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Extracorporeal Shock Wave Therapy, (or ESWT), is a multidisciplinary device used in orthopaedics, physiotherapy, and sports medicine. Its main assets are fast pain relief and mobility restoration. Together with being a non-surgical therapy with no need for painkillers makes it an ideal therapy to speed up recovery and cure various indications causing acute or chronic pain.

MEDICAL STUDIES SUCCESS RATES

  • 91% improvement for Calcific Tendonitis (Journal of American Medical Association 2003)
  • 77% improvement for Tennis Elbow  (The Journal of Orthopedics’ 2005)
  • 90% improvement for Plantar Fascitis-foot pain (Journal of Orthopedic Research 2005)
  • 75% success rate for Achilles Tendonopathy (American Journal of Sports Medicine)
  • 75% success rate for Patellar Tendonopathy (American Journal of Sports Medicine)
Healthplus Shockwave Therapy

Extracorporeal Shock Wave Therapy, (or ESWT), is a multidisciplinary device used in orthopaedics, physiotherapy, and sports medicine. Its main assets are fast pain relief and mobility restoration. Together with being a non-surgical therapy with no need for painkillers makes it an ideal therapy to speed up recovery and cure various indications causing acute or chronic pain.

A shockwave is an intense, but very short energy wave traveling faster than the speed of sound.  The word “Extra-corporeal” means “outside the body” and refers to the fact that the shockwaves are generated outside the body. The energy promotes regeneration and reparative processes of the bones, tendons and other soft tissues along with analgesia and mobility restoration.

The basic science behind Shockwave Therapy is analogous to lithotripsy, the technology that uses acoustic shockwaves to break up kidney stones without surgery.  The technique of using shockwaves to break up kidney stones has been around for a nearly a quarter century now, and in the process of treating thousands and thousands of patients, it was found that many people undergoing the procedure had other unrelated aches and pains disappear.  It was at this point that scientists began to consider that shockwaves may have an effect to heal other sorts of tissues.

The process induces microtrauma to the injured tissue and the body responds by increasing blood circulation and metabolism. This in turn speeds up the body’s natural healing response by increasing cell generation and dissolving troublesome calcium deposits.

Shockwave therapy does not require the use of drugs or surgery and there are virtually no side effects and risks. Studies have shown that it is equal to or more effective than any other form of physical therapy, while being quicker and much more convenient. Mechanotransduction is the specific effect of shockwaves that causes all the biological reaction in the cells and tissue and is the important factor that differentiate SWT to ultrasound, laser, radiation, and any other therapy forms.

Specialized machines were then developed specifically with the idea of using these shockwaves on other parts of the body, and this is the origin of Shockwave Therapy. The type of Shockwave therapy we use at Healthplus Clinics is specialized to specifically help treat musculoskeletal conditions.

The vast majority of recent studies suggest that shockwave is highly effective. Assuming you have an injury appropriate to extra-corporeal shockwave technology treatment, most recent independent studies suggest somewhere between a 65% and a 95% “success” range, with values around 80% being the most commonly cited number.

MEDICAL STUDIES SUCCESS RATES

  • 91% improvement for Calcific Tendonitis (Journal of American Medical Association 2003)
  • 77% improvement for Tennis Elbow  (The Journal of Orthopedics’ 2005)
  • 90% improvement for Plantar Fascitis-foot pain (Journal of Orthopedic Research 2005)
  • 75% success rate for Achilles Tendonopathy (American Journal of Sports Medicine)
  • 75% success rate for Patellar Tendonopathy (American Journal of Sports Medicine)

Some people (approximately 20%) do not respond to this treatment, although a proportion of these will subsequently respond to a further course of treatment.  If, after 3-4 months, a pronounced improvement is not felt, you should discuss this with us at Healthplus Clinics further so that we can formulate a plan of management.

At Healthplus Clinics we find that our results with the Swiss Dolorclast Machine, are at least this successful.  The most important factor in getting a good result with Shockwave Therapy appears to be in selecting appropriate patients most likely to benefit from this technology.

