Shockwave therapy (ESWT) is an innovative and scientifically backed approach to treating acute and chronic musculoskeletal pain and connective tissue disorders.  ESWT is backed by evidence (1-18) and works well in conjunction with a range of complementary regenerative solutions such as individualised exercise programs, acupuncture and many of our specialised chiro techniques here at Tweed Coast Chiropractic.

Overall, Extracorporeal Shockwave Therapy is a healing accelerator and is particularly efficacious in treating the average person, the weekend warrior to elite athletes.

How Does Extracorporeal Shockwave Therapy Work? 

Extracorporeal Shockwave Therapy (ESWT) stimulates a cascade of biological responses across cellular, tissue, and organ levels stimulating regeneration and awakening the body’s natural healing system (1,2). This includes heightened collagen synthesis, cellular proliferation, accelerated healing, pain reduction, neovascularization, and diminished inflammation.

Shockwave therapy is a treatment option that can offer patients and athletes a safe means for an expedited return to normal daily activities and competition, requiring minimal to no downtime.

While treatments are customized for each patient, generally, treatment times are 20 minutes in length, with weekly visits of approximately 2 – 6 weeks.

What injuries can be treated with shockwave therapy?

Shockwave therapy is used to reduce pain and promote healing from tendinopathy and many other sports injuries (2-18). The efficacy of shockwave is well documented and include:

  • foot pain: plantar fasciitis – This inflammatory condition is quite common and can cause severe heel and arch pain; with particularly acute symptoms upon rising or taking that first step out of bed in the morning. The plantar fascia, which connects the heel bone to the toes, becomes inflamed and is exacerbated by overuse.
  • Achilles’ tendinopathiesusually occur due to overuse and excessive chronic stress upon the tendon. A lack of flexibility or a stiff Achilles tendon can increase the risk of these injuries. Repetitive minuscule injuries and small tears to the tendon fibers take a toll on the Achilles tendon. People who suffer from Achilles tendinopathy may experience pain, swelling, stiffness, and limited mobility.
  • knee pain:patella tendinopathy (jumper’s knee): Jumper’s knee is caused by overuse of your knee joint, such as frequent jumping on hard surfaces. It’s usually a sports-related injury, linked to leg muscle contraction and the force of hitting the ground. This strains your tendon. With repeated stress, your tendon may become inflamed.
  • leg pain-calf and hamstring injuries: these injuries are high on the list of injuries among athletes of all ages, and published studies prove the efficacy of ESWT in accelerated healing
  • hip pain:rectus femoris and lateral hip pain with gluteal tendinopathies: Hip pain in comes in many forms and many different causes, and Extracorporeal Shockwave Therapy has been shown to greatly alleviate hip pain.
  • elbow pain: Golfers and tennis elbow: Lateral epicondylitis (Tennis Elbow) and medial epicondylitis (Golfer’s elbow) are common inflammatory conditions triggered by repetitive motion. Both are prevalent among athletes and weekend warriors.
  • shoulder pain (rotator cuff injuries): Rotator cuff injuries can be acute or chronic. Usually, the pain increases at night, and the presence of shoulder weakness is part of the symptom profile. Calcium deposits may also form on the shoulder tendon.
  • Bursistis : Common sites for bursitis include the shoulder (subacromial bursa), hip (trochanteric bursa), knee (prepatellar bursa), elbow (olecranon bursa), Achilles tendon (retrocalcaneal bursa) and foot. One of the most common causes of bursitis is injury, overuse or repetitive motions that put stress on a particular joint. A bursa is a small fluid-filled sac that acts as a cushion between bone and soft tissue (muscles, tendons, and skin) These bursae prevent friction and allow for smooth joint movements. When you overuse or injure a joint, a nearby bursa can become irritated or inflamed. The bursa fills with excess fluid, causing significant pain and restricting movement.
  • Adhesive Capsulitis (frozen shoulder): this results in impingent to the shoulder and movement, limiting motion and affecting daily living.
  • Osteoarthritis of the knee: Knee osteoarthritis (OA) is one of the most common chronic degenerative joint disorders, resulting in arthritic symptoms such as joint pain, stiffness, limited range of motion (ROM), and functional loss. Studies suggest that ESWT may be effective in reducing suprapatellar effusion and improving symptoms in mild knee OA. 
  • Medial Tibial Stress Syndrome/Periostitis / shin splints: This is a common overuse injury of the lower extremity. It typically occurs in runners and other athletes that are exposed to intensive weight-bearing activities such as jumpers. It can be associated with prolonged time away from sport, ESWT can accelerate recovery time.

