Shockwave Therapy
Extracorporeal shock wave therapy (ESWT) is the transcutaneous application of high-energy acoustic waves to break down tissue or to promote healing and repair.
There are two types of shockwave: radial and focused. Our clinic utilizes radial.
During the 1990s and early 2000s, numerous research teams shared findings suggesting that ESWT could be used as a therapeutic tool. Researchers demonstrated the use of ESWT to reduce pain and promote healing in bone, tendon, ligament and fascia in patients with musculoskeletal disorders, and to reduce spasticity in patients with neurological disorders.
ESWT shows potential in:
Knee osteoarthritis
Fracture nonunion
Spasticity of spinal and supraspinal origin (stroke, brain injury, multiple sclerosis, cerebral palsy)
*Device approved by the FDA but not covered by most insurance plans
Multiple published studies have examined the use of ESWT in patients with musculoskeletal disorders and spasticity related to neurological diagnoses. A study published in Europa Medicophysica in March 2005 concluded that patients with lateral epicondylitis refractory to conservative care who were treated with radial ESWT experienced a decrease in pain and functional impairment and an increase in the pain-free grip strength test. A study published in the November 2017 issue of the Journal of Stroke and Cerebrovascular Diseases demonstrated encouraging results when testing the use of ESWT in patients with spasticity related to stroke. ESWT also reduced spasticity related to multiple sclerosis according to studies published in Multiple Sclerosis Journal in April 2015 and Archives of Physical Medicine and Rehabilitation in November 2018.
Adverse events and contraindications
Mild adverse events include transient discomfort, skin erythema and localized swelling.
Contraindications or situations in which ESWT may be inappropriate include:
Treatment over air-filled tissue (lung, gut)
Pregnancy
Presence of local tumor or infection
Less than six weeks since local corticosteroid injection
Age less than 18 (except for patients diagnosed with Osgood-Schlatter disease)
Treatment of pre-ruptured tendons
Blood-clotting disorders, including local thrombosis
Spacca G, et al. Radial shock wave therapy for lateral epicondylitis: A prospective randomised controlled single-blind study. Europa Medicophysica. 2005;41:17.
Guo P, et al. Positive effects of extracorporeal shock wave therapy on spasticity in poststroke patients: A meta-analysis. Journal of Stroke and Cerebrovascular Diseases. 2017;26:2470.
Studies that show promise with shockwave:
Effectiveness and Safety of Shockwave Therapy in Tendinopathies
Shockwave in Lower Limb Conditions