Conditions Treated by Shockwave Therapy

At Healthplus Clinics we regularly and successfully treat with Shockwave Therapy:

Foot – Plantar Fasciitis, heel spurs, medial tibial stress syndrome (shin splints) & Achilles tendonitis

Knee – Patellar tendonitis, jumper’s knee & shin pain

Elbow – tennis or golfer’s elbow

Shoulder – rotator cuff tendonitis & calcification

Hip – trochanteric bursitis

Muscles – various trigger points throughout the body and muscle tension

Bones – Stress fractures, non-union (delayed bone healing)

Nerves – Morton’s Neuroma

Benefits of Shockwave Therapy

Shockwave therapy is a recent development that is used successfully at Healthplus Clinics. As compared to other treatment methods, the benefits of Shockwave Therapy are:

  • Treatment success rates equal to or better than surgery (75-90% with Shockwave)
  • Non-invasive
  • Safe
  • Reduces pain
  • Decreases scar tissue
  • Drastically reduced healing and recovery period
  • Immediate analgesic effects
  • No anaesthesia required
  • New technology with proven researched medical effectiveness levels
Risks of Shockwave Therapy

Shockwave Therapy, like all treatments, while offering considerable benefits, may also provide some level of risk. Healthplus Clinics require every patient to make an informed decision about beginning Shockwave Therapy, in particular:

  • While rare, some patients may experience short-term aggravation of symptoms
  • You may experience redness, bruising, swelling and numbness to the area
  • Potential tendon rupture or ligament rupture and damage to the soft tissue
  • Pain and discomfort during and after treatment
  • Potential damage of lung and gut tissue
  • Potential damage of immature epiphyses
  • Possible dissemination of malignant tumors
  • Potential damage to articular cartilage
Shockwave Therapy FAQs

What equipment do you use?

At Healthplus Clinics we use a SWISS DOLORCLAST® SMART20.

When is Shockwave therapy appropriate for me?

At Healthplus Clinics we always conduct and initial assessment to determine if your condition is appropriate for treatment with Shockwave Therapy. Shockwave Therapy is used when all other treatments have been exhausted and the injury become chronic, lasting for more than 3 months. Shockwave Therapy is most effective for conditions resulting from connective tissue attachments to bone. Shockwave Therapy is a “stand alone” treatment, no other modalities or exercises will be given during a SWT treatment.

How does shockwave Therapy work?

Shockwaves accelerate the healing process by activating the body’s self-healing powers, particularly in cases where the body has been unable to do it on its own.  It stimulates metabolism and enhances blood circulation which enables damaged tissue to regenerate and eventually heal. The treatment relieves pain by producing an analgesic effect on the treatment area. Healing occurs over several treatments by initiating an inflammatory response and ultimately vascularization to the area. The high energy acoustic waves that are transmitted through the surface of the skin are spread radially (spherically) into the body and the body responds with increased metabolic activity around the area of the pain. This stimulates and accelerates the healing process and is especially useful for those suffering from chronic heel, shoulder, knee, Achilles, elbow and back pain.

Your therapist will apply shockwaves through a specially designed hand piece that produces strong pneumatic energy pulses for short periods of time.  The shockwave energy pulses are applied directly to the affected tissue areas in a controlled procedure.

Shockwaves have a mechanical effect on the tissue.  Pressure in the front of the shockwave is transmitted into the tissue, creating micro-cavitation bubbles that expand and burst into a resultant force.  This force penetrates tissue and stimulates cells in the body which are responsible for bone (osteoblast) and connective tissue (fibroblast) healing. Research has also shown that Shockwave also breaks down calcium deposits.

How is shockwave Therapy performed?

Stage 1 – Isolate the area to be treated with Shockwave Therapy using palpation and gentle pressure.

Stage 2 – Gel is applied to the area of treatment to allow the transfer of acoustic waves efficiently and smoothly.

Stage 3 – The Shockwave applicator is slightly pushed against the area to be treated and the start button is pressed.

Does the treatment hurt?

The treatment can cause a little discomfort, but a vast majority of people tolerate this very well, particularly because the first 500 or so impulses generally have an immediate pain-relieving effect.  Some patients feel a little bit of discomfort for a day after treatment, but this is not seen in most of those treated.  It is extremely rare for patients to need painkillers after the treatment.

How many treatments will I need?

Normally 3 Shockwave Treatment are necessary. Further healing takes place up to 6 weeks after the sessions. On occasion 5 Shockwave Therapy Treatment sessions may be needed for very chronic conditions. The effect of the treatment is cumulative, this means that each session builds on the previously to produce the outcome required.

After the first session of Shockwave Therapy there may be temporary reduction of pain associated with an anesthesia effect from the hyper-stimulation of the tissue.

