Can we help?
the following conditions have been successfully treated with shockwave:
Tendinopathies
Both short and long term tendinopathies may respond - conditions such as:
- Shoulder: supraspinatus tendonitis, biceps tendonitis
- Elbow: common extensor/flexor tendons (tennis and golfers elbow)
- Hip/groin region – gluteus medius; adductor and hamstring origin tendons
- Knee – patellar tendon (jumper’s knee); quadriceps tendon
- Foot and ankle – Achilles and tibialis posterior tendon, Plantar Fascitis
adhesive capsulitis
Most commonly occurring in the shoulder - when it is often known as "frozen shoulder"
muscle pain
Chronic muscle aches and pains, trigger points and myofascial pain syndromes
Painful exostosis and boney non-union
Lumps and Bumps on bones such as heel spurs or Hagland's deformity, ("pump bump"), chronic Osgood-Schlatter disease
How successful is Shockwave Therapy?
After only 3 or 4 treatments with shockwave therapy, around 80% of patients report a reduction of pain and regaining of normal function. More specifically the breakdown for the percentage of people reporting improvement by body part has been reported as follows:
- 91% reduction in pain for calcific tendinopathy (Journal of American Medical Association, 2003)
- 90% reduction in pain for plantar fasciitis (Journal of Orthopedic Research, 2005)
- 86% reduction in pain for rotator cuff tendonitis (Journal of American Medical Association, 2003)
- 80% reduction in pain for non-union fractures (Clinical Orthopedics and related research, 2001)
- 77% reduction in pain for tennis elbow (The Journal of Orthopedics, 2005)
- 75% reduction in pain for jumper’s Knee (patellar tendonitis) – (American Journal of Sports Medicine, 2007)
- 75% reduction in pain for achilles tendinopathy (American Journal of Sports Medicine, 2007)
The National Institute for Clinical Excellence (NICE) currently have issued approval for shockwave in some musculoskeletal conditions. (IPG376 (Greater trochanteric pain syndrome), IPG312 and IPG571 (Achilles tendinopathy), IPG311 (plantar fascitis), IPG21 (calcific tendonitis) and PG313 (tennis elbow ) )
This list is not exhaustive. If you think we may help, get in touch!
FOR THE SCIENCE GEEKS
How Does Shockwave Work?
The mechanisms behind the treatment success of shockwave therapy, particularly for tendinopathy, are not yet fully understood. However the current evidence base suggests interplay between mechanical, bio-chemical and pain relief mechanisms. The mechanical effects are most likely created through cavitation phenomenon. The subsequent cell membrane vibrations that ensue are a result of mechanotransduction.
Mechanotransduction causes the following cellular responses:
• Significantly increased prevalence of vascular endothelial growth factor, endothelial nitric oxide synthase and proliferating cell nuclear antigen. Therefore SWT induces angiogenesis.
• Immediate elevation of Interleukin-6 and Interleukin-8. A five-fold increase in matrix metalloproteinase-2 and 5. All of these substances are closely linked with tendon homeostasis, fibroblast activity and pathological tissue destruction. It is subsequently postulated there is a pro-inflammatory action of SWT.
• Positive effects on bone health through the reduction of osteoclast activity and the stimulation of osteoblast activity.
• Immediate pain relief through hyper-stimulation mechanisms, reduction in substance-P and reduced calcitonin gene-related peptide. Also termed as regulating neurogenic inflammation.
• Long-term pain relief through the selective destruction of unmyelinated nerve fibres.