ExtracorporealShockwave Therapy (ESWT)

What is Extracorporeal Shockwave Therapy?

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.

How does it work?

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.

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 are
  • 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

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?

Written consent and a full explanation will be obtained with your Consultant prior to the treatment. A certified ESWT practitioner will perform the treatment. They will position you in a comfortable and effective position. The practitioner will then ask you to locate your area of pain and they will palpate this area. They will mark the area of pain and apply gel to the area. The shockwave applicator will be applied and the practitioner will ask for your feedback throughout the procedure. This should not take more than 15-20 minutes.

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 butactivity 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

Will I need a follow up appointment?

We would advise a follow up appointment with your Consultant 6-8 weeks after the third treatment if the pain persists.