Do you suffer from chronic pain in your heels, elbow, or shoulder? Plantar fasciitis, Achilles tendonitis, and calcific shoulder tendonitis bogging you down? Want to be free of your body aches and pains through the use of a safe and tested technique? Then this article is just for you!
Shockwave therapy, also known as Extracorporeal Shock Wave Therapy (ESWT), is a non-invasive/non-surgical, clinically proven and highly effective treatment for chronic soft tissue injuries and certain bone conditions. The process itself is simple: an extracorporeal Shockwave is generated through a hand-held probe and applied to the area of pain and discomfort. The idea of Shockwave therapy originated from the discovery that focused shockwaves were able to break down kidney stones, gallstones, salivary stones and pancreatic stones.
Table of Contents
- What Is The History of Shockwave Therapy?
- How Does Shockwave Therapy Work?
- What Does Shockwave Therapy Help With and Where Is It Used?
- Are There Any Side Effects to Shockwave Therapy Treatment?
- What Is An Extracorporeal Shockwave?
- When May Shockwave Therapy Not Be Suitable?
- How Long Is a Shockwave Therapy Session, and What Can I Expect?
- Does Shockwave Therapy Help Arthritis?
- Magne-tec: The Place for State-of-the-Art Shockwave Therapy Equipment!
What Is The History of Shockwave Therapy?
The history of Shockwave therapy is quite remarkable. The first systematic investigations for the use of shock waves in medicine were, believe it or not, performed on accident in the 1960s. A German company called Dornier was experimenting with high velocity projectiles when an employee accidentally touched a metal plate the very moment a shockwave projectile hit the plate. He felt something in his body like an electrical shock. Measurements taken shortly afterwards indicated no electricity whatsoever in the incident and the generated shockwave had apparently traveled from the plate over the hand in the man’s body. Following this, between 1968 until 1971, the interaction between shockwaves and biological tissues in test animals was thoroughly investigated in Germany, with the program being completely financed by the German Dept. of Defense. It was observed that shockwaves, when applied to muscles, fat, and connective tissue, created negligible side effects, and intact bone tissues remained relatively unharmed as well.
Finally, in February 1980, the first treatment of a human subject was performed by Shockwave therapy, and in 1984, the modality was approved by the U.S. Food and Drug Administration in 1984. Shockwave therapy is also approved by Health Canada.
Throughout the 1980s, researchers using Shockwave therapy for kidney stones noticed that it appeared to increase bone density in nearby bones, leading them to explore it for orthopedic purposes. Ever since, Shockwave therapy has proven successful in the treatment of acute and chronic injuries, and pain resulting from
illness and injury. The best part? You don’t have to use painkillers with it. Shockwave therapy triggers the body’s own innate natural healing mechanism and thereby brings about relief and gradual healing. People have reported reduced pain and improved mobility after just the first treatment!
How Does Shockwave Therapy Work?
Shockwave therapy, as mentioned before, is a treatment technique that involves creating a series of low energy extracorporeal shockwaves that are directly applied to an area of injury, painful spots and myoskeletal tissues with sub-acute, sub-chronic and chronic conditions. Shockwaves are characterized by a jump change in pressure, high amplitude and non-periodicity. The kinetic energy of the shockwave projectile, created by compressed air, is transferred to the transmitter at the end of the hand-held probe and further into the tissue. This creates a breakdown of scar tissue, which promotes regeneration and reparative processes of the bones, tendons and other soft tissues. Unlike normal elastic tissue, scar tissue is non-elastic and prevents normal function and movement, thus weakening the unaffected healthy tissue surrounding it. This causes further pain and damage. By increasing blood circulation and breaking down scar tissue, Shockwave therapy stimulates cell regeneration, supports normal healing and the rapid reduction of pain. Normal functioning of the area is thus restored and the reparative and regeneration processes of the bones, tendons, and other soft tissues. As a result, the innate healing mechanism of the body is activated.
What Does Shockwave Therapy Help With, and Where Is It Used?
Shockwave therapy is used in the treatment of many soft tissue and musculoskeletal conditions, especially those involving connective tissues such as tendons and ligaments. It is most suited for people who have chronic (i.e., more than six weeks due to overuse or repetitive strain) tendinopathy (commonly known as tendinitis) and haven’t responded to other conventional forms of treatments. Most of these common problems include jumper’s knee, rotator cuff, plantar fasciitis, tennis elbow and calcific tendinitis of the shoulder. Shockwave therapy has shown to effectively treat the following conditions:
- Chronic neck dysfunction
- Calcific tendinitis of the rotator cuff muscles and bony spurs.
- Tennis and golfer’s elbow (lateral epicondylitis and medial epicondylitis)
- Patellar tendonitis (jumper’s knee) & chronic tendinopathies
- Shin splints and shin pain (tibial stress syndrome)
- Lumbar and cervical spine regions and chronic muscular pain
- Heel pain, heel spurs, plantar fasciitis, Achilles tendonitis
- Greater trochanter pain syndrome
- Patellar tendinopathy
- Bone Pathologies, Osteoporosis, delayed bone healing, bone non-union, fractures.
