ESWT
What is Extracorporeal Shockwave Treatment?
Extracorporeal Shockwave Treatment (ESWT) is a non-invasive (no incisions) treatment that involves the delivery of acoustical energy, or sound waves, to affected areas of the body to trigger the body’s own natural repair mechanisms and stimulate healing.
Extracorporeal Shockwave Treatment (‘extracorporeal’ meaning ‘outside the body’) is a safe and effective treatment option. The recovery period is shorter than traditional invasive surgery and the procedure eliminates many of the risks associated with traditional surgery.
Extracorporeal Shockwave Treatment has been used effectively for many years around the world. It was approved in the United States by the FDA for treatment of Plantar Fasciitis in 2000 and for Lateral Epicondylitis in 2003.
What is it Used For?
Millions of people suffer from pain caused by inflammation of tendons and other soft tissues attached to bones. ESWT has been used effectively worldwide to treat these conditions:
- Heel Pain (Plantar Fasciitis)
- Tennis Elbow (Lateral Epicondylitis)
- Golfers Elbow (Medial Epicondylitis)
- Shoulder Calcifications (Calcific Tendonitis)
- Achilles Tendonitis
- Knees (Patellar Tendonitis)
ESWT has also been used to treat bone pathologies such as Delayed-Union and Non¬Union Fractures - conditions where broken bones do not properly heal back together.
How Does it Work?
The widely accepted theory is that ESWT causes microtrauma and controlled injury at the affected area, thereby leading to the formation of blood vessels (revascularization) which triggers the body’s natural healing process and repair mechanisms. Studies have shown an 80% and higher success rate in significantly reducing or eliminating pain.
What are Alternative Treatments?
We will first pursue conservative treatment options to reduce or eliminate pain. Conservative treatment may include such measures as rest, non-steroidal anti-inflammatory medications (NSAIDs), steroid injections, over-the-counter pain relievers, physical therapy, and shoe inserts (for heel pain). When pain has been persistent for 6 months or longer and conservative treatment has failed, ESWT is increasingly being used to avoid traditional invasive surgery.
Is This Treatment Right for Everyone?
This must be determined on a case-by-case basis. Regardless, ESWT is not recommended for use on pregnant women, children, anyone with a pacemaker, or anyone on anti-coagulant therapy or who has a history of bleeding problems.
What Happens Before, During and After Treatment?
BEFORE: Patients will be instructed to discontinue medication containing aspirin or non-steroidal anti-inflammatory medications (e.g. Motrin) for several days before treatment (and most likely for up to 30 days following treatment) unless otherwise instructed by the treating doctor. Patients will be asked to stop eating and drinking a number of hours prior to treatment due to the use of anesthesia.
DURING: Treatment typically lasts 20 to 30 minutes and is performed on an outpatient basis in a surgical center. To avoid discomfort during treatment, most doctors administer a local anesthetic at the point of pain and perform the procedure with the patient under intravenous (conscious) sedation.
AFTER: Patients may experience discomfort in the treated area after the effects of anesthesia have subsided. Some bruising, swelling, and temporary numbness is normal and expected. In the immediate days following treatment, many doctors will recommend RICE — Rest, Ice, Compression, Elevation. For 1 to 2 weeks following treatment, patients may continue to have the same type of pain experienced prior to treatment.
For 4 weeks following treatment, patients are advised not to participate in stressful activities (e.g. jogging, heavy housework, yard work, participating in sports) involving the affected area. Patients can then typically resume normal activity. Heel pain patients are typically instructed to avoid flat shoes such as sandals and slippers; continued use of orthotics may be encouraged.
Healing is generally complete at about 12 weeks, although patients may continue to experience additional reduction in pain thereafter.
Download the color brochure on Extracorporeal Shockwave Treatment (requires Acrobat reader).