It takes several days for injuries to begin to heal, and many patients see an improvement before the end of the second week.  Depending upon your diagnosis, the healing process may take several weeks or even months to be completed, but pain relief often precedes the completion of the healing process.

How often will I need the treatment?

Shockwave Therapy Treatment sessions are generally delivered weekly for three weeks. In response to very chronic conditions this can continue for 5 weeks.

How long does the treatment last?

Before you have shockwave therapy for the first time at Healthplus Clinics, we will conduct a 30 minute assessment and treatment session. At Healthplus we do this in order to determine whether Shockwave Therapy is an efficient method of treatment for your condition. Follow up Shockwave Therapy treatments take about 10-15 minutes depending on the disorder that is treated. We will reassess your condition on each session to determine further requirements. As standard we allow 20 minutes for every follow up appointment.

Will I feel any pain after the treatment?

When you leave Healthplus Clinics you will most likely be pain free. However, within 2–4 hours after the treatment, you may experience some soreness in the treated area. This soreness has been reported as tolerable and not limiting.

Some patients may experience some redness, swelling, red spots after treatment which is the body’s natural response that healing is taking place and subsides within a few days. If you are concerned please contact the clinic on 0800 043 7103.

What should I do before treatment?

Anti-inflammatory medication should not be taken within 10 days of starting treatment, during treatment and for 12 weeks after treatment. If you are unsure as to whether you should discontinue medication, please check with your GP or consultant prior to booking an appointment.

What should I do if I am in pain after treatment?

As part of your Shockwave Therapy treatment we want an inflammatory response so refrain from using ice or anti-inflammatory medications. Paracetamol and other pain killers are acceptable

What should I do after treatment?

Even if you have no pain we recommend that you refrain from intensive activities for 48 hours after each treatment.  You should continue your usual stretching/eccentric physiotherapy exercises.

How much does Shockwave Therapy cost?

Healthplus Clinics charge £600 for initial consultation and three sessions of shockwave therapy. In the event you require further sessions of shockwave therapy a charge of £150 per session will be made.

Healthplus Clinics have arrangements with a number of insurance companies. Should this be the case, charges may vary from our standard charge.

How do I fund Shockwave Therapy?

Insured patients:  Many of the major medical insurance companies in the UK have approved Shockwave Therapy and will cover this treatment for some indications. At Healthplus Clinics we encourage our patients to check with their insurer before commencing treatment.  We can supply patients with the appropriate codes for the procedure on request to assist with these enquiries.

Self-funding patients:  For those who are not insured but who want to have Shockwave Therapy treatment, we offer a comprehensive and very competitive self-pay package of treatment along with 0% finance (subject to status and Terms & Conditions).  Please contact us for further details.

Does private health insurance cover Shockwave Therapy?

Many of the major medical insurance companies in the UK have approved Shockwave Therapy and will cover this treatment for some indications. At Healthplus Clinics we encourage our patients to check with their insurer before commencing treatment.  We can supply patients with the appropriate codes for the procedure on request to assist with these enquiries.

Are there any contra-indication to Shockwave Therapy?

There are a number of contra-indication to Shockwave Therapy. These will be discussed in detail prior to the start of treatment. For the purposes of general discussion the main contra-indications are as follows:

  • Cortisone injection within the last 6 weeks
  • Haemophilia or any blood coagulation disorder
  • Blood thinning medication ( e.g. Heparin, Warfarin)
  • Heart or circulatory problems (Thrombosis)
  • Growing children (Growth Plates)
  • Cancer
  • Diabetes
  • Pregnancy
  • Shockwaves are generally not applied to target areas located above air filled tissue (lungs), large nerves and blood vessels, the spinal column or the head.

What if shockwave treatment doesn’t seem to be working?

Even though a majority of people (70-80%) respond to shockwave treatment within a few weeks (and sometimes earlier than this), it may take several months before the maximum effect is achieved.

Some people (approximately 20%) do not respond to this treatment, although a proportion of these will subsequently respond to a further course of treatment.  If, after 3-4 months, a pronounced improvement is not felt, you should discuss this with us further so that we can formulate a plan of management.  Remember that we have other treatment options available and we will do everything we can to help you.

Healthplus Shockwave Therapy - Why Us ?

When you visit Healthplus Clinics Shockwave Therapy you will experience a unique and pro-active treatment service with a professional interested in your individualised treatment. You will be welcomed to Healthplus Shockwave Therapy by the vibrant clinic environment and cheerful staff and receive personal attention and thorough detail from your healthcare professional.

