Extracorporeal shockwave THERAPY (eswT)

Extracorporeal Shock Wave Therapy ESWT has been used for decades in the management of renal stones. Its orthopaedic and musculoskeletal applications are more recent - perhaps over the past decade. There is increasing evidence, from NICE and others, that ESWT is effective in managing inflammatory conditions of tendons, bursitis and enthesopathies, non-union fracture, leg ulcers, and other conditions.

The term shockwave refers to a mechanical pressure pulse that expands as an energy wave much like ultrasound. The shockwave is produced either by a projectile or by an electrical spark. The shockwave energy is passed from the device to the painful area of anatomy, where it interacts with the tissue creating a physiological effect. This has been shown to create an increase in cell membrane permeability. This process induces microtrauma to the injured tissue increasing blood circulation by a process known as neovascularisation that promotes healing.

ESWT shockwaves create "cavitation bubbles". These are simply small empty cavities created behind an energy front. They expand to a maximum size and then collapse; when these bubbles collapse a force is created. In the human body, this force is strong enough to help break down pathological deposits of calcification in soft tissues.

TREATMENT OPTIONS

Plantar Fasciitis

Achilles Tendonitis

Morton’s Neuroma

Patellar Tendonitis

Trochanteric Bursitis

GOLFERS & TENNIS ELBOW

Calcific Shoulder

Dupuytren’s contracture

De Quervain syndrome

Non-Union Fractures

Carpal Tunnel

Muscular Tears

Painful trigger points

scar tissue break down

Pain Management

OsteoarthritiC PAIN

Leg ulcers & more…

New blood vessel formation - Nutrient blood flow is necessary to start and maintain the repair processes of damaged tissue structure. The application of acoustic waves creates capillary micro ruptures in tendon and bone.

Stimulation of osteoblasts - ESWT has been shown to stimulate cells in the body known as osteoblasts.

Reversal of chronic inflammation - Chronic inflammation occurs when the inflammatory response is not completely halted. It can damage healthy tissue and results in chronic pain. Mast cells are one of the key components of the inflammatory process. Their activity may be increased by using pervasive acoustic waves.

Dissolution of calcified fibroblasts - Calcium build-up is most often a result of micro-tears or other trauma to a tendon. Acoustic waves break up the existing calcification.

Dispersion of pain mediator “Substance P” - Substance P is a neurotransmitter that mediates pain information through C-fibres. This neuropeptide is generally associated with intense, persistent and chronic pain. It relays pain messages to the central nervous system. Lowering the concentration of Substance P reduces the stimulation of afferent nociceptive fibres and thus reduces the pain.

Release of trigger points - Trigger points are the principal cause of pain in the back, neck, shoulder and limbs. Delivering acoustic energy unblocks the calcium pump and thus reverses the metabolic crisis in the myofilaments and releases the trigger points.