Extracorporeal Shockwave Therapy (ESWT)

Dolorclast w292Extracorporeal Shockwave Therapy or ESWT is a new technology to treat chronic, painful conditions of the musculoskeletal system through the use of sound waves.

What makes this treatment unique is that it seems to work best when an injury reaches the chronic, non-healing state.  ESWT manages to do this by kick starting the healing process in chronic conditions, returning the tissues into the acute phase of healing.

How does it work and what does it treat?

The shockwave works by exerting a mechanical pressure onto the damaged tissue and in particular the cell membrane. By making the cell membrane more permeable there is an increase in blood supply and metabolism. Both of these reactions provide the basis of healing.

ESWT has been shown to also increase both the number of osteoblasts (these repair and create bone) and fibroblasts (which repair connective tissue such as ligament, tendon and fascia).

As ESWT has been shown to repair bone and connective tissue what do we at The Footcare Centre use it on?

In addition to stimulating the healing process, ESWT seems to have a direct and immediate effect on nerves, thereby reducing pain. This analgesic effect occurs by the brain “switching off”  the nerve signals as the shockwave causes hyper-stimulation of the nerve fibres. This means patients often walk away from treatment feeling instantly relieved, this is usually temporary but can have a longer effect.

How successful is it?

Recent studies have shown a success rate of between 65-95%, most citing approximately 75-80%. One such study is Wang CJ, Chen HS, Huang TW: Shockwave therapy for patients with plantar faciitis: a one year follow up study.

How many sessions are needed?

The evidence suggests that three sessions of treatment, 10 days apart is most effective.

Even though the response to shockwave treatment is normally exceptionally good within a few weeks, it may take several months before maximum effect is achieved.

How safe is it?

ESWT has been found to have no serious side effects. Mild side effects such as tingling, aching and redness are rare and short lived. We do not carry out the procedure if you have:

  • An open wound around the effected tissue
  • Neuropathy
  • Lymphoedema
  • Undergoing anticoagulant therapy such as Warfarin, Heparin or Clopidogrel
  • Pregnancy
  • If you have received an cortisone injection within the last 11 weeks prior to treatment

If you are to be considered for this therapy then the following criteria has to be met:

  • When at least 3 months of conservative care has failed
  • When there are no known contraindications
  • When other treatments are considered not appropriate



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