Shock Wave Therapy (ESWT)

Shock Wave Therapy (ESWT)

Also referred to as extracorporeal shockwave therapy (ESWT), this method uses high-energy pressure waves to target and treat tendon attachment problems as well as muscle and bone conditions, and is largely complication free. Shockwave therapy uses sound waves focused deep within the body at the root cause of the pain, where they are most effective.

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ESWT stimulates cell metabolism by activating mitochondria and releasing growth factors that accelerate the healing process of painful conditions such as tendon damage. The sound waves also cause the formation of new blood vessels (angiogenesis and vasculogenesis), which improves circulation and stimulates the body’s self-healing mechanisms, making it possible for damaged or degenerated tissue to regenerate and heal.

It is also thought that shock wave therapy can cause stem cells to migrate and “come home”. In the case of calcium deposits, such as calcific tendonitis of the shoulder, it is possible to directly shatter the deposit. This causes it to break down into small parts that are easily metabolized by the body. ESWT also has a direct impact on pain transmission: first, the cell walls of the pain receptors are affected, causing them to transmit fewer negative impulses. Secondly, ESWT causes sensory overload in affected tissues and nerves, reducing their ability to transmit pain. In particular, chronic pain can be alleviated in the long term using this method.

Using ESWT, extremely rapid and sustainable improvements can be achieved without radiation.

Ideal applications for ESWT:

  • All types of tendon inflammation
  • All types of tendonopathy, non-inflammatory painful degeneration of the tendons, i.e., the Achilles tendon
  • Tennis elbow / golfer elbow
  • Trochanteric pain syndrome (hip)
  • Tendinitis calcarea (calcification in the tendon anchor area of the shoulder) and frozen shoulder
  • Plantar fasciitis / heel spurs
  • Fascia therapy
  • Old cicatrized muscle injuries
  • Fresh muscle injuries (low intensity and focused)
  • Skeletal muscle pain
  • Patellar tip syndrome and Morbus Schlatter disease (MOB)
  • OCD in adults (degeneration of the cartilage-bone area, usually in the knee or ankle joint)
  • Pseudarthrosis of the small bones (=Non-union of fractures)
  • Stress Fracture
  • Shin splints
  • M. Osgood-Schlatter
  • Tension of the neck and back muscles, persistent tension of the large muscles (upper arm, forearm, pelvic region, thigh, lower leg)

ESWT should not be used in the following cases:

  • Blood thinners (Marcoumar, Plavix)
  • Pregnancy
  • Tumors
  • Not directly on a growth plate
  • Osteomyelitis (bone suppuration) or other severe local infections
  • Less than 6 weeks after a local cortisone injection and less than 3 weeks after a systemic infiltration

How does shockwave therapy work?

First, your physician will discuss the cause of your condition with you and explain why shockwave therapy would be effective in your situation. Possible complications such as superficial bruising, swelling, etc. are also discussed, and a consent form must be signed. In most cases, three (in rare cases up to five) shockwave treatments are necessary. During treatment, a topical gel is first applied to the area to allow the shockwaves to penetrate into the body and target the problem area with no energy loss. The treatment itself takes five to ten minutes, during which time the doctor will explain each step of the process. ESWT has a very high success rate when combined with an accurate diagnosis. However, no therapy has a 100% guarantee of success, and the degree of effectiveness also depends on the severity and prior duration of symptoms.

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