What is Extracorporeal Shockwave Therapy?
Shockwave therapy is a non-invasive treatment method that utilizes mechanical (not electrical) high energy sound waves to treat various musculoskeletal conditions such as plantar fasciitis and Achilles tendonitis. The high-energy shock waves deliver a mechanical force to the affected area of the body.
This therapy is still a new treatment modality, and the exact mechanism of action is not fully understood. It is typically recommended when other treatment options have failed or been unsuccessful and the patient’s condition is in more of a chronic state.
The proposed mechanism of action is to promote vascularization (blood flow) at the site of pain which stimulates growth of healthy tissue, “calls upon” white blood cells in the body, and increases growth factor and protein synthesis to stimulate collagen growth and remodeling.
Each treatment takes approximately 10 minutes. This is an outpatient procedure. A gel will be applied to your skin over the area to be treated, and the shockwave therapy will then be delivered through a handheld probe. When the therapy is happening, you may hear a “tapping noise” and are likely to feel some discomfort. This does not require local anesthesia. See below for office pictures.
Why Do I Need Shockwave Therapy?
Acute plantar fasciitis and Achilles tendonitis typically respond well to conservative treatments such as stretching, orthotics (shoe inserts), changes in activity and physiotherapy. However, sometimes the pain continues and is in more of a chronic state. This is seen with thickening of the ligament or tendon, a decrease in inflammatory markers, and dark areas (hypoechoic or anechoic) areas near the bone-tendon or bone-ligament interface. This is diagnosed with musculoskeletal ultrasound in our office (see below).
These changes generally occur between 6 and 12 months after onset of presentation of symptoms and indicate the condition has transferred from acute to chronic. At this point, traditional and conservative measures are less effective. Shockwave therapy is a great “next in line” non-invasive treatment for chronic Achilles tendonitis or plantar fasciitis to consider prior to surgical intervention.
Shockwave Therapy FAQ’s
What are the Benefits of Shockwave Therapy?
This treatment has been shown to increase blood circulation activity in the cells in the treatment area, which in turn speeds up the body’s own healing process. The nerves can also be overstimulated by the shockwave, which leads to reduced pain sensation.
How Many Sessions Will I Need?
Our office will perform one (1) treatment per week for three (3) total weeks. The last (4th) treatment will be one month following the third treatment. Each session is $50 per foot PER treatment and is not covered by insurance.
After the 4th session, we will see you back in the office in an additional month. If symptoms have not improved, we can discuss continuation of treatment vs. other options.
What are the Side Effects?
Shockwave therapy can cause discomfort but has been proven to be a safe treatment. Possible side effects include:
- Pain during and up for 24 hours after treatment.
- Skin reddening and swelling around the heel area.
- Bruising around the site of treatment (minor bleeding from small blood vessels in the heel can lead to bruising)
- Calf aching and numbness
- A very small risk of rupture of the Achilles or Plantar fascia (extremely rare).
- The majority of these symptoms, if they occur, should get better within a couple of days and normally within a week prior to the next treatment.
Who should Avoid Shockwave Therapy?
Patients who have a history of CRPS, RSD or hypersensitivity reactions, open wounds or sores, patients with a seizure disorder or with certain cardiac conditions. Pregnant women should also avoid shockwave therapy.
Post Shockwave Instructions
DO NOT take any anti-inflammatory drugs such as Motrin, Ibuprofen, Aleve, Advil, Naprosyn, Celebrex for up to 3 weeks after the last treatment.
You may take extra strength Tylenol or any pain prescription we may have given you.
It is OK to take Aspirin (ASA) 81mg a day therapy.
NO running, climbing ladders, long distance walking or excessive stair climbing for up to 1 month after the last treatment.
Please continue with the exercises and stretches given to you for plantar fasciitis.
DO NOT ice the area. Pain may become worse after treatment before it gets better for up to 1 month after the last treatment.
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2097 Henry Tecklenburg Dr. #210 West
Charleston, SC 29414