Extracorporeal Shock Wave Therapy (ESWT) is a non-invasive method of treating specific soft tissue injuries. ESWT evolved from Extracorporeal Shock Wave Lithotripsy (ESWL), where shock waves are used to break down kidney stones. In ESWT, lower energy levels are used in Sports Medicine and Orthopaedic conditions to stimulate an individual’s own tissue healing mechanisms. Sports medicine physicians use focal shock waves to the affected region that are accurately guided by real-time ultrasound images.
Indications for ESWT
The indications for ESWT include
What is a Shock Wave?
A 'shock wave' is a pulsed wave that delivers a sudden high pressure to a targeted area, followed by a negative pressure. "Extracorporeal" means that the shock wave is delivered from outside the body.
How do Shock Waves Heal an Injury?
It is thought that the shock waves trigger the body's repair mechanism through the local release of various growth factors and over-stimulates pain transmitting nerve endings. This leads to a short-term reduction in pain and sensitivity.
What does the Treatment Involve?
The course of treatment involves 2 outpatient sessions that are usually spaced one week apart. Before each session, avoid heavy meals (light meals are fine). Wear clothes that will allow the injured site to be exposed easily. Inform your doctor of any medical conditions or if you are pregnant. Sometimes it can help to decrease discomfort during the procedure if you ice the area for 10 minutes before the ESWT or take a pain medication before arriving for the appointment.
During the ESWT session, you will be positioned comfortably on an examination table. An ultrasound scanner is used to accurately guide the shock waves to the injury site. You will feel a strong 'tapping' sensation with each shock wave, and the treatment usually lasts 10 minutes.
What should I do after the treatment?
You can resume your normal daily activities after each treatment. It is ok to ice the area if you have local discomfort. Aggravating activities (e.g. running in the case of heel spurs) should be avoided until 2 weeks after the second ESWT session. Concurrent therapy (e.g, physiotherapy, or orthotics) may be prescribed to address the underlying biomechanical causes of the injury.
Are there any Adverse Effects?
The shock waves may be uncomfortable or painful but most patients tolerate it well. Minor bruising may develop, but that is temporary and rare.
How Can I Access ESWT Treatment?
You will need to see a doctor at CSMC first to confirm the diagnosis and decide if ESWT is medically indicated.
Each session of ESWT will last about 30 minutes total inclusive of preparation time.