Frequently Asked Questions

Shockwave Therapy

What is Extracorporeal Shockwave Treatment?

Extracorporeal Shockwave Treatment is a non-invasive (no incisions) treatment that involves the delivery of high energy sound waves, or acoustical energy, to affected areas of the body to trigger the body's own natural repair mechanisms and stimulate healing. Shockwave Treatment ('extracorporeal' meaning 'outside the body') is a safe and effective treatment option. The recovery period is shorter than traditional invasive surgery and the procedure eliminates many of the risks associated with traditional surgery. Extracorporeal Shockwave Treatment (ESWT) has been used effectively for many years around the world. It was first approved in the United States by the FDA in October 2000 for the treatment of Plantar Fasciitis, a type of heel pain. The FDA subsequently approved ESWT for Lateral Epicondylitis, commonly referred to as Tennis Elbow, in March 2003.

What Is ESWT (Extracorporeal Shockwave Treatment) Used For?

ESWT has been used effectively worldwide to treat "insertional tendinopathies," such as:

  • Heel Pain (Plantar Fasciitis)
  • Tennis Elbow (Lateral Epicondylitis)/li>
  • Shoulder Calcifications (Calcific Tendonitis)
  • Achilles Tendonitis
  • Knees (Patellar Tendonitis)

Millions of people suffer from pain caused by inflammation of tendons and other soft tissues attached to bones, commonly referred to as "insertional tendinopathies."

How Does Extracorporeal Shockwave Treatment Work?

The widely accepted theory is that Extracorporeal Shockwave Treatment (ESWT) causes micro-trauma and controlled injury at the affected area, thereby leading to the formation of blood vessels (revascularization) which triggers the body's natural healing process and repair mechanisms. The sound waves are also thought to release adhesions and scarring to help increase mobility an doptimize healing. Studies have shown a 60-80% success rate in significantly reducing or eliminating pain.

What Happens Before, During and After ESWT Treatment?

BEFORE: Patients will be instructed to discontinue medication containing aspirin or non-steroidal anti-inflammatory medications (e.g. Motrin) for several days before treatment (and most likely for up to 30 days following treatment) unless otherwise instructed by the treating doctor. Patients will be asked to stop eating and drinking a number of hours prior to treatment due to the use of anesthesia.

DURING: Treatment typically lasts 20 to 30 minutes and is performed on an outpatient basis in a surgical center. To avoid discomfort during treatment, most doctors administer a local anesthetic at the point of pain and perform the procedure with the patient under intravenous (conscious) sedation.

AFTER: Patients may experience discomfort in the treated area after the effects of anesthesia have subsided. Some bruising, swelling, and temporary numbness is normal and expected. In the immediate days following treatment, many doctors will recommend RICE – Rest, Ice, Compression, Elevation. Weekly follow-up visits with your doctor allow the physiotherapy needed for optional healing.

For four weeks following treatment, patients are advised to not participate in stressful activities (e.g. jogging, heavy housework, yard work, participating in sports) involving the affected area. Patients can then typically resume normal activity. Heel pain patients are typically instructed to avoid flat shoes such as sandals and slippers; continued use of orthotics may be encouraged.

Healing is generally complete at about twelve weeks, although patients may continue to experience additional reduction in pain thereafter.

What are Alternative Treatments?

Most doctors will first pursue conservative treatment options to reduce or eliminate pain. Conservative treatment may include such measures as rest, non-steroidal anti-inflammatory medications (NSAIDs), steroid injections, over-the-counter pain relievers, physical therapy, and orthotics (for heel pain). Chiropractors will usually recommend ice, physiotherapy, exercises, and orthotics (heel lifts) prior to considering more aggressive approaches. However, when conservative treatments have failed, ESWT is increasingly being used to avoid traditional invasive surgery.

Is This Treatment Right for Everyone?

You should speak to your doctor or call Dr. Bidkaram, DC if you're not currently seeing one, about your specific needs to see if Extracorporeal Shockwave Treatment is right for you. ESWT is not recommended for use on pregnant women, children, anyone with a pacemaker, or anyone on anti-coagulant therapy or who has a history of bleeding problems.

What is the Success Rate?

Statistically, over 90 percent of patients that receive this therapy experience a reduction and/or elimination in their pain. In patients that suffered from plantar fasciitis and heel pain related problems, the pain reduction was remarkable. Nearly all patients had successful results with only one treatment of ESWT. For this reason, many people are turning to ESWT to treat their injuries.

Call us for any questions you might have about your specific medical condition and if Extracorporeal Shockwave Treatment (ESWT) is right for you.

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Extracorporeal Shock Wave Therapy (ESWT) is a popular treatment method used to combat common concerns including heel pain, plantar fasciitis, Achilles tendonitis, tennis elbow, shoulder tendonitis, lateral epicondylitis, and more.

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