Persistent pain from an injury or overuse can make walking, exercising, working, and other everyday activities difficult. Extracorporeal shockwave therapy (ESWT) is a noninvasive treatment that uses targeted acoustic waves and may be incorporated into rehabilitation for certain musculoskeletal conditions. For appropriate patients, it can provide another conservative treatment option when pain continues to interfere with movement and function.
What Is Extracorporeal Shockwave Therapy?
Extracorporeal shockwave therapy, commonly called ESWT or shockwave therapy, is a noninvasive treatment that delivers controlled acoustic waves to a targeted area of the body. experiencing:
Despite the name, the treatment does not involve an electrical shock being delivered into your body.
The acoustic energy is directed toward the affected tissues using a handheld applicator placed against the skin.
How Does Shockwave Therapy Work?
During treatment, acoustic waves are transmitted through the skin into the targeted tissue.
These mechanical waves may stimulate biological responses within the treated area and are used clinically for certain musculoskeletal conditions, particularly some persistent tendon and soft-tissue problems.
The treatment area, intensity, and number of sessions should be determined according to the patient’s condition and response to care.
What Conditions May Be Treated With Shockwave Therapy?
Shockwave therapy may be considered for certain musculoskeletal conditions, particularly chronic tendon and soft-tissue problems.
Depending on the diagnosis and individual patient, these may include:
- Plantar fasciitis
- Achilles tendon problems
- Tennis elbow
- Golfer’s elbow
- Certain shoulder tendon problems
- Patellar tendon problems
- Other persistent tendon and soft-tissue conditions
Having one of these conditions does not automatically mean shockwave therapy is appropriate. An evaluation is necessary to determine the cause of the symptoms and the appropriate treatment approach.
Shockwave Therapy for Plantar Fasciitis
Plantar fasciitis is a common cause of heel pain.
Symptoms are often especially noticeable during the first steps after getting out of bed or after sitting for an extended period.
When plantar fascia symptoms become persistent, shockwave therapy may be considered as part of a broader conservative treatment program.
Treatment may also include stretching, strengthening, footwear recommendations, activity modification, and other appropriate rehabilitation strategies.
Shockwave Therapy for Achilles Tendon Pain
The Achilles tendon connects the calf muscles to the heel and is exposed to significant stress during walking, running, jumping, and other activities.
Achilles tendon problems may cause pain, stiffness, tenderness, and difficulty participating in normal activities or sports.
For certain chronic Achilles tendon conditions, shockwave therapy may be incorporated into rehabilitation along with progressive exercise and activity modification.
Shockwave Therapy for Sports Injuries
Athletes and active individuals frequently develop overuse injuries involving tendons and other soft tissues.
Repeated running, jumping, throwing, lifting, or training can place significant stress on these structures.
When an appropriate sports-related tendon problem becomes persistent, shockwave therapy may be considered alongside physical therapy and therapeutic exercise.
The goal is not simply to decrease symptoms but also to address strength, mobility, flexibility, and the physical demands necessary for a safe return to activity.
What Happens During a Shockwave Therapy Session?
Before treatment begins, the provider identifies the area to be treated.
A coupling gel may be applied to the skin to help transmit the acoustic waves.
A handheld applicator is then positioned over the treatment area and delivers controlled pulses according to the treatment settings selected for the patient.
The applicator may be moved over the targeted tissues during treatment.
What Does Shockwave Therapy Feel Like?
Patients may feel repetitive tapping or pulsing sensations during treatment.
The intensity can vary depending on the treatment area and settings.
Some areas may be more sensitive than others, particularly when the applicator passes over an irritated structure.
Patients should communicate with the treating provider about their comfort throughout the session.
How Long Does Treatment Take?
Shockwave therapy sessions are generally relatively brief, although treatment time varies according to the area being treated and the individual treatment plan.
A patient may require a series of treatments rather than a single session.
The number and frequency of treatments should be based on the condition, clinical findings, and response to care.
Can Shockwave Therapy Replace Physical Therapy?
Not necessarily.
Shockwave therapy may be one component of a comprehensive rehabilitation program rather than a replacement for therapeutic exercise and physical rehabilitation.
For example, treating a painful tendon without addressing weakness, flexibility, movement patterns, training errors, or repetitive stress may leave important contributing factors unresolved.
Physical therapy can help address these functional issues while shockwave therapy targets an appropriate painful tissue.
Combining Shockwave Therapy With Physical Therapy
When appropriate, combining treatments allows rehabilitation to address the condition from multiple directions.
- Physical therapy may include:
- Strengthening exercises
- Flexibility exercises
- Range-of-motion exercises
- Balance and stability training
- Functional activities
- Progressive loading of injured tissues
- Movement and posture education
- Home exercise recommendations
The treatment plan should be individualized rather than using the same combination of therapies for every patient.
Can Shockwave Therapy Help Me Avoid Surgery?
For some musculoskeletal conditions, conservative treatments such as physical therapy, activity modification, therapeutic exercise, and shockwave therapy may be considered before more invasive treatment options.
However, no treatment can guarantee that surgery will be avoided.
Whether conservative treatment is appropriate depends on the diagnosis, severity of the condition, previous treatment, examination findings, and other individual factors.
Who May Not Be a Candidate for Shockwave Therapy?
Shockwave therapy is not appropriate for everyone.
Certain medical conditions, medications, pregnancy, treatment near particular structures, and other health considerations may affect whether the treatment can be safely performed.
This is why patients should be properly evaluated and provide an accurate medical history before beginning treatment.
Your provider can determine whether shockwave therapy is appropriate for your specific condition.
When Should Persistent Pain Be Evaluated?
Pain should be evaluated when it repeatedly returns, continues despite rest, or begins interfering with everyday activities.
Consider an evaluation when pain affects your ability to:
- Walk or stand
- Exercise or participate in sports
- Perform your job
- Climb stairs
- Lift or carry
- Sleep comfortably
- Complete normal household activities
Persistent symptoms should not simply be treated based on where they hurt. Determining which tissues are involved can help guide the appropriate treatment.
Conservative Treatment at Easy Reach Chiropractic & Physical Therapy
At Easy Reach Chiropractic & Physical Therapy, treatment is based on each patient’s condition, examination findings, functional limitations, and recovery goals.
Depending on the patient’s needs, conservative treatment may include physical therapy and rehabilitation, chiropractic care, therapeutic exercise, Class IV laser therapy, spinal decompression when appropriate, and other appropriate treatment options.
For patients recovering from workplace injuries, rehabilitation may also progress toward Work Conditioning and Work Hardening when medically appropriate and authorized.
Finding the Right Treatment for Your Pain
Persistent musculoskeletal pain can interfere with work, exercise, sports, and everyday activities, but the appropriate treatment depends on what is causing the symptoms.
An evaluation can help identify the affected structures and determine whether shockwave therapy, physical therapy, or another conservative treatment approach may be appropriate.
Contact Easy Reach Chiropractic & Physical Therapy to schedule an evaluation and discuss treatment options for persistent musculoskeletal pain.