At Healthplus Shockwave Therapy we have a Five Point Promise which separates us from our competitors. Our clinicians will always advise you of the lowest cost option for your individual condition or injury. Our aftercare service means that we will provide help and assistance should this be necessary with sequential and periodic reviews.

 

Five Point Promise:

1.   Specialist Healthcare Professionals with advanced training in Shockwave Therapy

2.   Clinically comprehensive

3.   Transparent prices

4.   Individualized treatment

5.   Professional aftercare

In addition Healthplus Shockwave Therapy offers:

  • Friendly and courteous staff.
  • Convenient appointment times.
  • Prompt service, we will never keep you waiting for a long period of time.
  • Professional but comfortable atmosphere.
  • Large treatment rooms with state of the art equipment.
  • Convenient location.
  • Over a decades of experience, with patients from celebrities, professional & Olympic athletes.
  • Consultant, GP, insurance and rehabilitation company referrals.
  • Direct claim procedure.
  • Lunch time and early morning appointments.
Shockwave Therapy Resources

Alvarez, R. G. et al. (2011). “Extracorporeal shock wave treatment of non- or delayed union of proximal metatarsal fractures.” Foot Ankle Int 32(8): 746-754.

Alves, E. M. et al. (2009). “The use of extracorporeal shock waves in the treatment of osteonecrosis of the femoral head: a systematic review.” Clinical Rheumatology 28(11): 1247-1251.

Aqil, A. et al. (2013). “Extracorporeal Shock Wave Therapy Is Effective In Treating Chronic Plantar Fasciitis: A Meta-analysis of RCTs.” Clinical Orthopaedics and Related Research® 471(11): 3645- 3652.

Arno, A. et al. (2010). “Extracorporeal shock waves, a new non-surgical method to treat severe burns.” Burns 36(6): 844-849.

Bisset, L. et al. (2005). “A systematic review and meta-analysis of clinical trials on physical interventions for lateral epicondylalgia.” Br J Sports Med 39(7): 411-422

Boddeker, R. et al. (2001). “Extracorporeal shockwave therapy (ESWT) in the treatment of plantar fasciitis–a biometrical review.” Clin Rheumatol 20(5): 324-330.

Buchbinder, R. et al. (2002). “Shock wave therapy for lateral elbow pain.” Cochrane Database Syst Rev(1): CD003524.

Buchbinder, R. et al. (2006). “Systematic review of the efficacy and safety of shock wave therapy for lateral elbow pain.” J Rheumatol 33(7): 1351-1363.

Burton, A. and T. J. Overend (2005). “Low-energy extracorporeal shock wave therapy: a critical analysis of the evidence for effectiveness in the treatment of plantar fasciitis.” Physical Therapy Reviews 10(3): 152-162.

Buselli, P. et al. (2010). “Shock waves in the treatment of post-traumatic myositis ossificans.” Ultrasound Med Biol 36(3): 397-409.

Cacchio, A. et al. (2011). “Shockwave therapy for the treatment of chronic proximal hamstring tendinopathy in professional athletes.” Am J Sports Med 39(1): 146 – 153.

Chang, K. V. et al. (2012). “Comparative effectiveness of focused shock wave therapy of different intensity levels and radial shock wave therapy for treating plantar fasciitis: a systematic review and network meta-analysis.” Arch Phys Med Rehabil 93(7): 1259-1268.

Cheing, G. L. and H. Chang (2003). “Extracorporeal shock wave therapy.” J-Orthop-Sports-Phys- Ther. 33(6): 337-343.

Cho, Y.-S. et al. (2012). “Effects of the Combined Treatment of Extracorporeal Shock Wave Therapy (ESWT) and Stabilization Exercises on Pain and Functions of Patients with Myofascial Pain Syndrome.” Journal of Physical Therapy Science 24(12): 1319-1323.

Chung, B. and J. P. Wiley (2002). “Extracorporeal shockwave therapy: a review.” Sports Med 32(13): 851-865.

Ciccone, M. et al. (2012). “Shockwave Therapy in Patients with Peripheral Artery Disease.” Advances in Therapy 29(8): 698-707.

D’Agostino, C. et al. (2011). “Effectiveness of ESWT in the treatment of Kienbock’s disease.” Ultrasound Med Biol 37(9): 1452-1456.