What are the Benefits of ESWT

Minimal risk and downtime.

Treatment with shockwave is non-invasive, and there are no known associated risks for healthy patients. There are certain conditions where ESWT is contraindicated (when pregnant, in the presence of a heart condition or pacemakers, taking meds that are known to interfere with blood flow). But otherwise, for a patient without underlying concerns, there is minimal risk. While some patients may experience mild swelling, bruising, and temporary aches in the days following the initial procedure, serious adverse side effects are not known to occur.

Most patients report some discomfort during shockwave therapy, but most do not find it painful. The amount of discomfort depends in part on the person, their injury, and whether the damaged tissues are close to a bone. (Treatments delivered closer to a bone are generally more uncomfortable.)  As soon as the treatment is over, the discomfort typically stops.

Faster recovery timelines and drug free

Accelerated healing is made possible with regenerative shockwave and is responsible for quickly getting patients and athletes back in motion and everyday activities.  It is also an alternative treatment with often better outcomes then other pain control measures such as steroid injections.

If you think we may be able to assist you with any of these issues get in touch with our chiropractors at Kingscliff. Tel 0266744032 or book online here.

References:

  1. Auersperg V, Trieb K. Extracorporeal shock wave therapy: an update. EFORT Open Rev. 2020 Oct 26;5(10):584-592. doi: 10.1302/2058-5241.5.190067. PMID: 33204500; PMCID: PMC7608508.
  2. Burton, Ian1; Cooper, Kay1,2,3; Alexander, Lyndsay1,2; Swinton, Paul Alan1. Effectiveness of combined shockwave therapy and plantar fascia stretching interventions in treating plantar heel pain: a systematic review and meta-analysis protocol. JBI Evidence Synthesis 19(5):p 1186-1192, May 2021. | DOI: 10.11124/JBIES-20-00186
  3. El Molla, S.S., Fahmy, A.M., Gamil, A.M. et al.Evaluation of plantar fasciitis improvement after shock wave therapy in calcaneal spur patients by musculoskeletal ultrasonography. Egypt Rheumatol Rehabil 48, 43 (2021). https://doi.org/10.1186/s43166-021-00085-y
  4. Dedes V, Stergioulas A, Kipreos G, Dede AM, Mitseas A, Panoutsopoulos GI. Effectiveness and Safety of Shockwave Therapy in Tendinopathies. Mater Sociomed. 2018 Jun;30(2):131-146. doi: 10.5455/msm.2018.30.141-146. PMID: 30061805; PMCID: PMC6029898.
  5. Circi E, Okur SC, Aksu O, Mumcuoglu E, Tuzuner T, Caglar N. The effectiveness of extracorporeal shockwave treatment in subacromial impingement syndrome and its relation with acromion morphology. Acta Orthop Traumatol Turc. 2018 Jan;52(1):17-21. doi: 10.1016/j.aott.2017.10.007. Epub 2017 Nov 16. PMID: 29153594; PMCID: PMC6136340.
  6. Notarnicola A, Ladisa I, Lanzilotta P, Bizzoca D, Covelli I, Bianchi FP, Maccagnano G, Farì G, Moretti B. Shock Waves and Therapeutic Exercise in Greater Trochanteric Pain Syndrome: A Prospective Randomized Clinical Trial with Cross-Over. J Pers Med. 2023 Jun 10;13(6):976. doi: 10.3390/jpm13060976. PMID: 37373965; PMCID: PMC10301141.
