Shockwave therapy for plantar fasciitis, arthritis, and tendinopathies is emerging. It has long been proven a safe and effective alternative treatment.
Shockwave should be considered for patients in which other conservative measures have failed and those wishing to avoid surgery. Perhaps you been suffering chronic, soft tissue type pain, that never seems to get better? Perhaps your injury only affects you when you are performing physical activity. Maybe your pain seems to go away short term. Then, as you get back into something you love, your pain returns.
Dealing with chronic tendon or soft tissue pain can be a real nuisance. Sometimes it can feel like you have tried just about everything to relieve it. If this is you, you may be someone who would benefit from shockwave therapy. Our team of osteopaths at Total Balance Healthcare has been trained in the safe and effective use of the shockwave machine, and it is another tool we can use to help you manage your injury.
So what is shockwave therapy? Shockwave uses a handpiece placed over the painful area. The machine generates energy through vibrations. The science states the repeated shock entering the tissue causes a blocking effect of the nerve endings of pain-sensitive fibers. This results in a rapid decrease in the pain symptoms.
Shockwave therapy also has the potential of replacing surgery in many orthopedic disorders, as complication rates are low and negligible.
Will shockwave help me with my problem? Research suggests that about 80% of patients who have shockwave treatment have found that it helps relieve their pain.
Shockwave therapy for arthritis
Shockwave therapy for arthritis, specifically knee osteoarthritis (KOA) has been shown in a recent systematic review and meta‑analysis to achieve a better therapeutic effect for patients compared to physical therapy. The extracorporeal shockwave therapy (ESWT) group had a lower visual analog scale (VAS) score, larger range of movement (ROM), and a better Lequesne Index (LI) than the placebo group after 1 month of therapy (P<0.05). Furthermore, at 1-month post‑therapy, the ESWT group had a lower VAS score, larger ROM, and a better Western Ontario and McMaster Universities Arthritis Index (WOMAC) than the physical therapy group (P<0.05), and the outcomes regarding pain, ROM, LI, and WOMAC were significantly different between the two different groups (P<0.05).
With an aging population, many of which have KOA, ESWT is effective and non-invasive. ESWT for arthritis may be one of the treatment alternatives available to this population, however more high‑quality trials with large patient sample sizes are necessary to substantiate these encouraging results.
Shockwave therapy for patellar tendinopathy
Shockwave therapy for patellar tendinopathy is safe and effective. Studies have shown that all measures of reported pain, function, and patient satisfaction with treatment and outcome, were significantly improved at the 1, 3, and 12-month stages. ESWT is useful for those whose prior treatments such as non-steroidal anti-inflammatory (NSAID) drugs, exercise, physiotherapy, and taping have failed. Shockwave provides a viable option for invasive and often, unsuccessful surgery.
Furthermore, a review of the available literature reports that shockwave treatment for chronic patellar tendinopathies that have not responded to other conservative measures and physiotherapy is an effective and safe procedure. Given the challenges faced by clinicians in treating tendinopathies, shockwave therapy is an evidence-based option.
Calcific tendinitis of the shoulder
A systematic review demonstrated that when compared to other conservative treatments, shockwave therapy is capable of significantly reducing pain and other symptoms of calcific tendinopathies of the shoulder. Shockwave resulted in 88.5% success rates in relation to pain and increased function. Furthermore, functional and sonographic studies have revealed significant VAS score improvements, an improvement in the arc-type calcific plaques of the rotator cuff as well as significant decreases in the size of calcium deposits following ESWT.
Other common tendinopathies shockwave is effective in treating include:
- Achilles tendinopathy
- Plantar fasciitis
- Shoulder and elbow tendinopathies, such as rotator cuff tendinopathy, lateral and medial epicondyle tendinopathy
- Patella tendinopathy or tears
- Hamstring tendinopathy or tears
- Gluteal tendinopathy
What you need to know
Will shockwave treatment hurt? To be honest, yes it will be uncomfortable during the session. The intensity applied will depend on the extent of the injury and your pain threshold. Some people report little to no pain, while others, only tolerate the lowest settings. Treatment lasts 5 minutes, and most patients are able to tolerate the short term pain for long term gain. During the session, the intensity can be adjusted if you are finding it too uncomfortable.
How often will I need treatment? We would usually suggest about 3 or 4 shockwave sessions in about a 2 week period. We can vary this as necessary.
Will I feel any pain after the treatment? Most people find that they get relief rather quickly after treatment. It is very uncommon to be feeling pain as a result of the shockwave treatment. Your practitioner will also give you advice on rehabilitation which is usually essential to the recovery.
Are you looking for support for your aches or pains? Book an appointment with our Osteopath, Dr. Lachlan Chisholm. Lachlan can address your symptoms with a hands-on treatment and rehabilitation program tailored to your needs.
This blog post is an educational tool only. It is not a replacement for medical advice from a registered and qualified doctor or health professional.
Any other questions not answered here? Get in touch with us!