EXTRACORPOREAL SHOCKWAVE THERAPY (ESWT) PATIENT INFORMATION DOCUMENT

What are the benefits of ESWT?

Shockwave is particularly effective in helping stubborn conditions, like chronic tendon pain, which may not have responded to other forms of treatment. Studies have shown that ESWT may provide pain relief in up to 70-80% of cases and may eliminate your need for surgery. ESWT is also non-invasive and deemed to be safe and effective for many conditions by the National Institute for Health and Care Excellence (NICE). 

Are there any risks or side effects? 

Some patients find shockwave treatment to be uncomfortable but most are able to tolerate it well. The treatment can be tailored to your individual response and adjusted accordingly. Some discomfort, redness or bruising may develop after treatment but this usually subsides within 48 hours. There is a small risk of tendon rupture or damage to the soft tissues following ESWT but the risk is extremely low and the potential benefit far outweighs any risk. 

Are there are reasons why I can’t have ESWT?

There are relatively few contraindications to the radial shockwave which we use here at Balanced.

ESWT is contraindicated if;

• You are pregnant
• You are undergoing cancer treatment
• You have an infection or wound at the treatment site
• You have had a steroid injection within the last 6 weeks
• You have loss of sensation at the site of injury 

ESWT may not be appropriate, or used with caution if; 

• You have metal pins, plates or prosthesis at the area requiring treatment
• You have a blood clotting disorder
• You are taking anti-coagulants medication
• You are under 18 years old
• You have had a serious soft tissue rupture at the injury site 

How can I prepare for my treatment?

ESWT works best when sessions are delivered approximately 1 week apart. Most injuries require a minimum of 3 sessions, which is why treatment is sold as a block of 3. We would ask that you are available for 3 weeks in a row ideally or for 3 sessions spaced over a month. There is a possibility that more sessions may be necessary if your condition is very chronic.

We need to access the skin of the injured body part so please ensure you are wearing loose fitting clothing to facilitate this. 

It is important that you do not take non-steroidal anti-inflammatory (NSAID’s) medication for 2 weeks prior to your 1st session and over the duration of your treatment as this may interfere with treatment effectiveness. If you are unsure if you take NSAID’s then it is best to clarify this with your GP or Pharmacist. 

What happens during an ESWT treatment session?

 Your treatment will be carried out by a trained member of our Physiotherapy team. If it is your first time in clinic, or if it is the first time seeing us with a new injury, we will take a detailed injury and medical history which will allow us to determine if ESWT is suitable for your injury or not and plan your treatment most effectively. Over the course of treatment your physiotherapist will discuss important injury management strategies such as rehab exercises and activity modification. 

ESWT is delivered via a hand held probe which is placed on the skin over the injured body part. Ultrasound gel will be placed on the skin first to allow the shockwaves to be transmitted more easily.

The treatment lasts around 5-10 minutes. It can be a little noisy and it can be uncomfortable however your practitioner can adjust this to tailor it to your response. 

What happens after the treatment session?

After a session of ESWT is over you can leave the clinic straight away. If discomfort persists then taking pain relief, like paracetamol, is okay but do not take any NSAID’s, such as ibuprofen, as this may interfere with the treatment effectiveness. You will be able to drive straight after treatment and can continue with normal day to day activities, however, it is advisable to avoid strenuous or high impact exercise for 48 hours after a session. After this you may resume your normal activities and rehabilitation regime but it is recommended that you do not increase load etc over the period of treatment. 

Follow up sessions will be booked at your convenience and the response to treatment will be monitored. You will see the largest benefit 3-4 weeks after the ESWT course ends. Once you have reached the end of a treatment block a discussion will be had about the next course of action. Usually this will mean starting to advance your 12 week rehabilitation programme but in some cases (chronic conditions) further ESWT may need to be planned but your referring clinician will advise you on this.