  7. Vahdatpour B, Taheri P, Zwre Zade A, Moradian S. Efficacy of Extracorporeal Shockwave Therapy in Frozen Shoulder. International Journal of Preventive Medicine 2014; 5(7): 875-88
  8. Wang CJ, Ko JY, Weng LH, Wang JW, Chen JM, Sun YC, Yang YJ. Extracorporeal Shockwave Shows Regression of Osteoarthritis of the Knee in Rats. J Surg Res. 2011; 171(2): 601-608.
  9. Choi IJ, Jeon JH, Choi WH, Yang HE. Effects of extracorporeal shockwave therapy for mild knee osteoarthritis: A pilot study. Medicine (Baltimore). 2023 Nov 17;102(46):e36117. doi: 10.1097/MD.0000000000036117. PMID: 37986308; PMCID: PMC10659666.
  10. Vahdatpour B, Taheri P, Zade AZ, Moradian S. Efficacy of extracorporeal shockwave therapy in frozen shoulder. Int J Prev Med. 2014 Jul;5(7):875-81. PMID: 25104999; PMCID: PMC4124565.
  11. Forogh, Bijan MDa; Karimzad, Yousef MDb; Babaei-Ghazani, Arash MDc; Janbazi, Lobaneh MDd; Bagherzadeh Cham, Masumeh PhDa,e; Abdolghaderi, Siavash MDb. Effect of extracorporeal shockwave therapy on medial tibial stress syndrome: a systematic review. Current Orthopaedic Practice 33(4):p 384-392, July/August 2022. | DOI: 10.1097/BCO.0000000000001127
  12. An S, Li J, Xie W, Yin N, Li Y, Hu Y. Extracorporeal shockwave treatment in knee osteoarthritis: therapeutic effects and possible mechanism. Biosci Rep. 2020 Nov 27;40(11):BSR20200926. doi: 10.1042/BSR20200926. PMID: 33074309; PMCID: PMC7670564.
  13. Unlocking the Power of ESWT for Athletes: A Game-Changer in Sports Medicine.” Published in the British Journal of Sports Medicine. Epub ahead of print: [01 Feb 2023]. doi:10.1136/bjsports-2023-107567.
  14. Schroeder AN, Tenforde AS, Jelsing EJ. Extracorporeal Shockwave Therapy in the Management of Sports Medicine Injuries. Curr Sports Med Rep. 2021 Jun 1;20(6):298-305. doi: 10.1249/JSR.0000000000000851. PMID: 34099607.
  15. Rhim HC, Borg-Stein J, Sampson S, Tenforde AS. Utilizing Extracorporeal Shockwave Therapy for in-Season Athletes. Healthcare (Basel). 2023 Apr 1;11(7):1006. doi: 10.3390/healthcare11071006. PMID: 37046934; PMCID: PMC10093829.
  16. . Rhim HC, Shin J, Kang J, Dyrek P, Crockett Z, Galido P, Wade C, Hollander K, Borg-Stein J, Sampson S, Tenforde AS. Use of extracorporeal shockwave therapies for athletes and physically active individuals: a systematic review. Br J Sports Med. 2024 Feb 7;58(3):154-163. doi: 10.1136/bjsports-2023-107567. PMID: 38228375.
  17. Beling A, Saxena A, Hollander K, Tenforde AS. Outcomes Using Focused Shockwave for Treatment of Bone Stress Injury in Runners. Bioengineering (Basel). 2023 Jul 25;10(8):885. doi: 10.3390/bioengineering10080885. PMID: 37627770; PMCID: PMC10451564.
  18. Fatima A, Ahmad A, Gilani SA, Darain H, Kazmi S, Hanif K. Effects of High-Energy Extracorporeal Shockwave Therapy on Pain, Functional Disability, Quality of Life, and Ultrasonographic Changes in Patients with Calcified Rotator Cuff Tendinopathy. Biomed Res Int. 2022 Mar 4;2022:1230857. doi: 10.1155/2022/1230857. PMID: 35281612; PMCID: PMC8916860.