Dizon, J. N. et al. (2013). “Effectiveness of extracorporeal shock wave therapy in chronic plantar fasciitis: a meta-analysis.” Am J Phys Med Rehabil 92(7): 606-620.

Elster, E. A. et al. (2010). “Extracorporeal shock wave therapy for nonunion of the tibia.” J Orthop Trauma 24(3): 133-141.

Engebretsen, K. et al. (2011). “Supervised exercises compared with radial extracorporeal shock-wave therapy for subacromial shoulder pain: 1-year results of a single-blind randomized controlled trial.” Phys Ther 91(1): 37-47.

Foldager, C. B. et al. (2012). “Clinical Application of Extracorporeal Shock Wave Therapy in Orthopedics: Focused versus Unfocused Shock Waves.” Ultrasound in Medicine & Biology 38(10): 1673-1680.

Furia, J. P. et al. (2010). “Shock wave therapy as a treatment of nonunions, avascular necrosis, and delayed healing of stress fractures.” Foot Ankle Clin 15(4): 651-662.

Furia, J. P. et al. (2013). “A single application of low-energy radial extracorporeal shock wave therapy is effective for the management of chronic patellar tendinopathy.” Knee Surgery Sports Traumatology Arthroscopy 21(2): 346-350.

Gunduz, R. et al. (2012). “Physical therapy, corticosteroid injection, and extracorporeal shock wave treatment in lateral epicondylitis : Clinical and ultrasonographical comparison.” Clin Rheumatol 31(5): 807-812.

Gur, A. et al. (2013). “Comparison of the Efficacy of Ultrasound and Extracorporeal Shock Wave Therapies in Patients with Myofascial Pain Syndrome: A Randomized Controlled Study.” Journal of Musculoskeletal Pain 21(3): 210-216.

Harniman, E. et al. (2004). “Extracorporeal shock wave therapy for calcific and noncalcific tendonitis of the rotator cuff: a systematic review.” J Hand Ther 17(2): 132-151.

Ho, C. (2007). “Extracorporeal shock wave treatment for chronic plantar fasciitis (heel pain).” Issues Emerg Health Technol(96 (part 1)): 1-4.

Ho, C. (2007). “Extracorporeal shock wave treatment for chronic rotator cuff tendonitis (shoulder pain).” Issues Emerg Health Technol(96 (part 3)): 1-4.

Huisstede, B. M. et al. (2011). “Evidence for effectiveness of Extracorporal Shock-Wave Therapy (ESWT) to treat calcific and non-calcific rotator cuff tendinosis–a systematic review.” Man Ther 16(5): 419-433.

Ibrahim, M. I. et al. (2010). “Chronic plantar fasciitis treated with two sessions of radial extracorporeal shock wave therapy.” Foot Ankle Int 31(5): 391-397.

Ioppolo, F. et al. (2012). “Extracorporeal Shock-Wave Therapy for Supraspinatus Calcifying Tendinitis: A Randomized Clinical Trial Comparing Two Different Energy Levels.” Phys Ther 92(11): 1376-1385.

Ioppolo, F. et al. (2013). “Clinical Improvement and Resorption of Calcifications in Calcific Tendinitis of the Shoulder After Shock Wave Therapy at 6 Months’ Follow-Up: A Systematic Review and Meta- Analysis.” Archives of Physical Medicine and Rehabilitation 94(9): 1699-1706.

Kapoor, S. (2012). “Pain management in patients with plantar fasciitis: the emerging role of radial extracorporeal shockwave therapy.” J Foot Ankle Surg 51(4): 541.

Kolk, A. et al. (2013). “Radial extracorporeal shock-wave therapy in patients with chronic rotator cuff tendinitis: a prospective randomised double-blind placebo-controlled multicentre trial.” Bone Joint J 95-B(11): 1521-1526.

Larking, A. M. et al. (2010). “Randomized control of extracorporeal shock wave therapy versus placebo for chronic decubitus ulceration.” Clin Rehabil 24(3): 222-229.

Lee, J.-H. and E.-Y. Han (2013). “A Comparison of the Effects of PNF, ESWT, and TPI on Pain and Function of Patients with Myofascial Pain Syndrome.” Journal of Physical Therapy Science 25(3): 341-344.

Lee, S. et al. (2014). “Effects of extracorporeal shockwave therapy on patients with chronic low back pain and their dynamic balance ability.” J Phys Ther Sci 26(1): 7-10.

