What is radial shockwave therapy?
Radial shockwave therapy machines are small, simple to build, and considerably cheaper to buy and run.
A quick step back in time shows us that extracorporeal shockwave therapy (ESWT) was first explored in the 1950s following the second world war. Skip a few decades, and there is evidence being published of how ESWT can be used for MSK indications.
We must not confuse radial shockwave therapy with focused shockwave therapy as they are two different waveforms that have different effects on human tissues.
In summary, radial shockwave therapy is a non-invasive medical treatment that generates sound waves to treat a variety of MSK conditions.
How does it work for MSK injuries?
Radial shockwave therapy stimulates pain and promotes an inflammatory response to re-initiate the healing process. It is also shown to effectively:
- Reduce pain,
- Improve blood flow,
- Promote cellular activity
The primary physiological mechanism of radial shockwave therapy is mechanotransduction, where a mechanical input is converted into a biological response.
This could be activating blood flow to the area to stimulate fibroblasts to produce collagen for scar tissue.
In truth, there is a lot more we don’t know about how it works than what we do know. But, being a non-invasive, mechanical input, the contraindications are minimal, meaning most of your patients can safely receive the treatment and see/feel its benefits.
How effective is radial shockwave therapy for MSK injuries?
Firstly, radial shockwave therapy is shown to be safe and effective for many MSK indications. It is certainly more effective when used in combination with progressive loading and exercise rehabilitation.
The effectiveness of shockwave therapy has been studied since the 1980s, and there are thousands of papers showing its’ effectiveness for, but not limited to:
- Plantar fasciitis,
- Tennis/Golfer’s elbow,
- Achilles tendinopathy
- Patella tendinopathy
- Calcific tendinopathy (shoulder)
The effectiveness of the treatment is based on factors such as:
- Correct diagnosis
- Stage of healing for the injury
- The severity of the injury
- Age and overall health of the patient
Another factor, which must be said, is your competence and treatment application which, as with anything, gets better over time!
Overall, studies show that radial shockwave therapy helps reduce pain and improves function in patients with these MSK injuries.
How many radial shockwave therapy sessions are required for improvement?
Again, there are a few factors that can affect this, very similar to the above.
A general rule of thumb is:
- 3-6 shockwave treatments every 3-7 days
- Shockwave treatment
o Average 2000-3000 shocks per treatment
o Average 5-10Hz
o Energy level varies on tolerance and treatment aim.
We are firm believers in 20% of shockwave treatment being prescribed, and 80% is personalised to the individual.
Always reassess and adjust settings where required. You may see improvements after 1 session, but you should know if it is having any effect after 3 sessions. Generally, the full effects will be seen anywhere between 4-12 weeks post-initial treatment.
But of course – it all depends!!
Does radial shockwave therapy hurt, and are there any side effects?
The treatment certainly isn’t comfortable, but it should always be tolerable. Some patients can tolerate the treatment more than others, so adjust the energy input and frequency accordingly to suit the patient.
There may be some minor side effects which can include, but not limited to:
- Local redness or swelling
- Bruising
- Pain or discomfort after treatment
If the patient has an increase in pain or pain that doesn’t settle, reassess the patient and determine why this may have happened.
Often, a negative reaction is down to misdiagnosing the patient or delivering too much energy to the tissues
Can you use radial shockwave therapy with our treatments?
Definitely! Radial shockwave therapy shouldn’t be used as a standalone therapy and should be complemented with other interventions.
Several studies have shown that a combination of shockwave therapy and exercises was superior to exercises or shockwave alone. Exercise rehabilitation will help improve strength and range of movement.
There is good anecdotal evidence of using shockwave alongside therapies such as laser or ice compression.
Regarding medications, a patient who is taking an anti-coagulant is contraindicated.
Medications, like aspirin, should be approached with caution. Ultimately, if you are unsure, seek further advice and hold off on treatment.
Click here to find out more about The Powershocker radial shockwave therapy machine, which you can add to clinic for as little as ÂŁ95+vat per month.
Any further questions about radial shockwave therapy, speak to a specialist.
