Extracorporeal Shockwave Therapy (ESWT)

What is Extracorporeal Shockwave Therapy?

Shockwave therapy is a non-invasive and highly effective treatment for multiple musculoskeletal conditions. It works by delivering impulses of energy to target affected tissues.

How does it work?

It is a good option for conditions that have not responded to appropriate physiotherapy or for those who want to avoid injection therapy or surgery. There is no risk of infection or tendon rupture which can be a complication of more invasive options. A course of shockwave would not be repeated within 6 months of the initial treatment.

  • Pain reduction by lowering the levels of Substance P
  • Increasing metabolism to reverse chronic inflammation
  • New blood vessel formation that increases blood flow to promote tissue healing and regeneration
  • Resolution of muscular tightness and trigger points
  • Stimulation of collagen production
  • Removal of calcium build up in tendons and muscles

What conditions can be treated?

  • Achilles Tendinopathy
  • Plantar Fasciitis +/- Heel Spurs
  • Shoulder pain – Frozen Shoulder or Tendinopathy of the Shoulder +/- calcification
  • Trochanteric Bursitis /Greater Trochanter Pain Syndrome
  • Lateral and Medial Epicondylitis
  • Biceps Tendinopathy
  • Carpal Tunnel Syndrome
  • Trigger Finger
  • Adductor Tendinopathy
  • Hamstring Tendinopathy
  • Iliotibial Band Syndrome
  • Patella Tendinopathy
  • Osgood-Schlatter Disease
  • Medial Tibial Stress Syndrome
  • Peroneal Tendinopathy
  • Myofascial Pain Syndrome or Trigger Points to Neck, Back or Legs
  • Stress Fractures

What happens in a consultation?

Dr Lakhera will assess the patient and if suitable can start the treatment in that session.  Gel is applied to the area to aid the transfer of the energy. The shockwave probe is lightly pushed onto the gel area and the treatment is started.

Treatment is usually 20-30 minutes.

A minimum of 3-5 treatments are needed for an improvement to be seen with weekly intervals between treatments.

There will be suggested restrictions to physical activity during the treatment course to get the best results.

What are the risks of the treatment?

Discomfort during and for a short time after treatment. This is usually described as tolerable but it is often suggested to get someone else to drive you home if the treatment is in the lower limb.

Redness, bruising, swelling or numbness to the treated area that will resolve within a week. Simple painkillers or ice application can help this. If the pain is severe or lasts longer than 7 days then contact the clinician involved.

The treatment may not work at all but usually patients notice an improvement after 6-12 weeks.

What is the evidence?

Shockwave is clinically proven to work for multiple conditions and is NICE (National Institute for Health and Clinical Excellence) approved. Elite sport has been using the method for years with good results.

What are the contraindications?

  • Pregnancy
  • Regular or long-term use of antiplatelet medications (e.g. Aspirin or Clopidogrel) or anticoagulants (e.g. warfarin or rivaroxaban)
  • Blood clotting disorders
  • Have had a steroid injection to the affected area within the last 12 weeks
  • Under the age of 18
  • Acute inflammation to the area of treatment
  • Bone Cancer
  • Cardiac Pacemaker or other cardiac devices or implants

Cost

£300 for 3 sessions

£450 for 5 sessions

Shockwave treatment is covered by some insurers, please contact your insurer to check.