WHAT IS SHOCKWAVE THERAPY?

Shockwave therapy, also known as Extracorporeal Shock Wave Therapy (ESWT), is a non-invasive medical treatment that uses shockwaves to promote healing and reduce pain in various musculoskeletal conditions.  

Deeper.

Shockwave therapy units reach a therapeutic penetration depth of up to 6 cm* for Radial Pressure Wave devices and 12.5 cm* for Focus Shockwave devices. Both types of shockwave devices impact tissue at the surface level down to deeper depths of penetration to treat a wide range of pathologies.2-12

Faster.

On average, shockwave therapy normally consists of 1-6 treatments to help produce effective clinical outcomes.2-12  Typically, treatment times last for 5 minutes1, allowing the treatment to fit into the time constraints of a therapy session and be easily incorporated into an overall plan of care.

Easier.

Shockwave therapy provides easy-to-use transmitter handpieces to effectively treat patients, reducing the wear and strain on the clinician’s hands. The various device handpieces serve to deliver treatments and provide clinician comfort during use.

Two Types of Sound Waves

Extracorporeal shockwave therapy (ESWT) technology encompasses the use of two distinct forms of sound waves to transfer energy into tissue, resulting in two types of shockwave devices that clinicians can choose to incorporate into their practice.

Focus Shockwaves vs.
Radial Pressure Waves

The Chattanooga® Focus Shockwave device generates sound waves via an electromagnetic hand piece with a built-in water buffer, while the Radial Pressure Wave devices utilize a pneumatic/ballistic design. These differences impact the waveforms they produce.13,14

Focused shockwaves have higher peak energy and generate maximal force at a selected depth16. Radial pressure wave devices generate their maximal energy on the skin, which then dissipates as it travels to depth15. Energy levels at depth are dictated by the settings on the machine and the applicator used.

Focused Shockwave Therapy

PENETRATION DEPTH
0-12.5 CM

 

ENERGY CAPACITY
High

 

REPETITION OF SESSIONS
Fewer necessary

 

EFFECTIVE AGAINST CHRONIC CONDITIONS
Yes

 

FOCAL POINT
Inside tissue

 

PRECISION
High

 

PAIN
Low

 

INDICATION RANGE
Large

 

OVERALL EFFECT
Cell & Tissue Matrix

 

NOISE LEVEL
Lower

 

Radial Shockwave Therapy

PENETRATION DEPTH
3-5 CM

 

ENERGY CAPACITY
Low

 

REPETITION OF SESSIONS
More necessary

 

EFFECTIVE AGAINST CHRONIC CONDITIONS
Depends on the indication

 

FOCAL POINT
At transmitter tip

 

PRECISION
Wider spread

 

PAIN
Low-Mid

 

INDICATION RANGE
Standard/Soft Tissue

 

OVERALL EFFECT
Tissue Matrix

 

NOISE LEVEL
Higher

 

Treatment Applications

Treatment is performed directly on the skin, but is non-invasive. The time alloted for a specific treatment will depend on the area and depth of the tissue being treated. This will normally fall within 2-4 minutes per area treated.

 

 

What are the Benefits of using Shockwave Therapy opposed to traditional methods of treatment:

•  Short treatment time (a few minutes)

•  Precise and targeted application

•  Results in a few treatments5-8

•  Non-invasive technology

•  Alternative to medication

RPW Applications
Focus Shockwave Applications
  1. Myofascial trigger points12
  2. Disorders of tendons insertions11
  3. Pulse vibration massage18
  4. Pain and inflammation in orthopaedic conditions13
  5. Pulse vibration massage18
  6. Plantar fasciitis14

Calculate the ROI on your Shockwave investment for your clinic

FEATURED SHOCKWAVE THERAPY DEVICES

Are there any side-effects of Shockwave Therapy?

Shockwave therapy can take a chronic condition back to acute thus ‘rebooting’ a stalled healing process. This can potentially result in some minor sides effects such as heat and redness, some petechia and soreness. These potential side effects are not common and only last for a few days.

 

How long does a Shockwave Therapy session last?

A typical treatment session would involve having 2000 shocks delivered between 10-15Hz. Consequently, to treat a single area the intervention may only take 2-3 minutes. Invariably this provides an analgesic effect allowing the therapist to also intervene with manual and exercise therapy more effectively.

 

How many Shockwave Therapy treatment sessions are required to make a difference?

The nature of the condition and the patient’s response to the treatments will play a key role in determining how many treatments will be needed. The research states between 3-5 sessions are required. One systematic review tells us that we should expect up to an 89% positive outcome after 3 sessions, delivered once a week.

