Published on: 16 November 2018
Shockwave was initially recognised mainly as a treatment of Tendinopathies (see our blog on tendon pain >) but current research is showing success in treatment for chronic pain that has failed to respond to other interventions.
In England the official clinical guidance for treatments is issued by NICE (National Institute for Health & Clinical Excellence). Their responsibility is to make recommendation on numerous treatments that have been evidenced and backed by significant research.
When looking at Shockwave there are six current conditions which NICE guidelines support and there is now a considerable body of global evidence to support Shockwave as an alternative to surgery in the following circumstances:
- Elbow pain (medial and lateral epicondylopathy)
- Hip pain (gluteal tendinopathy)
- Knee pain (patella tendinopathy)
- Achilles pain
- Plantar heel pain/plantar fasciitis
How does it work?
It’s important to understand shockwave therapy is not used on acute pains and should only be used if standard practice and physiotherapy exercise have failed over a period of 6 months.
Shockwave works by using radial acoustic shockwaves to encourage self-healing. The shockwaves (which are not electrical, they are sound shockwaves) are given using a hand held tool that delivers the waves for a brief amount of time directly to the affected tissue. The pressure from the shockwaves will be transferred to the tissue. As a product, micro-cavitation bubbles are produced, which will expand, burst, and produce a resultant force. This goes through the tissue and stimulates the cells dealing with connective tissue and bone healing.
By stimulating these cells, the natural self-healing mechanisms are triggered. This process involves increased metabolism and gives an inflammatory response allowing the healing process to take effect.
See what one of our patients had to say about the process -
“Following a year of pain into the sole of my foot (later to be diagnosed as Plantarfasciopathy) and a course of physiotherapy with no relief I was starting to think I was going to have to stop my love of running and put up with this pain forever.
Then I was referred to MCH physiotherapy team, where I was assessed and advised to undertake shockwave therapy. I was a little apprehensive at first as I heard it was very painful, however following 1 session I found it was nothing to be afraid of as it was uncomfortable but not unbearable. I was given another 2 sessions and was advised I needed to stop using any form of NSAID (such as ibuprofen and naproxen) and even more importantly was shown a number of exercises to aid my rehabilitation.
After two sessions I was starting to feel a benefit, which drove me on to progress with the exercises I was given. My physiotherapist then slowly introduced me to running again and I have not looked back since.”