- Muscle sprain without discontinuity
- Carpal Tunnel Syndrome
- Erectile dysfunction
Shockwave therapy is a therapeutic modality that is becoming increasingly commonplace in physiotherapy. It is also used in orthopedics, sports medicine, urology, mobility restoration, and to promote bone healing and treat bone necrosis. Additionally, it is an effective alternative to surgical treatment of non-healing fractures, wound healing and has shown positive results in short-term and long-term outcomes in diabetic patients suffering from foot ulcers. Some of its benefits are:
- It has excellent cost/effectiveness ratio.
- No anesthesia or drugs required whatsoever.
- Barely any side-effects.
Are There Any Side Effects to Shockwave Therapy Treatment?
Side effects from Shockwave therapy are limited to numbness or tingling in the treated area, mild bruising, reddening, red spots, swelling, and pain. However, the recovery period is minimal compared with that of surgical intervention. Shockwave therapy should not be used if there is an infection, bone tumor, a circulation or nerve disorder, or a metabolic bone condition. Shockwave therapy should also not be used if there are any open wounds or tumors, or during pregnancy. People using blood-thinning medications or who have severe circulatory disorders may also not be eligible for treatment. One may experience temporary tenderness, soreness, and swelling for a few days following the Shockwave treatment procedure, because the shockwaves stimulate an inflammatory response from the body. This is nothing to be alarmed about, since this is the body reacting and healing itself naturally. However, it is important to not take any anti-inflammatory medication after treatment, as this may slow down results.
Most patients take a day or two off after treatment but don’t require a prolonged recovery period. Clinical experience and patient outcomes to date show that when performed by experienced practitioners, Shockwave therapy is an invaluable addition to conventional recovery therapies. It provides an alternative pathway to optimal recovery for athletes and those who wish to remain active. These side effects usually subside after 5 to 10 days.
What Is An Extracorporeal Shockwave?
An extracorporeal shockwave is a non-invasive, non-electrical high energy acoustic wave applied to an area of pain and discomfort. It is characterized by a jump change in pressure, high amplitude, and non-periodicity, as well as carries high energy. The kinetic energy of the Shockwave, created by compressed air, is transferred to the transmitter at the end of the hand-held probe and further into painful spots and myoskeletal tissues with sub-acute, sub-chronic, and chronic conditions. The energy promotes regeneration and reparative processes of the bones, tendons and other soft tissues.
There are three main techniques through which shockwaves are generated: electrohydraulic, electromagnetic, and piezoelectric principles, and each represents a different technique of generating shockwaves.
Electrohydraulic principle represents the first generation of orthopedic Shockwaves. They are high-energy acoustic waves generated by underwater explosion with high-voltage electrode spark discharge, and the acoustic waves are then focused with an elliptical reflector and targeted at the diseased area to produce therapeutic effect. It is characterized by large axial diameters of the focal volume and high total energy within that volume.
Shockwave generation through the electromagnetic technique involves the electric current passing through a coil to produce a strong magnetic field. A lens is used to focus the waves, with the focal therapeutic point being defined by the length of the focus lens. The amplitude of the focused waves increases by non-linearity when the acoustic wave propagates toward the focal point.
Shockwaves of piezoelectric technique involves a large number (usually >1,000) of piezocrystals mounted in a sphere and receives a rapid electrical discharge that induces a pressure pulse in the surrounding water steepening to a shockwave. The arrangements of the crystals cause self-focusing of the waves toward the target center and lead to an extremely precise focusing and high-energy within a defined focal volume.
When comparing different shockwave devices, the important factors include pressure distribution, energy density, and the total energy at the second focal point in addition to the principle of shockwave generation of each device.
In any case, Shockwaves create a swift increase in blood circulation to the target area. As a result, the fibrous scar tissue which has developed over time, especially in chronic conditions, gets broken down. This leads to pain relief and healing over time.
When May Shockwave Therapy Not Be Suitable?
Shockwave therapy is suitable for a various number of conditions with minimal side effects, but like most other healing modalities, is not an option in many circumstances, such as:
- Blood clotting disorders (including thrombosis)
- While taking oral anti-coagulants or severe coagulopathy
- If one has received a steroid injection in less than 6 weeks
- If one has a pacemaker fitted
- Presence of tumors at the treatment site
- Presence of infection, open wounds or skin abrasion at the treatment site
- If one is less than 18 years of age
- Treatment over an air-filled area such as the lungs or guts is not advisable
- Nerve disorders
- For application over open growth plates – not suitable for under 18 years.
- Over metal pins or plates
- Epiphyseal plate in the treatment area
- Brain or spine in the treatment area
- Fetus in the treatment area
This above list is not exactly in-depth, and it is advised to get assessed by a medical practitioner before considering Shockwave therapy. Certain individuals and conditions respond better to Shockwave therapy. It is important to be sufficiently screened by a medical practitioner before undergoing Shockwave therapy.
How Long Is A Shockwave Therapy Session, and What Can I Expect?
