Extracorporeal Shockwave Therapy (ESWT) treatment is a highly
effective treatment available for patients with chronic tendon disorders, and is used widely by Sports Physicians & Orthopaedic Surgeons. This is a very successful second line treatment for
patients who fail to respond to appropriate physiotherapy.
Tendonitis literally means inflammation of the tendon. In Acute
(recent) cases, tendonitis is usually treated using the R.I.C.E (rest, ice, compression, elevation and anti inflammatory medication). However, once the injury becomes chronic (long-term) - perhaps
through mis-management, or just ignoring the problem - it becomes a degenerative problem, and treating the injury becomes more difficult.
Shockwave therapy is a non surgical treatment, and works by
delivering impulses of energy, targeted to specific damaged tissues within the abnormal tendon. This increases the blood flow within the affected area, stimulating cell regeneration and healing, and
decreasing local factors which can cause pain.
How do I know ESWT is suitable for
ESWT is suitable for patients that have been unable to find a suitable cure for their tendonopathy or orthopaedic condition when using conventional treatment methods such as physiotherapy,
painkillers and injections.
How does ESWT work?
The device passes shockwaves through the skin to the injured part of the body. The shockwaves are generated by a projectile that is propelled at high speed inside a hand-held applicator. When the
applicator is placed on the surface of the skin - together with a ‘coupling medium' such as ultrasound gel - the impulses are delivered as a shockwave that spreads inside the injured part of the body
as an aspherical ‘radial' wave.
Passing radial shockwaves through the surface of the skin initiates an inflammation-like response in the injured tissue that is being treated. This prompts the body to respond naturally by increasing
blood circulation, the number of blood vessels and therefore metabolism in the injured tissue. This accelerates the body's natural healing process by increasing cell generation and dissolving calcium
How long does treatment take?
A typical session of ESWT will last for around 15 minutes, but the practitioner will often do some additional soft tissue work so expect an average session to last 30 minutes. Times also vary
according to how many impulses are required to treat the injury. A typical treatment programme would consist of 3-4 sessions, one every week.
Is ESWT treatment painful?
Some patients have noted minor discomfort during treatment but most patients have been able to tolerate this without the need for any medication. It is worth noting that patients who find the
treatment uncomfortable often have better clinical outcomes.
Will I be in pain after the treatment?
Patients normally experience a reduction in pain or no pain at all immediately after treatment. A dull pain may present itself a few hours later, but this normally only lasts for around a day or a
little longer in rare cases.
What should I do if I'm in pain after the treatment?
ESWT works by initiating an inflammation-like condition in the tissue that's being treated. The body responds by increasing the metabolic activity around the impact area which in turn accelerates the
body's own healing processes. Patients are advised to use prescription-free painkillers in they experience any discomfort after treatment. However, patients should not us anti-inflammatory medicine
or try to cool down the treated area because this will interfere with the body's natural healing abilities.
What if I have no pain after treatment?
Some patients emerge from treatment with no discomfort whatsoever, but we strongly recommend they refrain from intensive activities that stress the treated area for at least the next 48
What if ESWT treatment doesn't work for me?
Even though the response to ESWT treatment is normally exceptionally good within the first few weeks, it may take several months before the maximum effect is achieved. If patients do not experience a
pronounced improvement after 3 or 4 months, your clinician will be able to advise you on the next suitable step to take.
Are there any contradictions or precautions I need to consider?
Yes. Cortisone injections should not be administered during the month before treatment starts, haemorrhage tendencies and coagulation system disturbances with supporting medication, heart conditions
and blood circulation disturbances, acute inflammation in the treatment area, and cancer and pregnancy.