Liu, S. et al. (2012). “Radial Extracorporeal Pressure Pulse Therapy for the Primary Long Bicipital Tenosynovitis a Prospective Randomized Controlled Study.” Ultrasound in Medicine & Biology 38(5): 727-735.

Marwan, Y. et al. (2014). “Extracorporeal shock wave therapy relieved pain in patients with coccydynia: a report of two cases.” The spine journal : official journal of the North American Spine Society 14(1): e1-e4.

Mittermayr, R. et al. (2012). “Extracorporeal shock wave therapy (ESWT) for wound healing: technology, mechanisms, and clinical efficacy.” Wound Repair Regen 20(4): 456-465.

Moen, M. H. et al. (2012). “Shockwave treatment for medial tibial stress syndrome in athletes; a prospective controlled study.” Br J Sports Med 46(4): 253-257.

Mouzopoulos, G. et al. (2007). “Extracorporeal shock wave treatment for shoulder calcific tendonitis: a systematic review.” Skeletal Radiol 36(9): 803-811.

Notarnicola, A. et al. (2010). “Extracorporeal shockwaves versus surgery in the treatment of pseudoarthrosis of the carpal scaphoid.” Ultrasound Med Biol 36(8): 1306-1313.

Ogden, J. A. et al. (2002). “Shockwave therapy for chronic proximal plantar fasciitis: a meta-analysis.” Foot Ankle Int 23(4): 301-308.

Ogden, J. et al. (2001). “Shock Wave Therapy (Orthotripsy(R)) in Musculoskeletal Disorders.[Report].” Clinical Orthopaedics & Related Research 387: 22-40.

Perez, M. et al. (2003). “Extracorporeal shock wave therapy for plantar fasciitis.” Clin Podiatr Med Surg 20(2): 323-334.

Petrisor, B. et al. (2009). “Extracorporeal shockwave therapy: A systematic review of its use in fracture management.” Indian journal of orthopaedics 43(2): 161-167.

Qureshi, A. A. et al. (2011). “Shock wave therapy in wound healing.” Plast Reconstr Surg 128(6): 721e-727e.

Reznik, J. E. et al. (2013). “Extracorporeal shock wave therapy as a treatment for heterotopic ossification.” Physical Therapy Reviews 18(4): 300-307.

Roehrig, G. J. et al. (2005). “The role of extracorporeal shock wave on plantar fasciitis.” Foot Ankle Clin 10(4): 699-712, ix.

Romeo, P. et al. (2011). “Extracorporeal shock wave therapy in pillar pain after carpal tunnel release: a preliminary study.” Ultrasound Med Biol 37(10): 1603-1608.

Romeo, P. et al. (2014). “Extracorporeal Shock Wave Therapy in Musculoskeletal Disorders: A Review.” Medical Principles and Practice 23(1): 7-13.

Rompe, J. D. et al. (2008). “Mid-portion Achilles tendinopathy–current options for treatment.” Disabil Rehabil 30(20-22): 1666-1676.

Rompe, J. D. et al. (2010). “Low-energy extracorporeal shock wave therapy as a treatment for medial tibial stress syndrome.” Am J Sports Med 38(1): 125-132.

Sarkar, B. et al. (2013). “Efficacy of low-energy extracorporeal shockwave therapy and a supervised clinical exercise protocol for the treatment of chronic lateral epicondylitis: A randomised controlled study.” Hong Kong Physiotherapy Journal 31(1): 19-24.

Saw, A. (2005). “Extracorporeal shock wave therapy for musculoskeletal pathology–a literature review.” Med J Malaysia 60 Suppl C: 8-10.

Saxena, A. et al. (2012). “Comparison between extracorporeal shockwave therapy, placebo ESWT and endoscopic plantar fasciotomy for the treatment of chronic plantar heel pain in the athlete.” Muscles Ligaments Tendons J 2(4): 312-316.

Schmitz, C. and R. DePace (2009). “Pain relief by extracorporeal shockwave therapy: an update on the current understanding.” Urol Res 37(4): 231-234.

Schmitz, C. et al. (2013). “Treatment of chronic plantar fasciopathy with extracorporeal shock waves (review).” J Orthop Surg Res 8(1): 31.

Seil, R. et al. (2006). “Extracorporeal shock wave therapy for tendinopathies.” Expert Rev Med Devices 3(4): 463-470.

Sems, A. et al. (2006). “Extracorporeal shock wave therapy in the treatment of chronic tendinopathies.” J Am Acad Orthop Surg 14(4): 195-204.

