Extracorporeal Shockwave Therapy (ESWT)

Extracorporeal (outside the body) Shockwave (high energy sound waves) therapy is a non-invasive treatment designed to treat the causes of chronic pain without the need for injections, medication or surgery.

The treatment stimulates an inflammatory-like response in the tissue that is being treated. The body then responds by increasing the blood flow and metabolism to the injured area. This, in turn, accelerates the body’s own healing processes. The shockwaves break down injured tissue and calcifications. The National Institute for Health and Care Excellence (NICE) has deemed this procedure safe. Studies have shown this treatment to be between 50% to 70% effective. Generally, between three to six treatments are required and these are performed at weekly intervals. Each treatment lasts for approximately 10-15 minutes.

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What are the contra-indications for having this treatment?

Clotting disorders
Taking any antiplatelet (such as aspirin/clopidigrel) or anticoagulants (such as warfarin/rivaroxaban)
Infection of the affected area
Bone cancer
Steroid injection in the past 12 weeks
Cardiac pacemakers or implanted devices
History of tendon/ligament rupture
Under 18 years of age
Pregnancy

Are there side effects?

The shockwaves are felt as pulses which can be a little uncomfortable. The energy of the sound waves can be adjusted as tolerance levels improve
You may experience some redness, bruising, swelling and numbness to the area. This should resolve within a week
Small risk of tendon rupture or ligament rupture and damage to soft tissue

About the Treatments

How should I prepare?

You must refrain from taking any anti-inflammatory medication for 2 weeks prior to the treatment and throughout the treatment
You can eat and drink normally before the procedure

What happens during the procedure?

Essentially, whereas a steroid injection works best for inflammatory conditions by suppressing an inflammatory response to a healing injury, ESWT has the opposite effect.

Shockwave therapy uses a non-invasive device to deliver sound wave energy to the affected part. The waves desensitize nerve endings in the target area to quickly reduce pain, followed by a controlled microscopic trauma to the area to promote new blood flow to the area and thus deliver healing growth factors to injury.

ESWT promotes healing by setting up a mild inflammatory response within the target structure to actually kickstart the early phase of healing. This is why no steroid injections should have been applied to the target structure for 3 months prior to treatment. Non-steroidal anti-inflammatory medications should also be avoided for 2 weeks before and also during the duration of treatment

What can I expect after the procedure?

You will normally experience a reduced level of pain or no pain at all immediately after the treatment but a mild pain may occur after a few hours. You can take over the counter pain relief such as paracetamol but anti-inflammatory medications should be avoided
Ice therapy should also be avoided throughout the course of your treatment as it can interfere with the body’s healing process
You can load normally after this treatment but activity must be reintroduced slowly. Your Consultant will advise on the level of activity you can perform after the treatment

What can be treated using ESWT?

Plantar fasciitis
Insertional Achilles tendinopathy
Tennis/Golfer`s elbow
Greater trochanteric pain syndrome
Medial tibial stress syndrome
Sub-acromial pain syndrome
Calcific tendinopathy
Patella tip syndrome
Osgood-Schlatter disease

Shockwave Therapy FAQs

Which Conditions?

In the upper limb, ESWT is very helpful in the management of calcific tendinitis of the shoulder, where an acute build-up of a calcium deposit in the rotator cuff tendons can be broken down by the treatment waves. Also, the ESWT waves are very good at assisting healing of Tennis Elbow/Golfer's Elbow, which are conditions that are frequently resistant to traditional methods such as physiotherapy and cortisone injections.

Around the hip and knee, ESWT can be used to treat Greater Trochanteric Pain Syndrome, which presents as a debilitating pain on the outer side of the hip. Furthermore, it is used to manage Patellar Tendon Pain and Osgood-Schlatter’s disease, around the front of the knee.

In the foot and ankle, two major conditions are appropriate for ESWT. These are Plantar Fasciopathy (Fasciitis), a very common and painful condition due to irritation of the plantar fascia, a strong ligament type structure under the base of the heel. The second condition is Achilles Tendinopathy, which may be non-insertional, in the body of the tendon itself, or insertional where the tendon joins the back of the heel bone.

Does it Hurt?

How Many Sessions?

After Treatment

Monitoring

Is Shockwave Therapy covered by insurance?

Extracorporeal Shockwave Therapy (eswt)

Why choose the London Orthopaedic Clinic?

The London Orthopaedic Clinic provides high-quality, expert orthopaedic and musculoskeletal care tailored to the individual needs of our patients. The Clinic is based at Mayo Clinic Healthcare, at the heart of London’s internationally renowned Harley Street medical district. London Orthopaedic Clinic offers cutting-edge diagnostics, treatment, management and personalised care, in a state-of-the-art clinic in central London.

The expert multi-disciplinary team of more than 20 leading specialists includes Orthopaedic Surgeons, Rheumatologists, Pain Management Consultants, allied specialists and Consultant Radiologists who work together to reduce pain, improve movement and make a real difference to patients’ lives.

The London Orthopaedic Clinic offers patients something truly unique: access to world-leading experts, high-tech diagnostics and the latest innovative treatments, together with the feeling of trust and safety of a small family practice.