 

Can Shockwave Therapy be used with other treatments / modalities?

Yes. What the current research is telling us is that when shockwave is combined with other interventions like exercise or manual therapy the outcomes are superior to using either intervention on its own.

 

References:

*Data on file.
** Falcon®, V-ACTOR®, SPINE-ACTOR®, and PERI-ACTOR® are registered trademarks of Storz Medical AG.

  1. As compared to the depth of penetration from manual therapy vs. extracorporeal shockwave therapy; average session of time extracorporeal shockwave therapy being five minutes; decrease is muscle strain from operating an extracorporeal shockwave device compared to manual therapy on a clinician’s hands.
  2. Cristina d'Agostino M, Craig K, Tibalt E, Respizzi S. Shock wave as biological therapeutic tool: From mechanical stimulation to recovery and healing, through mechanotransduction. Int J Surg. 2015 Dec;24(Pt B):147-53.
  3. Furia JP, Rompe JD, Cacchio A, Maffulli N. Shock wave therapy as a treatment of nonunions, avascular necrosis, and delayed healing of stress fractures. Foot Ankle Clin. 2010 Dec;15(4):651-62.
  4. Ciampa AR, de Prati AC, Amelio E, Cavalieri E, Persichini T, Colasanti M, Musci G, Marlinghaus E, Suzuki H, Mariotto S. Nitric oxide mediates anti-inflammatory action of extracorporeal shock waves. FEBS Lett. 2005 Dec 19;579(30):6839-45.
  5. Gollwitzer H, Saxena A, DiDomenico LA, Galli L, Bouché RT, Caminear DS, Fullem B, Vester JC, Horn C, Banke IJ, Burgkart R, Gerdesmeyer L. Clinically relevant effectiveness of focused extracorporeal shock wave therapy in the treatment of chronic plantar fasciitis: a randomized, controlled multicenter study. J Bone Joint Surg Am. 2015 May 6;97(9):701-8.
  6. Gollwitzer H, Diehl P, von Korff A, Rahlfs VW, Gerdesmeyer L. Extracorporeal shock wave therapy for chronic painful heel syndrome: a prospective, double blind, randomized trial assessing the efficacy of a new electromagnetic shock wave device. J Foot Ankle Surg. 2007 Sep-Oct;46(5):348-57.
  7. Ulusoy A, Cerrahoglu L, Orguc S. Magnetic Resonance Imaging and Clinical Outcomes of Laser Therapy, Ultrasound Therapy, and Extracorporeal Shock Wave Therapy for Treatment of Plantar Fasciitis: A Randomized Controlled Trial. J Foot Ankle Surg. 2017 Jul - Aug;56(4):762-767.
  8. Rompe JD, Decking J, Schoellner C, Nafe B. Shock wave application for chronic plantar fasciitis in running athletes. A prospective, randomized, placebo-controlled trial. Am J Sports Med. 2003 Mar-Apr;31(2):268-75.
  9. Gerdesmeyer L. Current evidence of extracorporeal shock wave therapy in chronic Achilles tendinopathy.NCBINCBI Logo Int J Surg. 2015 Dec;24(Pt B):154-9. doi: 10.1016/j.ijsu.2015.07.718. Epub 2015 Aug 29.
  10. Nedelka T.Mechano-transduction effect of shockwaves in the treatment of lumbar facet joint pain.Neuro Endocrinol Lett. 2014
  11. Schmitz C. Efficacy and safety of extracorporeal shock wave therapy for orthopedic conditions: a systematic review on studies listed in the PEDro database.Br Med Bull. 2015;116:115-38. doi: 10.1093/bmb/ldv047. Epub 2015 Nov 18.
  12. Ogden JA. Shockwave therapy for chronic proximal plantar fasciitis: a meta-analysis.Foot Ankle Int. 2002 Apr;23(4):301-8
  13. Operation & Installation Instructions for Mobile 2 RPW USA (Radial Pressure Wave) REF 2905-US..
  14. Focus Shockwave Operating Manual (Chattanooga)
  15. McClure S, Dorfmuller C. Extracorporeal shock wave therapy:Theory and equipment. Clin Tech Equine Pract 2003;2:348-357.
  16. S. Broadbent, JJ. Rousseau, RM. Thorp, SL. Choate, FS. Jackson, DS. Rowlands. Vibration therapy reduces plasma IL6 and muscle soreness after downhill running. 2010 Sep;44(12):888-94


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