Seok, H. and S. H. Kim (2013). “The effectiveness of extracorporeal shock wave therapy vs. local steroid injection for management of carpal tunnel syndrome: a randomized controlled trial.” Am J Phys Med Rehabil 92(4): 327-334.

Serizawa, F. et al. (2012). “Extracorporeal shock wave therapy improves the walking ability of patients with peripheral artery disease and intermittent claudication.” Circ J 76(6): 1486-1493.

Shaheen, A. A. (2011). “Low-Energy Radial Extracorporeal Shock Wave Therapy for Chronic Plantar Fasciitis: A Randomized Control Trial.” World Applied Sciences Journal 12(1): 10-15.

Speed, C. A. (2004). “Extracorporeal shock-wave therapy in the management of chronic soft-tissue conditions.” Journal of Bone & Joint Surgery 86(2): 165-171.

Stasinopoulos, D. and M. I. Johnson (2005). “Effectiveness of extracorporeal shock wave therapy for tennis elbow (lateral epicondylitis).” Br J Sports Med 39(3): 132-136.

Strash, W. W. and R. R. Perez (2002). “Extracorporeal shockwave therapy for chronic proximal plantar fasciitis.” Clin Podiatr Med Surg 19(4): 467-476.

Thiel, M. (2001). “Application of shock waves in medicine.” Clin Orthop Relat Res(387): 18-21.

Thomson, C. E. et al. (2005). “The effectiveness of extracorporal shock wave therapy for plantar heel pain: a systematic review and meta-analysis.” BMC Musculoskeletal Disorders 6: 19-.

van der Worp, H. et al. (2013). “ESWT for tendinopathy: technology and clinical implications.” Knee Surgery Sports Traumatology Arthroscopy 21(6): 1451-1458.

van Leeuwen, M. T. et al. (2009). “Extracorporeal shockwave therapy for patellar tendinopathy: a review of the literature.” Br J Sports Med 43(3): 163-168.

Vidal, X. et al. (2011). “Radial extracorporeal shock wave therapy (rESWT) in the treatment of spasticity in cerebral palsy: A randomized, placebo-controlled clinical trial.” NeuroRehabilitation 29(4): 413-419.

Wang, C. J. (2003). “An overview of shock wave therapy in musculoskeletal disorders.” Chang Gung Med J 26(4): 220-232.

Wang, C. J. et al. (2011). “Treatment of diabetic foot ulcers: a comparative study of extracorporeal shockwave therapy and hyperbaric oxygen therapy.” Diabetes Res Clin Pract 92(2): 187-193.

Wang, C.-J. (2012). “Extracorporeal shockwave therapy in musculoskeletal disorders.” Journal of Orthopaedic Surgery and Research 7(1): 11.

Xu, Z. H. et al. (2009). “Extracorporeal shock wave treatment in nonunions of long bone fractures.” Int Orthop 33(3): 789-793.

Yalcin, E. et al. (2012). “Effects of extracorporal shock wave therapy on symptomatic heel spurs: a correlation between clinical outcome and radiologic changes.” Rheumatol Int 32(2): 343-347.

Yin, M. C. et al. (2014). “Is extracorporeal shock wave therapy clinical efficacy for relief of chronic, recalcitrant plantar fasciitis? A systematic review and meta-analysis of randomized placebo or active- treatment controlled trials.” Arch Phys Med Rehabil 95(8): 1585-1593.

Zelle, B. A. et al. (2010). “Extracorporeal shock wave therapy: current evidence.” J Orthop Trauma 24 Suppl 1: S66-70.

Zhao, Z. et al. (2013). “Efficacy of extracorporeal shockwave therapy for knee osteoarthritis: a randomized controlled trial.” J Surg Res 185(2): 661-666.

Zwerver, J. et al. (2011). “No effect of extracorporeal shockwave therapy on patellar tendinopathy in jumping athletes during the competitive season: a randomized clinical trial.” Am J Sports Med 39(6): 1191-1199.

Important Information about Shockwave Therapy

The treatment can cause a little discomfort, but a vast majority of people tolerate this very well, particularly because the first 500 or so impulses generally have an immediate pain-relieving effect.

Some patients feel a little bit of discomfort for a day after treatment, but this is not seen in most of those treated.  It is extremely rare for patients to need painkillers after the treatment.

If you notice any excess bruising, pain or unusual sensations please contact us immediately on 0800 043 7103.

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