Extracorporeal Shockwave Therapy treatment (ESWT) is a clinically proven treatment available for patients presenting primarily with chronic tendon disorders. This is a successful second line treatment for patients who fail to respond to appropriate conservative management including physiotherapy.
Shockwave is a procedure where sound waves of energy are passed through the skin to the injured part of the body using a special device. The shockwaves are mechanical and not electric and work by increasing blood flow to the injured area. This accelerates the body’s healing process.The ESWT application lasts about 5 minutes to deliver the shockwave energy and you must attend for 3 sessions over 3 consecutive weeks.
Patients must have an on-going tendinopathy or calcification for more than 6 months and have failed at least one course of conservative treatment such as physiotherapy, injection therapy or orthotics. All patients must have had some imaging to confirm diagnosis prior to ESWT.
- Lung tissue in direction of sound fields
- Presence of a Cardiac pacemaker
- Has had a Cortico-Steroid injection in the area in past 3 months
- Over or near bone growth centers until bone growth is complete
- Malignancy is known to be present in or near the treatment area
- Treatment site has open wounds, skin rashes, swollen, inflamed, or infected areas
- Over ischemic tissues in individuals with vascular disease
- Coagulation disorder or taking anticoagulant/antiplatelet medications
- Infection at the treatment site to avoid the risk of spreading
- History of latex allergy or allergy to coupling solution
Conditions include Plantar fasciitis, Achilles Tendinopathy, Patellar tendinopathy, Calcific tendonitis, Greater trochanter pain syndrome, Tennis elbow
Referral for shockwave
Shockwave treatment is predominantly accessed via our Sports and Musculoskeletal medicine Service. Your GP can refer you to the sports service via the e-Referral system. You will initially receive a specialist clinical assessment. Shockwave is not considered to be a first-line treatment option. You must have had some form of imaging and undertaken a course of conservative treatment, such as physiotherapy, prior to receiving shockwave therapy.
For more information read this Extracorporeal Shockwave Therapy Leaflet
How does it work?
Shockwave therapy is a non surgical treatment in which sound energy is targeted to specific damaged tissues within the abnormal area. This is believed to cause a pro-inflammatory response by increasing the blood flow within the affected area, stimulating cell regeneration and healing, and decreasing local factors which can cause pain.
Is the shockwave treatment painful?
The treatment itself can be painful during the application of the ESWT. The treatment is delivered according to patient response, if a patient is unable to tolerate the pain levels the settings will adjusted to reduce the discomfort. A mild ache may occur later that day but should pass after a day. A patient may therefore take analgesic pain relief such as paracetamol before or after attending the session. NSAID's are not recommended during treatment.
Are there any side effects/risks?
The National Institute for Health and Care Excellence (NICE) have deemed this procedure to be safe treatment option with minimal reported side effects. You will experience some pain during the treatment, but you should be able to tolerate this. Following the treatment,there is a small chance you may experience some temporary redness or bruising to the area which normally resolves quickly. There is a small risk of tendon rupture and damage to the soft tissue.
How long does the treatment session last?
The shockwave appointment is 20 minutes, however the the ESWT application lasts 3-4 minutes to deliver the set number of impulses of shockwave energy.You will have to fill in some outcome measure forms at your first session.
How often must I attend?
You must attend for 3 sessions over 3 consecutive weeks.
When does the shockwave clinic run?
The shockwave clinic currently runs on Tuesday mornings and Wednesday afternoons.
Where is the shockwave clinic?
The shockwave service runs from the Physiotheray Department, Ground Floor, Yellow Corridor, Homerton Hospital.
What should I wear?
You should wear comfortable clothing that allows access to the affected area- shorts/tracksuit for knee issues or a vest for shoulder problems.