Shockwave Therapy

What is Shockwave Therapy?

Extracorporeal shockwave therapy is a specialized form of treatment designed to improve the health of a tissue by delivering high intensity bursts of mechanical energy.

This energy shock is not electrical, but rather a rapid high frequency vibration in the form of a Radial Pressure Wave (RPW).

When appropriately applied, Shockwave can increase local blood flow, improve healing response, break apart scar tissue and adhesions, reduce muscle spasm, and directly decrease pain. Most patients tolerate the treatments well, and report only mild discomfort.

How does Shockwave Therapy treatment work?

Radial pressure waves created during treatment can have several effects on the target tissues including,

1. Cellular Level Change – delivery of shockwaves affects the chemical environment of tissues at a cellular level. This causes changes to free radicals which boost the release of natural substances that help to prevent pain and resolve inflammation.

2. Blood Flow Change – Normal blood flow is critical to the healing process, and shockwaves help to create new capillaries in the target tissue. This ultimately redirects new blood flow into the affected area improving soft tissue healing.

3. Muscle Tone Reduction – Shockwave treatment reduces the contractile activity of muscle and can also stop dysfunctional patterns of neuro-cognitive pain associated with chronic conditions. This effectively decreases muscle spasm, and can be used to eliminate trigger points.

4. Pain Reduction – Shockwave pulses directly affect nerve fibres that transmit pain signals to our brain. Through the Gate Control Mechanism, shockwaves act on interneurons in the A-β fibers which prevent the communication of pain to the brain

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What conditions can Shockwave Therapy treat?

High frequency vibration in the form of a Radial Pressure Waves (RPW) have proven effective in treatment for,

  • Plantar Fasciitis
  • Heel spurs/Heel pain
  • Calcific Tendonitis
  • Patellar Tendonitis (Jumper’s Knee)
  • Achilles Tendonitis
  • Rotator Cuff Tendonitis
  • Myofascial Trigger Points in muscle
  • Iliotibial Band Syndrome (IT Band Syndrome)
  • Tennis Elbow and Golfer’s Elbow
  • Bursitis
  • Heterotopic Ossification (Myositis Ossificans)

What should I expect with my Shockwave Therapy appointment?

Along with your treatment, your initial appointment will include an assessment to ensure Shockwave Therapy is both safe and appropriate for your specific problem. Our clinic uses the Storz Shockwave System to deliver treatment, which is the most widely used system for Radial Pressure Wave ECSW in practice. Aside from pre and post treatment prep and clean up, the actual application of shockwave lasts 3-5 minutes.

Storz Shockwave System is manufactured and sold by Shockwave Canada, a Canadian medical device company specializing in the world’s most effective shockwave technology.

The majority of our patients appreciate the faster rate of improvement when combining traditional physiotherapy with shockwave treatment. After the treatment, the rest of your visit will be spent with your physiotherapist, who may also use manual therapy, exercise prescription, or other modalities to facilitate rapid recovery.

Does Shockwave Therapy hurt?

Most patients experience mild discomfort during treatment, but it is generally well tolerated. The initial discomfort typically fades as the area becomes desensitized as it is being treated. Your physiotherapist will adjust the intensity of stimulus depending on your comfort level, and can gradually ramp it up to minimize discomfort. Shockwave Therapy purposefully creates an inflammatory response in injured soft tissue, so you may also experience mild discomfort following treatment. Patients should not apply ice or take anti-inflammatories after shockwave treatment, as this inflammatory healing response shouldn’t be reduced.

How many Shockwave Therapy treatments will I need?

Most conditions require three to five treatments at one-week intervals. However, more chronic or complicated conditions may require more treatments. Most patients experience significant improvement while undergoing the first three Shockwave treatments, and improvements often continue for several weeks thereafter. Each case is different. A thorough clinical examination will help to inform how many treatments you will require..

How successful is Shockwave? Does it really work?

Shockwave Therapy is one of the most widely researched rehabilitation modalities used in physiotherapy clinics, with increasing numbers of scientific studies added each year. The majority of research validates the effectiveness of extracorporeal shockwave, and shows successful treatment rates of up to 90%! References to current research studies on Shockwave Therapy can be found below.

Is Shockwave Therapy covered by insurance?

Registered physiotherapists administer our shockwave treatments, so if you have extended health benefits that include physiotherapy you may have a portion (or all) of your treatment covered. Cornerstone Physiotherapy can also bill directly to most health insurance companies. Please call us for further details.

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REFERENCES

  • Extracorporeal shock wave therapy as a treatment for heterotopic ossification. Physical Therapy Reviews. Aug2013, Vol. 18 Issue 4, p300-307.
  • Treatment for insertional Achilles tendinopathy: a systematic review. Knee Surgery, Sports Traumatology, Arthroscopy. Jun2013, Vol. 21 Issue 6, p1345-1355.
  • A single application of low-energy radial extracorporeal shock wave therapy is effective for the management of chronic patellar tendinopathy. Knee Surgery, Sports Traumatology, Arthroscopy. Feb2013, Vol. 21 Issue 2, p346-350.
  • Conservative Management of Midportion Achilles Tendinopathy. Sports Medicine. 2012, Vol. 42 Issue 11, p941-967.
  • Shockwave therapy for chronic Achilles tendinopathy: A double-blind, randomized clinical trial of efficacy. Acta Orthopaedica. Apr2008, Vol. 79 Issue 2, p249-256.
  • Extracorporeal shock wave therapy in runners with a symptomatic heel spur. Knee Surgery, Sports Traumatology, Arthroscopy. Oct2006, Vol. 14 Issue 10, p1029-1032.
  • Extracorporeal shock wave therapy promotes cell proliferation and collagen synthesis of primary cultured human tenocytes. Knee Surgery, Sports Traumatology, Arthroscopy. Dec2011, Vol. 19 Issue 12, p2159-2168.
  • The Efficacy of Extracorporeal Shock-Wave Treatment: A New Perspective. Athletic Therapy Today. Nov2005, Vol. 10 Issue 6, p50-51.