With so many gadgets and special machines promising decreased pain and increased function, it is important that patients are able to make an informed decision about supplementing their care plan with a different kind of therapy. Before consenting for any treatment session, it is important to know exactly what purpose it is intended to serve, and whether this treatment is safe and effective for your given condition.
What is Shockwave?
The science behind Shockwave therapy lies in the transmission of energy. The high intensity pulses delivered by a handheld transmitter promote regeneration and repair of tissues such as bones and tendons. The evidence proving the effectiveness of Shockwave as a treatment makes it a valuable addition to your physiotherapy session.
What are the benefits of shockwave therapy?
The high frequency vibration transmitted via Shockwave therapy is associated with:
- Improved circulation
- Stimulation of the body’s natural healing process
- Increased tissue strength
- Breaking up calcifications (beneficial for conditions such as calcific tendonitis)
- Pain reduction
- Trigger point release
What is the evidence?
Shockwave therapy has evidence supporting its use in a variety of conditions, and the below examples are not to be seen as an inclusive list.
Patients with chronic plantar fasciitis experienced significant improvements in pain, function and quality of life when treated with Shockwave in comparison to a placebo. Seventy percent of patients with persistent plantar fasciitis treated with Shockwave reported an “excellent” decrease in pain with significant results seen as little as two weeks after treatment. Only 11% of patients treated with one to three treatments of Shockwave therapy in this study reported return of their symptoms, compared to 55% of a conventional treatment group.
Calcific shoulder tendinitis
The evaluation of 28 trials comparing treatment of calcific tendonitis with Shockwave therapy versus a placebo consistently showed significant benefits of high energy Shockwave treatment in areas of pain, function and resolution of calcifications.
Chronic hamstring tendinopathy
Forty professional athletes with chronic hamstring tendinopathy were assigned to either a four week treatment of anti-inflammatories and physiotherapy (including a hamstring exercise program) or Shockwave treatment. At three months post-treatment, 85% of the patients treated with shockwave and only 10% of the control group reported at least a 50% reduction in pain.
A group of sufferers of chronic lateral epicondylitis (or tennis elbow) between 40 and 50 years old who had shockwave therapy twice a week over five weeks reported a significant decrease in pain when conventional methods alone had provided little relief.
When looking at a group with persistent achilles tendinopathy that being treated with twelve week exercise program, the group that was treated with Shockwave once a week for three weeks of the program reported higher scores of function and activity in comparison to the group that performed exercises alone.
It is important that with all of these stated benefits Shockwave therapy is not seen as a magic wand to cure all ailments. Some studies report that shockwave alone was not effective for particular conditions such as shoulder impingements. In this case and many others, muscle imbalances lead to altered physical function and physiotherapy will likely prove to be more valuable to a patient than shockwave treatments alone.
More information can be found at http://www.shockwavetherapy.eu/
Bannuru, R. R., Flavin, N. E., Vaysbrot, E., Harvey, W., & Mcalindon, T. (2014). High-Energy Extracorporeal Shock-Wave Therapy for Treating Chronic Calcific Tendinitis of the Shoulder: A Systematic Review. Annals of Internal Medicine, 160(8), 542.
Cacchio, A., Rompe, J. D., Furia, J. P., Susi, P., Santilli, V., & Paulis, F. D. (2010). Shockwave Therapy for the Treatment of Chronic Proximal Hamstring Tendinopathy in Professional Athletes. The American Journal of Sports Medicine, 39(1), 146-153.
Dobreci, D., & Dobrescu, T. (2014). The Effects of Extracorporeal Shockwave Therapy (ESWT) in Treating Lateral Epicondylitis in People between 40 and 50 Years Old. Procedia – Social and Behavioral Sciences, 137, 32-36.
Gerdesmeyer, L., et al (2008). Radial Extracorporeal Shock Wave Therapy is Safe and Effective in the Treatment of Chronic Recalcitrant Plantar Fasciitis: Results of a Confirmatory Randomized Placebo-Controlled Multicenter Study. The American Journal of Sports Medicine, 36(11), 2100-2109.
Rompe, J. D., Furia, J., & Maffulli, N. (2009). Eccentric Loading Versus Eccentric Loading Plus Shock-Wave Treatment for Midportion Achilles Tendinopathy: A Randomized Controlled Trial. The American Journal of Sports Medicine, 37(3), 463-470.
Wang, C. (2006). Long-term Results of Extracorporeal Shockwave Treatment for Plantar Fasciitis. American Journal of Sports Medicine, 34(4), 592-596.
Yu, H., et al. (2014). Effectiveness of Passive Physical Modalities for Shoulder Pain: Systematic Review by the Ontario Protocol for Traffic Injury Management Collaboration. Physical Therapy, 95(3), 306-318.