Understanding Shockwave Therapy
Shockwave Therapy, also known as Extracorporeal Shockwave Therapy (ESWT), is a non-invasive treatment that uses acoustic waves to target musculoskeletal tissues. It has been used in sports medicine, orthopedic medicine, and rehabilitation settings for a variety of tendon, ligament, and soft tissue conditions.
Unlike injections or surgical procedures, shockwave therapy is performed externally and does not require incisions.
What Is Shockwave Therapy?
Shockwave therapy uses a specialized device that delivers acoustic energy to a targeted area of the body.
The goal is to apply controlled mechanical energy to tissues that may be contributing to pain, dysfunction, or activity limitations. Researchers believe these acoustic waves may influence cellular activity, blood flow, tissue remodeling processes, and pain signaling pathways.
Shockwave therapy is considered a non-invasive procedure because treatment is delivered through the skin without surgery.
Types Of Shockwave Therapy
Patients may encounter different forms of shockwave treatment.
Focused Shockwave Therapy
Focused shockwave therapy delivers acoustic energy to deeper tissues and is often considered "true" extracorporeal shockwave therapy.
Radial Shockwave Therapy
Radial pressure wave therapy delivers energy more superficially and is commonly used in musculoskeletal medicine.
The specific technology utilized depends on the condition being evaluated, physician preference, and treatment goals.
Conditions Commonly Evaluated For Shockwave Therapy
Shockwave therapy has been studied in a variety of musculoskeletal conditions. Published literature and orthopedic practices commonly discuss its use in conditions such as:
Plantar Fasciitis
Chronic heel pain and plantar fascia-related symptoms.
Achilles Tendinopathy
Pain and dysfunction involving the Achilles tendon.
Tennis Elbow
Lateral elbow pain associated with overuse of the wrist extensor tendons.
Golfer's Elbow
Pain involving the tendons on the inner side of the elbow.
Patellar Tendinopathy
Sometimes referred to as jumper's knee.
Calcific Tendinopathy
Certain shoulder tendon conditions involving calcium deposits.
Not every patient with these conditions is a candidate for shockwave therapy, and treatment decisions should be individualized.
How Is Shockwave Therapy Performed?
Although protocols vary, treatment generally involves:
- Evaluation and diagnosis
- Identification of the treatment area
- Application of ultrasound gel
- Delivery of acoustic energy through a handheld device
- Follow-up assessment
Most treatments are performed in an outpatient setting.
Specific treatment protocols vary depending on the condition and physician recommendations.
What Does Shockwave Therapy Feel Like?
Patient experiences vary.
Many individuals describe:
- Tapping sensations
- Pulsing sensations
- Pressure
- Temporary discomfort in sensitive areas
The experience depends on:
- Treatment location
- Energy settings
- Tissue sensitivity
- Individual pain tolerance
Your physician can discuss what to expect based on your specific treatment plan.
Why Is A Diagnosis Important?
Shockwave therapy is not a diagnosis.
It is a treatment modality that may be discussed for selected conditions.
The most important step is identifying:
- The source of symptoms
- Contributing factors
- Functional limitations
- Activity goals
Treatment decisions should always begin with a thorough evaluation.
What Happens During The Evaluation Process?
Evaluation typically includes:
Medical History
Review of symptoms, prior treatments, and activity goals.
Physical Examination
Assessment of movement, strength, flexibility, and function.
Imaging Review
Review of X-rays, MRI studies, ultrasound findings, or other imaging when appropriate.
Treatment Discussion
Review of available treatment options and whether shockwave therapy may be appropriate for further discussion.
Treatment Considerations
Treatment recommendations depend on:
- Diagnosis
- Symptom duration
- Functional limitations
- Previous treatments
- Imaging findings
- Activity goals
Potential discussions may include:
- Physical therapy
- Exercise programs
- Activity modifications
- Bracing
- Injection procedures
- Shockwave therapy
- Surgical consultation when appropriate
The best treatment strategy is individualized.
Frequently Asked Questions
What is shockwave therapy?
Shockwave therapy is a non-invasive treatment that uses acoustic waves to target musculoskeletal tissues.
Is shockwave therapy surgery?
No.
Shockwave therapy is performed externally and does not involve surgical incisions.
What conditions are commonly discussed with shockwave therapy?
Conditions commonly evaluated include plantar fasciitis, Achilles tendinopathy, tennis elbow, golfer's elbow, patellar tendinopathy, and certain shoulder tendon conditions.
Is shockwave therapy the same as an injection?
No.
Shockwave therapy uses externally delivered acoustic energy and does not involve an injection.
Do all patients with tendon pain need shockwave therapy?
No.
Treatment recommendations depend on the diagnosis, symptoms, previous treatments, and individual goals.
Can shockwave therapy be combined with other treatments?
Treatment plans are individualized and may include multiple approaches depending on the clinical situation.
The Dr. Peaches Perspective
Dr. Peaches believes that successful treatment begins with an accurate diagnosis and a clear understanding of the patient's goals.
Shockwave therapy is one of several non-surgical treatment options that may be discussed for selected musculoskeletal conditions. The decision to incorporate any treatment modality should be based on the diagnosis, symptoms, functional limitations, previous treatments, and individual goals.
Whether the goal is returning to golf, pickleball, running, fitness, work, travel, or simply remaining active, treatment plans should be tailored to the individual.
Help people stay in the game.