Shockwave therapy (SWT), also known as extracorporeal shockwave therapy, is a non-invasive procedure that uses low energy acoustic wave pulsations to treat various musculoskeletal disorders.Here at Physiocore, it is mostly applied to chronic conditions, especially those that affect connective tissues like tendons, ligaments and joint structures.
In Canada, shockwave therapy has been available since the mid-90s, although it has surged in popularity with the introduction of low energy SWT. The procedure is known to stimulate the natural healing process of the body and has been proven to decrease pain due to its direct effect on nerve endings.
How Shockwave Therapy Works
As the name suggests, shockwave therapy makes use of acoustic shock waves that are made to pass through and skin and then aimed to injured areas. The audible, mechanical waves are of much lower energy than in other medical applications and they are not electric in nature.
The procedure works by increasing blood flow to the affected area, thereby accelerating the healing process. Studies have shown that shockwaves induce re-vascularization or the formation of new blood vessels that supply tendons, ligaments, bones, and surrounding tissues. The shockwaves are also believed to facilitate the release of local growth factors and have a profound effect on stem cells.
There are two kinds of shockwave: low and high energy. Both are effective but the latter is discussed in more detail here. Our high energy shockwave at Physiocore can be targeted directly to the injured area, resulting in several effects:
- Increased cell membrane permeability that subsequently results in increased microscopic circulation and metabolism. This promotes natural healing and may lead to the dissolution of calcific depositsembedded in the injured tissue.
- Shockwaves stimulate osteoblasts or the cells that are responsible for new bone production.Shockwaves also stimulate fibroblasts or the cells responsible for the repair of connective tissues.
- Reduction in pain via two mechanisms. The first is through hyperstimulation anesthesia wherein nerve endings are overwhelmed with a barrage of stimuli, resulting in short-term pain reduction. The second is through the gatecontrol mechanism wherein nerves are stimulated in such a way that the brain perceives the stimuli first instead of the pain, thereby resulting in long-term pain reduction.
Conditions that Can be Treated with Shockwave Therapy
Shockwave therapy has become more and more common in physiotherapy. It is a more advanced treatment procedure that is often considered if conservative treatments fail to give patients adequate relief. It is best suited for people who have chronic (>six weeks) tendinopathies which haven’t responded to other treatment regimen.
Shockwave therapy can be used to treat various conditions including the following:
- Plantar Fasciitis
- Achilles Tendinopathy
- Calcific Tendinitis (Rotator Cuff)
- Retrocalcaneal Bursitis
- Morton’s Neuroma
- Hip Pain, Shoulder Pain
- Medial Tibial Stress Syndrome
- Heel Spurs, Hallux Rigidus (Stiff Toe)
- Lateral Epicondylosis (Tennis Elbow)
- Medial Epicondylosis (Golfer’s Elbow)
- Patellar Tendinosis (Jumper’s Knee)
- Chronic Stress/Non-union Fractures
Is Shockwave Therapy Safe? Are There Any Side Effects?
The use of shockwave therapy is very safe. In fact, it has been successfully used in medical facilities throughout Europe for more than 20 years. It is an excellent alternative to surgery since there are fewer risks involved, there is no anesthesia, no downtime, and no need to take medications.
However, shockwave is not for everyone as there are conditions that preclude patients from receiving treatment. Such conditions include pregnancy, cancer, clotting disorders presence ofa pacemaker, taking blood thinners, local infection, age (less than 16 years), cortisone injections within the last two weeks, and steroid injection in the past three months. You will want to talk to one of our clinical specialists to ascertain if this is the appropriate treatment for you.
After the procedure, you may feel temporary tenderness, soreness, or swelling for a couple of days because the shockwaves stimulate an inflammatory response. It is nothing serious or anything that will require additional medical intervention. It is just the body trying to heal itself naturally. Hence, it is imperative NOT to take any painkillers or anti-inflammatory medication after the procedure as this could slow down the results. Upon completion of the treatment, you can return to your daily routine almost immediately. However, strenuous activities must be avoided 48 hours after each session.
How is the Procedure Performed?
On your first visit, our physiotherapist will conduct an assessment and take your full medical history to make sure that you are an ideal candidate for shockwave therapy. The procedure is pre-planned by marking the trigger points and the injured area. An ultrasonic gel is applied then theSWT handpiece is positioned to begin transmitting shockwaves. The handpiece delivers gently compressed air impulses through the gel. The whole procedure lasts approximately 15 minutes.
Depending on the results, shockwave therapy is usually performed once a week for 3-6 weeks. The treatment can cause mild discomfort but your physiotherapist can adjust the intensity to keep it tolerable. The majority ofpatients report substantial improvement after just one treatment session. Success rates are 80% and rise to as high as 90% with a second treatment.
Is Shockwave Therapy Covered by OHIP?
Shock therapy is not covered by the Ontario Health Insurance Plan (OHIP), although it may be covered by some private medical or drug plans. It may also be covered under some extended benefit plans. Kindly check with your provider or talk to one of our staff at Physiocore. You’ll be surprised to find out how affordable it is and certainly worth every penny when you consider the benefits and the relief that you’ll get after just one or two treatment sessions.
How to get started?
Shockwave therapy is its own treatment for a chronic injury or pain caused by an injury to the musculoskeletal system. It’s a conservative form of treatment that works when other traditional therapies fail to provide the much-needed relief. You don’t need surgery or medications with it – the objective of the therapy is to trigger your body’s natural healing power.
For those in Ontario, Physiocore is one of the most trusted rehab therapy clinics offering shockwave therapy. We have gained a sterling reputation for proving outstanding care by being a multi-disciplinary injury rehab centre. We take utmost pride on our team which boasts 40 years of combined experience. Book an appointment today or give us a call at 905-882-1908 to know how we can help and get you on the road to fast recovery.