Focused Acoustic Pressure Therapy, also known as Extracorporeal Shockwave Therapy (ESWT) is a new technology using acoustic pressure waves to treat chronic, painful conditions of the musculoskeletal system. It consists of a series of high-energy percussions to the affected area. The acoustic pressure wave (aka shockwave) is a physical sound wave “shock”, not an electric one. It can be described as an intense, very brief energy wave traveling faster than the speed of sound. The word “extracorporeal” means “outside the body” and refers to shockwaves being generated outside of the body.
The science behind Acoustic Pressure Therapy is similar to the technology that uses acoustic waves to break up kidney stones without surgery. The technology to break up kidney stones has been used for nearly a quarter of a century and over the years has found a correlation with increased healing properties in unrelated aches and pains in people who have had the kidney stone procedure. As a result, scientists began to recognize the effects of shockwave therapy on musculoskeletal injuries. Special machines for soft tissue injuries were subsequently developed and now shockwave can be used as a noninvasive and safe treatment for hundreds of musculoskeletal conditions.
How does it work?
Extracorporeal Shockwave Therapy (ESWT) stimulates certain components within the body so that it can heal. The treatment begins by producing an inflammatory response, essentially taking a chronic, nagging condition and bumping it back into an acute phase of healing. The body responds by increasing metabolic activity around the injured site which promotes the remodeling of dysfunctional tissues. Remodeled tissues include collagenous tissues such as tendinopathies, trigger points, muscle strains, ligament sprains, etc. Thus, the healing process is accelerated significantly. Shockwaves then begin to breakdown scar tissue and calcification surrounding the site of pain. Finally the pain is diminished through nociceptive inhibition. ESWT is also believed to diminish pain over long periods of time through the stimulation of what is known as the “gate control” mechanism, where nerves can be stimulated to “close the gate” to pain impulses sent to the brain and activating a sort of reset button on pain perception.
What are the benefits of Shockwave Treatment?
This therapy stimulates the body’s natural self-healing process. There is actually an immediate reduction of pain and improved range of motion. ESWT may also eliminate your need for surgery depending on the amount of instability present.
What conditions can you treat with ESWT?
Extracorporeal Shockwave Therapy can be used to treat a wide variety of musculoskeletal conditions and is especially helpful in those that involve the connections between soft tissue and bones. Some of the most common injuries treated are as follows, however the possibilities are endless.
- Rotator Cuff injury
- Frozen Shoulder
- Tennis/Golfers Elbow
- Jumper’s Knee
- Tendinitis
- Plantar Fasciitis/ Fasciosis
- Achilles injury
- Muscle strains and Ligament sprains
- Carpal Tunnel
- Finger and Toe pain
- OCD lesions
- Bone spurs
- Bursitis
- SI Joint Pain
- Wrist Pain
- Jaw Pain
- Arthritis Pain
Are there contraindications and/or precautions?
Contraindications include:
- Coagulation disorders, thrombosis, heart or circulatory patients
- Use of anticoagulants, especially Marcumar, Heparin, Coumadin
- Tumor diseases, carcinoma, cancer patients
- Pregnancy: using the machine over the abdomen
- Polyneuropathy in case of diabetes mellitus
- Using the machine over open growth plates
- Cortisone therapy within the last 6-12 weeks
Side effects include: (These side effects generally abate after 5-10 days).
- Swelling, reddening, haematomas
- Petechiae, bruising
- Pain
- Skin lesions (especially after previous cortisone therapy)
How many treatments will I need?
Most injuries take between three and six treatments to reach full resolution, but there is a possibility that two or more additional treatments may be necessary if the condition being treated is very chronic and/or includes severely restricted joint range of motion. An example of this would be Adhesive Capsulitis, a condition in which the connective tissue surrounding the shoulder joint becomes thick, stiff and inflamed and movement becomes significantly limited. Each treatment ranges from 5 to 20 minutes in duration depending on the number of pulses or shocks administered.
Most patients see an initial degree of improvement in pain and range of motion almost instantly following their first ESWT treatment. However, the healing process takes several days to weeks for completion and decreased pain tends to proceed the conclusion of the healing process.
Does the treatment hurt?
Extracorporeal Shockwave Therapy may be uncomfortable at times throughout the treatment, however most people can easily tolerate the procedure. Adjustments on the machine allow the healthcare provider to increase or decrease the pressure patients feel during the procedure as well. Two to four hours after treatment, there may be some additional discomfort such as a feeling of soreness and in some instances temporary bruising and swelling can also occur.
What is the success rate for this kind of treatment?
The vast majority of published peer reviewed research papers over Extracorporeal Shockwave Therapy show positive and beneficial effects in the treatment of musculoskeletal conditions. A successful treatment is considered as a patient having at least 75% reduction in pain within 3 months of treatment. Worldwide, success rates are around 80 to 90%.
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