Shockwave patient information

This information leaflet is for patients considering shockwave therapy as part of their treatment plan. The leaflet provides information on the potential benefits, risks and what to expect during the treatment.

If you have any questions ask your health care professional.

What is Shockwave Therapy?

Shockwave therapy (also known as ECSWT which stands for extracorporeal shockwave therapy) is a safe, non-invasive procedure used to manage a variety of soft tissue and tendon problems. It is commonly used for persistent symptoms that have not responded to other interventions. During the treatment, ultrasound gel is applied to the skin, then a handheld probe is placed at the affected area and mechanical shockwaves are passed through the skin to the affected tissue. It is still not known exactly how shockwave therapy works, but it is thought that the treatment stimulates the body’s own healing process and influences nerve fibres reducing pain.

Are there any risks or side effects?

The National Institute for Health and Care Excellence (NICE) has deemed shockwave to be a safe procedure and side effects are typically short lasting. It is normal to experience some discomfort during the procedure. If this gets too much the settings can be adjusted to reduce it.

Following the treatment you may experience some pain, numbness, altered sensation, redness, bruising or swelling at the treatment site – these symptoms normally settle themselves within a week.

Shockwave therapy is not appropriate for everyone, and its effectiveness does vary between individuals. You are not allowed to have shockwave if you:

 

• Are pregnant.
• Are under 18.
• Have had a steroid injection to the same area in the last 3 months.
• Have an infection or wound problem at the proposed treatment area.
• Have any implants or metalwork at the proposed treatment area.
• Have a tumour at the affected area.
• Have a tendon rupture/tear at the site to be treated
• Are currently taking antibiotics known as fluoroquinolones (these usually end in ‘…floxacin’)
• Have an allergy to the gel being used on the skin

 

To help maximise the effectiveness of the treatment DO NOT take any anti-inflammatory medication (such as ibuprofen or naproxen) for 2 weeks prior to your shockwave therapy starting and throughout the course of the treatment.

 

What happens during treatment?

You will receive 3 sessions of shockwave therapy. The treatment sessions last up to 10 minutes and are carried out approximately 1 week apart by a trained member of the musculoskeletal team.

It is very important that you attend all the treatment sessions to gain maximal benefit.

During the session,

• The health professional will examine you and confirm the tender area. They will ensure you are as comfortable as possible throughout the treatment.
• They will explain what the treatment involves and if you are happy to go ahead treatment will begin.
• Treatment takes about 5-10 minutes for each session.
• A gel is applied to the skin before giving the treatment. Shockwave is non-invasive (no break to the skin). It involves mechanical shockwaves being passed through the skin to the sore area using a hand-held probe. The shockwaves are not electrical but are low energy pressure waves that can be heard.
• Most patients do have some mild pain or discomfort during the procedure. You will be asked how much pain you are having during the treatment, and we will attempt to adjust the treatment to help manage this.
• Shockwave is a safe treatment showing good results; however, it works best when combined with active exercises. The person treating you will discuss these other treatments with you.

What Happens After shockwave treatment?

You may return to your normal activities, including work, straight away.

It is advised to avoid any strenuous, pain-provoking activity for 48hours after the treatment.

You may feel some pain-relief from the treatment straightaway. Commonly it can take several weeks for longer-term improvement.

 

After the session, if you have any discomfort, do NOT

 

• use ice on the treated area,
• take non-steroidal anti-inflammatory medicines (for example, ibuprofen or naproxen)

 

This is because these may reduce the healing effect of shockwave therapy.

 

You will be referred to physiotherapy at the same time as shockwave therapy. Appropriate rehabilitation and exercise alongside shockwave have been shown to improve outcomes. It is vital for the long-term management of your condition that you follow the advice of your physiotherapist.

You will be reviewed by your referring clinician approximately 8 weeks after you have completed your shockwave treatment to assess the response to the treatment.

Ensuring Effectiveness

In order for us to assess the effectiveness of shockwave therapy we will monitor your pain levels and function before and after receiving shockwave therapy. Some patients will be asked to fill in a questionnaire before your treatment starts.

 

Dr Mohamed Bhamani –  GPwER MSK & Rheumatology, Clinical Lead at Leylands MSK Clinic

Damian Buck – lower limb Advanced Practice Physiotherapist, Bradford Teaching Hospitals Foundation Trust

Last Reviewed October 2023