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Shockwave is used in therapy to reduce long-term pain in the musculoskeletal system. It is emitted under pressure and is therefore able to deliver energy to where the pain is located. It is also a method used in the fight against cellulite.
The shock wave is generated under high pressure in a very short time and has a low frequency. As a result, after applying the camera head, the wave reaches the deep layers of the skin and hits the pain point precisely. Although the method is very innovative, it is worth using. It is a completely safe and non-invasive method. Therefore, it is used during rehabilitation and in the treatment of chronic pain in muscles, tendons, bones, joint capsules and ligaments.
The shock wave is designed to deliver energy from the acoustic wave to the body. This process occurs thanks to a special head that emits waves when placed on the skin. When the energy reaches the inside of the body, it positively influences lesions in various layers of the skin and tissues.
Shock waves are sound waves that have specific physical properties, including non-linearity, high peak pressure followed by low tensile amplitude, short rise time, and short duration (10 ms). They have a single pulse, wide frequency range (0-20 MHz) and high pressure amplitude (0-120 MPa)
These features produce a negative and a positive shock wave phase. The positive phase produces direct mechanical forces, while the negative phase generates cavitation and gas bubbles which then implode at high speed, generating a second shockwave.
Compared with ultrasonic waves, the peak pressure of the shock wave is about 1000 times greater than the peak pressure of the ultrasonic wave.
Types of the shock wave
Shock waves differ in their properties and their operation depends on the amount of released energy and the energy density of the flux. In physical therapy, extracorporeal shock wave therapy is referred to as ESWT (Extracorporeal Shock Wave Therapy), i.e. the shock wave is generated outside the human body.
The ESWT shockwave is classified into two types:
- Radial Shock Wave Therapy (RSWT);
- Focused Shock Wave Therapy (FSWT).
The shock wave is very effective. The advantages include:
- elimination of pain – the shock wave non-invasively stimulates cell membranes and nerve endings;
- stimulating metabolism – thanks to the shock wave, blood circulation is much more efficient. In addition, the production of collagen is improved. The shock wave will also reduce scars and stretch marks;
- relaxation and relaxation – the treatment with the use of a shock wave reduces muscle tension, thanks to which we feel relaxed and relaxed after the treatment.
In addition, you should remember about the high effectiveness of the treatment. The effects are visible after just a few treatments, and the patient quickly recovers.
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The average cost of treatments using a shock wave is about PLN 60-80. In some offices, you can use, for example, sessions combining various treatments. Therefore, you can use, for example, a shock wave and high-energy laser or a shock wave and lymphatic drainage.
In this case, the price for both treatments may be more favorable and is usually determined individually. However, it should be remembered that the price of the treatment is influenced, among others, by:
- the office in which we decide to perform the procedure. Please note that each office has its own individual price list;
- the place on the body that will be treated – the larger the area, the higher the price;
- the number of treatments performed – the more treatments we plan, the lower the price we can get.
Shock wave treatments can be used, among others in rehabilitation. The indication is:
- spine pain;
- tendinitis;
- painful shoulder syndrome;
- tennis elbow;
- Achilles tendon pain;
- hip pain;
- shoulder pain;
- increased muscle tone;
- pain after injuries;
- shooting hip;
- the so-called jumper’s knee;
- calcaneal spur.
Treatments should be performed in series, and the effects are visible after approx. 3-5 treatments. They should be performed several days apart. The treatments have an analgesic and stimulating effect.
If in doubt whether our health problems should be treated with a shock wave, it is always worth consulting a physiotherapist. In this way, we will be sure, and in addition, the doctor will dispel any doubts and propose an appropriate treatment and select its frequency.
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Unfortunately, although the shock wave treatments are very effective and bring quick results, not everyone can benefit from them.
In order to avoid unpleasant complications, it is worth bearing in mind that the contraindication to the procedure is:
- a history of myocardial infarction – this applies to patients who are considering surgery within the first three months after the infarction;
- tumor;
- pregnancy;
- venous thrombosis;
- inserted pacemaker;
- have recently taken steroid injections (in the last 12 weeks)
- having a joint prosthesis or a metal implant in the treatment area;
- acute inflammation at the site of pain and various post-traumatic conditions;
- advanced stage of osteoporosis;
- hemophilia.
In such a situation, it is very important to inform your physiotherapist about the state of our health, past surgical procedures and medications used on a daily basis.
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Shockwave is not an invasive procedure and does not require anesthesia or any pharmaceuticals. The patient may feel pain, but it depends on whether we are also suffering from other diseases or ailments. In addition, individual sensitivity to stimuli also has a great influence. The severity of the disease and the presence of inflammation are also very important.
Shock wave treatments should be performed in series, and the effects are visible after approx. 3-5 treatments. It is best to do them several days apart. The difference can be seen after the first treatment.
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There aren’t many side effects after the treatment. They include primarily:
- redness and swelling at the treatment site;
- a feeling of tingling, numbness;
- dizziness and nausea;
- feeling of pain.
It is worth reporting any side effects to the person performing the procedure.
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The procedure is performed using a special apparatus that emits a shock wave. The wave is produced outside the body. For the procedure to be effective, the head of the device must be carefully applied to the site of the most severe symptoms reported by the patient. It happens that the place is determined on the basis of an ultrasound examination.
The procedure takes about 5-10 minutes. Its duration depends on the type of disease and is determined individually. It is also necessary to adjust the type of waves, the frequency of the pulses and the depth at which the waves are to reach. Usually, a physiotherapist sets a series of 3-5 treatments to be performed once or twice a week.
The procedure may be a bit painful, but there is no need for anesthesia. Usually, patients are able to endure the unpleasantness of the procedure.
The shockwave has the effectiveness confirmed by clinical trials, and additionally it is very safe. For this reason, these treatments are widely used in the treatment of diseases of the musculoskeletal system. Patients usually feel improvement after the first treatment. In 80% of cases, the symptoms improve or even disappear after 2-3 treatments.
Limitations in the use of shock wave treatment
The treatment should be strictly avoided in the area of:
- head;
- chest and lungs;
- spinal cord;
- point clusters of large nerves (skull, spine, ribs);
- peripheral nerves and vascular structures;
- lymph nodes;
- sites with an implanted foreign body (e.g. endoprosthesis, implant).
Should shockwave treatments be combined with other treatments?
It depends on what ailments are being treated, but many specialists have the task that shockwave therapy complements physiotherapy and rehabilitation.
Shockwave therapy is most effective as part of a full treatment and rehabilitation program. Any biomechanical problems (such as posture, gait, running style, muscle length, and strength problems) that led to the problem should continue to be addressed for the best long-term results. Your doctor will recommend an exercise program to complement the shockwave effect.
A number of studies have shown the effectiveness of shockwave surgery in treating tendon problems when other forms of conservative treatment have failed. Shockwave is now more and more used earlier in treatment to facilitate and accelerate recovery.
It is recommended that you refrain from any activity stressing the treated area for 24 hours after the shockwave treatment, even if you do not feel pain after the treatment. For example, if you have undergone shockwave surgery for Achilles tendon pain, we strongly advise you not to run for 24 hours after each treatment.
It is also better not to do rehabilitation / physiotherapy exercises for 24 hours after shockwave treatment. You can walk and drive immediately after the procedure.
After the shockwave treatment, your physical therapist will also advise you not to take any anti-inflammatory medications such as Ibuprofen as this can potentially reduce the effect of the treatment. The shockwave stimulates a new healing response, which is a pro-inflammatory treatment, so we don’t want to inhibit this process. If you experience discomfort after the procedure, it is better to take paracetamol or use ice on the sore spot.