Extracorporeal shockwave therapy (ESWT) is a non-invasive treatment option that is used for various musculoskeletal conditions, including:
- plantar fasciitis
- iliotibial (IT) band syndrome
- shin splints
- patellar tendonitis
- frozen shoulder (adhesive capsulitis)
- tennis elbow (epicondylitis)
- post-surgical fibrosis (fibrous tissue growth)
ESWT involves the application of high-energy sound waves to the affected area to stimulate healing and reduce pain. The two main types of shockwave devices are piezoelectric and radial.
Piezoelectric machines have an applicator that contains an array of crystals made of ceramic material that are embedded in a concave bowl. A voltage is applied, which causes the crystals to deform very quickly. This generates a mechanical wave. The waves from the crystal array are focused by the concave bowl and directed into the patient’s body, through which it travels. Piezoelectric machines generate a high pitched, short “tick” sound with each pulse. The pulse frequency is varied by varying the power to the applicator. It is important to note that since the energy waves generated by piezoelectric machines are focused into a small area, treating large areas takes a lot of time/ treatment sessions.
Radial shockwave machines generate an energy wave using kinetic energy. An electromagnet inside the applicator accelerates a metal rod, called a “bullet,” against a strike plate. The strike plates are attachments to the applicator, and come in different sizes. Small attachments will concentrate the wave energy into a smaller area, but again, will require multiple treatments to cover large areas such as for shin splints or IT band treatment. Larger attachments will cover more area, but the energy is attenuated more because of this. Radial shockwave machines generate energy waves that cover more area than a piezoelectric generated wave, but are not as focused.
ESWT for plantar fasciitis:
Procedure: During ESWT, a handheld device delivers shockwaves to the plantar fascia, which is the tissue causing the pain and inflammation. The shockwaves help to break up scar tissue, promote blood flow, and stimulate the healing process.
Treatment sessions: ESWT is typically administered in a series of sessions, usually spaced about one week apart. The number of sessions required can vary, but it typically ranges from three to six sessions.
Effectiveness: ESWT has been shown to be effective in relieving pain and improving function in many patients with plantar fasciitis. Research studies have demonstrated positive outcomes, with reductions in pain and improvements in foot function.
Side effects: ESWT is generally considered safe, and serious complications are rare. However, some individuals may experience mild side effects such as temporary pain, redness, bruising, swelling, or numbness in the treated area.
Post-treatment: Following ESWT, it’s important to follow your healthcare provider’s instructions for post-treatment care. This may include rest, ice application, stretching exercises, and avoiding activities that may aggravate the condition. Physical therapy and orthotics may also be recommended to aid in the recovery process.
Suitability: ESWT is typically considered when conservative treatments, such as rest, stretching, orthotics, and medications, have failed to provide sufficient relief. Your healthcare provider will assess your individual case and determine if ESWT is a suitable option for you.
It’s worth noting that while ESWT can be effective for many people, individual results may vary.
Since it is a relatively save procedure with rare serious side effects, extracorporeal shockwave therapy is safe to do at home. There are personal devices available such as this one that allow consumers to apply the treatment to themselves. While it isn’t cheap, it is a fraction of the cost of the professional models and is just as effective.
The benefits of owning your own extracorporeal shockwave machine is that, if you have a chronic problem, such as in your shoulder, that surfaces a couple times a year, you can save a lot of money by doing the treatment yourself. A typical ESWT treatment at a physical therapist or chiropractor office runs anywhere from $50-$200/treatment, and they require you to get at least six; often more.
Bottom Line: whether you seek Extracorporeal Shockwave treatment from a therapist, or invest in your own machine, it can help your body heal from slow-healing soft tissue injuries by breaking down abnormal scar tissue and stimulating regeneration of newer tissue.
