Extracorporeal Shockwave Therapy
What is ESWT?
Extracorporeal shockwave therapy, or ESWT, is a non-surgical method for treating insertional tendon disorders. The therapy works by means of an electromagnetic explosion that results in hypersonic waves that are converged to a specified depth in the body. The focal point of the energy is pinpoint. Treatments generally take 10-15 minutes, and you may experience mild discomfort.
Is ESWT FDA approved?
Extracorporeal Shockwave Therapy has been approved by the FDA as a form of non-surgical treatment for plantar fasciitis, shoulder tendonitis, and medial and lateral epicondylitis.
How does ESWT work?
The depth of the converged energy is controlled by the provider, along with the intensity. Diseased, calcified areas of tendon are harder and have a higher brittleness factor and are unable to undergo plastic deformation upon impact of the energy, therefore they are reduced to smaller pieces and are able to be reabsorbed by the body. Healthy tissue is unharmed by the energy.
The energy of the shockwaves delivers “micro-trauma” to the targeted area to shock the body into healing. The body responds by addressing the damage and inflammation at the source of the pain by starting with the construction of new blood vessels. After the treatment, new and healthy tissue will begin to develop, restoring function and reducing pain in areas that were affected by severe inflammation. The pressure exerted on the tissue during shockwave treatment also has a direct and primary analgesic effect, in addition to stimulating long-term healing.
What Type of Conditions are Treated with ESWT?
This popular method of therapy is ideal when treating common injuries such as heel pain, plantar fasciitis, Achilles tendonitis, tennis elbow, shoulder tendonitis, lateral epicondylitis, and more. ESWT is regarded as breakthrough technology in the treating and healing of common pains. In fact, many of our patients with chronic pain have found pain relief after being treated with ESWT.
How many treatments are required?
Generally, it will take between 3-5 sessions. Sessions are typically 5-10 days apart.
What limitations will I have after treatments?
No ballistic activities such as running or jumping for 48 hours after treatments, i.e. Achilles tendinopathy, plantar fasciitis treatment.
How long does a full recovery take?
Each treatment is inducing microtrauma to the area being treated. After the last treatment, your body is fully able to undergo the healing process. The phases of tissue healing include the acute inflammatory phase, fibroblastic repair/subacute phase, and the remodeling phase. A good estimate of new healthy tendon being present is 12 weeks.
Am I a candidate for ESWT?
You are a candidate if your condition is chronic and/or reoccurring, and has been present for longer than 3 months. Most individuals that have found relief from ESWT have already exhausted all other conservative treatment methods. Of course, you would be a candidate if you are trying to avoid surgery.
a. Anteroposterior radiographs of a right shoulder with a Gartner type-II calcification of the supraspinatus before focused shockwave treatment.
b. 3 months after ESWT treatment showing that the calcification has disappeared.
"The Role of Extracorporeal Shockwave Treatment in Musculoskeletal Disorders" The Journal of Bone and Joint Surgery, American volume, pg. 255, Volume 100-A, Number 3, February 7, 2018.