Shockwave Therapy: What It Is, Benefits, and Risks

By: Parm Bhullar, Physiotherapist

What is shockwave therapy?

Extracorporeal Shockwave Therapy (ESWT or SWT) is a therapeutic modality used at Hayer Health by physiotherapists. SWT is a handheld device that is applied externally to the affected area of the body. 

Acoustic pressure waves, or low frequency waves, generated by the shockwave are used to treat various musculoskeletal conditions. SWT is commonly used for chronic tendinopathies (ie, plantar fasciitis, achilles or patellar tendinopathy) and bone pathologies (ie, delayed bone dealing, and bone stress injuries).

What are the benefits of shockwave?

The goal of SWT is to create a physiological effect, either mechanically or cellularly, for the purposes of promoting tissue healing, tissue regeneration, increasing blood flow, and reducing inflammation¹. 

Individuals may experience an improved range of motion and reduced pain following treatments. 

SWT offers a non-invasive treatment option for individuals, which can allow for activities of daily living to be resumed following treatment. The benefits can vary depending on the clinical presentation and individual factors, therefore your physiotherapist will discuss the benefits and risks prior to considering the use of the modality.

Are there any negatives or potential risks with shockwave?

While SWT is generally considered to be safe, there are potential risks and side effects. 

The side effects that an individual may experience after SWT include bruising, redness on the skin, pain during and after treatment that may last a couple of days, swelling, nerve sensitization, & headaches.²’³ 

Your physiotherapist at Hayer Health will also review contraindications for SWT, such as pregnancy or active infection in the area, prior to use.³

All of our physiotherapists at Hayer Health have completed training for SWT to ensure the device is used appropriately and safety concerns are taken into consideration.

Is there anything I need to know about post treatment care?

After receiving shockwave treatment, your body may be sore and you may experience pain after the treatment.³

 Based on the literature, managing pain symptoms by avoiding the use of nonsteroidal anti-inflammatory drugs (NSAIDs) may be advised.³ 

NSAIDS may counteract the effectiveness of the treatment as the purpose is to facilitate your body’s natural healing response to help with tissue healing.³ 

In terms of activity, it would depend on a case to case basis. Overall, activity should be modified to ensure pain is kept to a minimum but be sure to check in with your practitioner.³ 

Report any signs of skin irritation or redness to your physiotherapist.

How often should I come in to receive treatment?

The frequency of SWT treatments at Hayer Health can vary depending on the specific condition and individual being treated, as well as their response and overall progress. 

Generally, SWT will fall into a range of 3-5 treatment sessions which are typically spread 7 days apart.3 Our physiotherapists will develop a personalized treatment plan based on a detailed assessment.

Is there a higher fee for shockwave therapy?

No. The physiotherapy fee at Hayer Health is the same as a regular visit. We believe that SWT falls into physiotherapy services and do not charge extra for the use of this modality.

References:

  1. Dedes V, Stergioulas A, Kipreos G, Dede AM, Mitseas A, Panoutsopoulos GI. Effectiveness and Safety of Shockwave Therapy in Tendinopathies. Mater Sociomed. 2018 Jun;30(2):131-146. doi: 10.5455/msm.2018.30.141-146. PMID: 30061805; PMCID: PMC6029898.
  2. Roerdink, R. L., Dietvorst, M., van der Zwaard, B., van der Worp, H., & Zwerver, J. (2017). Complications of extracorporeal shockwave therapy in plantar fasciitis: Systematic review. International Journal of Surgery (London, England), 46, 133-145. https://doi.org/10.1016/j.ijsu.2017.08.587
  3. Tenforde, A. S., Borgstrom, H. E., DeLuca, S., McCormack, M., Singh, M., Hoo, J. S., & Yun, P. H. (2022). Best practices for extracorporeal shockwave therapy in musculoskeletal medicine: Clinical application and training consideration. Pm & r, 14(5), 611-619. https://doi.org/10.1002/pmrj.12790