Shockwave therapy treatments usually take about 10-15 minutes. During your first visit, an experienced physiotherapist will first talk to you about your symptoms and condition. He or she will explain Shockwave therapy in detail and then commence your treatment. This is usually followed by hands-on manual therapy, such as myofascial release or dry needling.
One might experience some amount of discomfort or pain during the procedure. The therapist will make sure to ask you how much pain you are experiencing and will adjust the treatment to help you cope with the procedure. There are no known side effects of Shockwave therapy. Sometimes, one may experience a slight pain within a few hours of treatment that may last 24 hours, but this is not serious nor is it anything to worry about.
Shockwave therapy stimulates your body to create new tissue cells in the injured area. Healing could take days, weeks, or months, depending on how acute or chronic the injury is. One may experience mild soreness or inflammation after treatment. In many cases however, patients will experience little to no pain from the very first day of treatment. It has been noted that most experience a substantial improvement in pain within 3 months (over 60% reduction in the intensity of pain) and a second treatment after 4 months has seen to be required in roughly 20% of patients only. After only 3 or 4 treatments with shockwave therapy, over 80% of patients report a reduction of pain and regaining of normal function. Although this may seem like a long time, it must be noted that an injury, especially a chronic one, takes time to develop and therefore will take time to heal. In most cases, total and complete healing often occurs in a year’s time. The good thing about Shockwave therapy is that after the procedure, one does not need to take a lengthy sick leave from work for painful recovery.
Does Shockwave Therapy Help Arthritis?
Osteoarthritis is the most common form of arthritis. It occurs when the protective cartilage that cushions the ends of the bones wears down over time and due to overuse. Although osteoarthritis can damage any joint, the condition most commonly affects joints in the hands, knees, hips, and spine. It is estimated that over 10% of the world‘s population suffers from the malady.
Improvements in the social and economic situation in the modern era have led to an enhancement in the quality of life and increase in the average life expectancy. This, however, has also resulted in an increase in the elderly population in society, and they tend to suffer from one or more chronic diseases, most commonly diabetes, hypertension, and arthritis. The incidence of chronic degenerative arthritis is especially high in comparison to other musculoskeletal diseases, with around 80% of individuals aged 55 or older developing it and women being more prone to it. What’s more, the disease frequently affects the knees, since the knees bear the weight of the body. Arthritis is painful and limits one’s movement in daily life, including when doing simple activities such as rising from a chair, standing, walking, and even descending stairs.
There are several treatments for degenerative arthritis. They include medication, surgery, exercise therapy, and physical therapy. Recently, Shockwave therapy has proven to be effective in reducing pain and improving function in people suffering from arthritis. Since the early 1990s, Shockwave therapy has been used in Germany as an effective treatment for musculoskeletal disorders after it was discovered to decompose kidney, gallbladder and bile duct stones.
The therapeutic principles of Shockwave are based on 2 theories – the micro-trauma theory and the cognitive decline theory. In the former, healing is facilitated by repeatedly stimulating affected areas with Shockwave therapy, creating temporary micro-traumas that encourage the creation of new blood vessels, which increases blood supply to the area. Shockwaves can also spread into tissues neighboring painful regions, thereby increasing oxidative processes in the mitochondria and the photochemistry effect that facilitates adenosine triphosphate (ATP) production. This results in the increase and expansion of blood and lymphatic vessels in the area and will also decrease pain and discomfort due by rapidly removing exudate, re-absorbing the unnecessary liquids accumulated in the area, facilitating blood circulation and increasing metabolism.
Shockwave therapy helps manage arthritis by stimulating and reactivating the healing process of connective tissues, including bones and tendons. Shockwave therapy has therefore been recommended as a safe, effective, and promising method for treating patients with arthritis.85% of patients who undergo Shockwave therapy have shown considerable improvement in painful symptoms and joint function. Morning stiffness rate was seen to have reduced by 44%, joint index was reduced by 39%, and functional index was reduced by 18%. In conclusion, it can be said that Shockwave therapy is an effective treatment for managing osteoarthritis.
Magne-tec: The Place for State-of-the-Art Shockwave Therapy Equipment!
Since the early 1980s, Magne-tec has been providing medical healthcare providers with the most advanced therapy devices on the market by carrying only the most effective & robust products, including Shockwave therapy equipment. Magne-tec caters to markets including but not limited to podiatry, physical therapy, sports rehabilitation, chiropractic, pain management, and chiropody, and prides itself on its association with world-class manufacturers whose product offerings are built on evidence-based medicine and years of sound research. These state-of-the-art technologies are guaranteed to improve clinical outcomes, increase patient retention, and ensure a positive financial return for clinics.
Magne-Tec is proud to be the exclusive distributor of the following “Best in Class” products: Swiss DolorClast® Shockwave by EMS (Switzerland), Sterodynator by GBO (previously Siemens – Germany), the Noveon nail fungus laser (USA), as well as multiple magnetic therapy /PEMF devices by MBS (Germany).
With over 30+ years of experience in the health industry, Magne-tec has built a loyal and satisfied client base across North America and transformed the lives of countless people in an extremely positive way. Will you be one of them as well?