Extracorporeal Shockwave Therapy (ESWT)

Extracorporeal shockwave treatment (ECSW) has been well tested. It has shown short-term results between 56% and 91% success rate in the treatment of multiple musculoskeletal conditions and may eliminate the need for surgery. The first medical treatment utilizing shockwave included lithotripsy which dissolved kidney stones without surgery. This technology is still used today on most patients with kidney stones. In the early 1990’s, this treatment was expanded to treat soft tissue injuries such as inflammation to ligaments and tendons and use for shockwave therapy has grown ever since. It has been evaluated and approved by the FDA.

Most patients require about 5 treatments, and it is commonly done without anesthesia in our office. The sessions are spaced 1 week apart and last about 10-15 minutes. Class IV Laser is administered to the region prior to the RWP where we then apply gel to the affected area. Then, using a hand-held device, we start with a lower energy and gradually increase through the 2000-4000 pulse cycles. Most patients tolerate this treatment well and describe it as a mild diffuse soreness or mildly uncomfortable (generally setting to a 5-6 on a discomfort level 10 being max). The soreness may last for a few hours up to 24 hours after treatment. Bony prominences are more uncomfortable than well-padded areas. Some patients may notice some skin redness or bruising to the treated area. There are no side effects to shockwave therapy.

There are very minimal limitations after the treatment and patients and athletes can go back to reasonably normal activity. However, the treatment will cause an inflammatory response and therefore anti-inflammatory supplements/medication such as Turmeric, Advil, Motrin, Ibuprofen and Aleve cannot be utilized. Applying ice to the affected area after treatment is also not recommended, also due to the anti-inflammatory effect that icing provides.

Patients tend to notice an improvement in their symptoms almost immediately. The maximum relief is usually felt 12 weeks after the last treatment and can take up to 4 weeks for pain relief. Most of the healing occurs between week 6 and 9.

The cost for five treatment sessions is $500 per area and $250 for additional region(s) (Ex. Right knee $500, add left knee $250. Total cost both knees $750). This typically is NOT covered by insurance.

If any of the following apply to you, please notify your clinician prior to any treatment:

• If you are taking Coumadin/warfarin
• If you are pregnant or trying to conceive
• If you are under 18 years of age
• If you have nerve or circulation disorders
• Infection at/near treatment area
• It should not be used over metal pins or plates
• It should not be used over areas of carcinoma or tumor growth