Extracorporeal Shockwave Therapy (ESWT)

Fit For Life NI > Extracorporeal Shockwave Therapy (ESWT)

ESWT is a procedure where shock waves are passed through the skin to the injured part of the body, using a special device.

Extracorporeal means outside of the body. The shockwaves are mechanical and not electric. They are audible, low-energy sound waves, which work by increasing blood flow to the injured area. This speeds up your body’s healing process. You will usually require a course of three treatments, one to two weeks apart.

ESWT is a procedure where shock waves are passed through the skin to the injured part of the body, using a special device.

 

Extracorporeal means outside of the body. The shockwaves are mechanical and not electric. They are audible, low-energy sound waves, which work by increasing blood flow to the injured area. This speeds up your body’s healing process. You will usually require a course of three treatments, one to two weeks apart.

Why should I have ESWT?

ESWT is offered to patients who have not responded well enough to other treatments such as physiotherapy, orthotics (insoles or leg braces), rest, steroid injection, ice therapy and pain relief.
It is a minimally invasive treatment that is carried out on an outpatient basis, which means that you can go home the same day. ESWT can offer relief from pain and other symptoms.

What does ESWT help?

What are the risks/side effects?

You will experience some pain/discomfort during the treatment, but you should be able to cope with this. Following the treatment, you may initially experience more pain, redness, bruising, swelling and numbness to the area. These side effects should resolve within a week, before your next treatment. There is a small risk of tendon rupture or ligament rupture and damage to the soft tissue, but studies have shown that five to seven out of ten patients have found it to be effective.

You must not have ESWT for Achilles tendinopathy or plantar fasciitis if you;

·are pregnant
·are taking antiplatelets excluding aspirin 75mgs (for example, clopidogrel) or anticoagulants (such as warfarin or rivaroxaban)
·have a blood clotting disorder
·are under the age of 18
·have been diagnosed with bone cancer
·have an infection in your foot
·have a history of Achilles tendon or plantar fascia ligament rupture
·have had a steroid injection into the affected area in the previous 12 weeks

These will be discussed with you by your physiotherapist when the treatment is offered. They will also discuss the benefits and risks of the procedure with you in more detail – please let them know if you have any questions or would like any further information.

Are there any alternatives?

If ESWT does not help your pain, then sometimes an operation may be available, depending on your condition. If required Fit for Life NI has established connection with a number of private hospitals and orthopaedic consultant specialists.

How can I prepare for ESWT?

·You will need to be available for the full course of treatment.
·You should not take any non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, for two weeks before your first procedure, and throughout your treatment. If you are unsure if any of your medicines contain NSAIDs then please check with your doctor, nurse or pharmacist.
·Wear comfortable clothing as you will be lying on your front for the treatment.

Giving my consent (permission)

We want to involve you in decisions about your care and treatment. If you decide to go ahead, you will be asked to sign a consent form. This states that you agree to have the treatment and you understand what it involves. If you would like more information about our consent process, please speak to the member of staff caring for you.

Who will carry out the procedure?

Your ESWT will be carried out by a chartered physiotherapist who will have undertaken special training to carry out the procedure.

Will I feel any pain?

Most patients do experience some pain or discomfort during the procedure. You will be asked how much pain you are experiencing during the treatment, and we will attempt to adjust the treatment to help manage this.

What happens after ESWT?

After the treatment you will be able to get up and walk straight away. If you do experience discomfort following the shockwave treatment you can take over the counter painkillers (such as paracetamol) but don’t take anti-inflammatory medication (such as ibuprofen) and ice therapy, as these can interfere with the body’s healing process

What do I need to do after I go home?

You will be able to return to your usual activities straight away and can return to work immediately. However we advise you not to undertake any strenuous, pain-provoking activity or high-impact exercise for 48 hours following the procedure. If you experience a sudden onset of pain to the area or any loss of function, please contact your GP or go to your nearest Emergency Department (A&E).

Further sources of information

National Institute for Health and Care Excellence (NICE)

NICE has produced recommendations for patients on ESWT for Achilles tendinopathy and plantar fasciitis.

These documents can be accessed on the NICE website. w: www.nice.org.uk