are very few disadvantages or side effects to treatment, however some of these may include:

  • Discomfort during treatment, (however, the intensity  is moderated for each client to their individual tolerance).
  • Pain or discomfort for a few days following treatment due to the body’s inflammatory response.
  • Treatment may not always be successful, and in this case surgery or referral may be an option. Despite a very good success rate with shockwave, we cannot guarantee results.


WHEN IS IT NOT SUITABLE?
Treatment is  suitable for the majority of people, but not if any of the following apply:

  • If you are pregnant
  • If you have a tumour (at/near the site of treatment)
  • If you have an infection at the site of treatment
  • If you are taking anticoagulants ("blood thinner")
  • If you have a pacemaker fitted
  • If you have had recent steroid injection (within the last 8 weeks)
  • If you are  under 18 years of age (With the exception of treating Osgood-Schlatters)

HOW LONG WILL IT TAKE?
​Typically, shorter term injuries will require around 3 applications, whereas long term, difficult to shift conditions may require 5 or 6 sessions. Each application last just a few minutes.


FOR THE SCIENCE GEEKS

How Does Shockwave Work?
The mechanisms behind the treatment success of shockwave therapy, particularly for tendinopathy, are not yet fully understood. However the current evidence base suggests interplay between mechanical, bio-chemical and pain relief mechanisms. The mechanical effects are most likely created through cavitation phenomenon. The subsequent cell membrane vibrations that ensue are a result of mechanotransduction.

Mechanotransduction causes the following cellular responses:
• Significantly increased prevalence of vascular endothelial growth factor, endothelial nitric oxide synthase and proliferating cell nuclear antigen. Therefore SWT induces angiogenesis.
• Immediate elevation of Interleukin-6 and Interleukin-8. A five-fold increase in matrix metalloproteinase-2 and 5. All of these substances are closely linked with tendon homeostasis, fibroblast activity and pathological tissue destruction. It is subsequently postulated there is a pro-inflammatory action of SWT.
• Positive effects on bone health through the reduction of osteoclast activity and the stimulation of osteoblast activity.
• Immediate pain relief through hyper-stimulation mechanisms, reduction in substance-P and reduced calcitonin gene-related peptide. Also termed as regulating neurogenic inflammation.
• Long-term pain relief through the selective destruction of unmyelinated nerve fibres.


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