On occasion, the body’s natural healing mechanism to address injuries are not enough to return the damaged area to equilibrium. This could be due to factors like repeated damage, old age, or an unsuitable environment for self-repair.
For certain musculoskeletal injuries and conditions, an acoustic pulse delivered into the damaged tissue assists to stimulate and induce the body to perform its self-repair function. The use of such acoustic pulses is termed shockwave therapy.
The original application of shockwave was to address kidney stones. This was done in an operating theatre setting. Researchers then found that a lower-intensity shockwave was able to address and treat various musculoskeletal conditions and to manage pain.
The low-intensity shockwaves used in therapy and pain management have been extensively studied, and are an accepted modality in many orthopaedic, musculoskeletal practices, podiatry centres, and hospitals in Singapore and around the world.
Shockwave therapy may treat musculoskeletal injuries and conditions such as degenerated or injured tendons, pain in the extremities, muscular aches and imbalances. In a lower limb clinic, this includes conditions like Achilles tendonitis, heel pain (heel spur syndrome, plantar fasciitis), patellar tendonitis, shin splints, iliotibial band syndrome (ITBS) and others.
Shockwave therapy can also be done to facilitate trigger point and fascial release, allowing for better ease of movement and range of motion for patients.
Addressing such injuries and muscular imbalances with shockwaves allow practitioners to assist their patients to manage or resolve their musculoskeletal pain effectively.
Shockwave therapy is an outpatient procedure. The shock wave handpiece is placed on the skin after a transmitter gel is applied to help conduct the acoustic pulses. The acoustic pulse is transmitted directly into the injured tissue, creating a force that induces the healing process. The body is then stimulated to repair and heal itself.
Shockwave therapy is performed without anaesthesia as it is important that the patient gives bio-feedback during the treatment. Active patient participation makes the therapy more successful.
Typically, patients can bear weight right after treatment, however, they are advised to reduce the level of physical activity for one to two weeks. Shock wave therapy can give fast, good outcomes for muscle and tendon injuries as well as chronic degenerative conditions; examples include Achilles tendinitis and plantar fasciitis.
In general, an average of 3 to 5 shockwave sessions is needed. These sessions are performed at weekly intervals. However, the number of treatments needed is dependent on factors like the condition being treated, patient profile, patient compliance, amongst others.
The main complications are pain and hypersensitivity at the site of treatment, right afterwards. These problems should steadily resolve within a couple of days. Pain and disability may persist if the patient aggravates the pre-existing condition with too much activity right after treatment.
Shock wave therapy is a non-invasive treatment which can help the patient achieve the cure without surgery. The response to treatment can vary based on the individual. When conservative treatment options are exhausted, surgery may be what is needed.
Complications are infrequent with a proper application of shock wave therapy by experienced healthcare providers.
Patients who are pregnant, who have blood clotting disorders, or are taking anticoagulants should avoid this therapy. Those who have had cortisone therapy up to six weeks before the treatment should also avoid this therapy. ESWT is not advised in patients with cancer.
ESWT is also unsuitable for children below the age of 18, your podiatrist at the children’s foot clinic may recommend alternative solutions to alleviate your child’s pain.
This list is not exhaustive, if you are in doubt, please check with your physician before undergoing shockwave therapy.
This may depend on the insurance policy. Discuss this with your healthcare provider and contact your insurance carrier before having the procedure.