Extracorporeal Shockwave Therapy (ECSWT)

ECSWT or Extra corporeal Shockwave Therary is a non-invasive, needle free and drug free solution for Plantarfasciopathy and Tendinopathy.

Originally used for treating kidney stones, Extracorporeal Shockwave Therapy (ECSWT) has proven itself to be effective in the treatment of certain musculoskeletal conditions over the last 2 decades.

ECSWT a highly specialised piece of equipment designed to deliver a precise, calculated dose of high energy into the treatment area. It is particularly favoured by active individuals as it is totally non-invasive and requires minimal or no down-time after treatment.

HOW DOES IT WORK?

Shock waves are acoustic pressure waves with a unique waveform characteristic. Research has shown that such waveforms have biological effects including:

1. Release of certain growth factors in the targeted tissues, which may lead to formation of new vessels and other biological effects associated with tissue healing. The effect occurs over a period of several months and is responsible for facilitating regeneration and repair in certain injured and degenerative tissues.

2. Effects on nerves carrying pain signals, which may result in pain reduction.

3. Interruption of the “pain-spasm” cycles which occur in many chronic pain situations.

EVIDENCE OF BENEFITS?

There are many papers supporting ECSWT for chronic plantarfasciopathy including: “Extracorporeal shock wave therapy contributes to healing and pain reduction in plantarfasciitis and ultrasound imaging is able to depict the morphologic changes related to plantarfasciitis as a result of this therapy.” Vahdaptour etal, 2012. Journal of Research in Medical Sciences.

“In conclusion, shockwave therapy not only decreased the pain VAS rating but also improved the gait parameters of the symptomatic foot in PF patients” Hsu etal Bone Joint J 2013;95-B:1088–93.

Extracorporeal shock wave therapy is effective in treating chronic plantar fasciitis: A meta-analysis of RCTs. Sun J, Gao F, Wang Y, Sun W, Jiang B, Li Z. Medicine (Baltimore). 2017 Apr;96(15) CONCLUSION: This meta-analysis suggested that FSW (focused shock wave) therapy can relieve pain in chronic PF as an ideal alternative option; meanwhile, no firm conclusions of general ECSWT and RSW (radial shock wave) effectiveness can be drawn.

Due to variations in the included studies, additional trials are needed to validate these conclusions.

WHAT CONDITIONS CAN BE TREATED?

Conditions most commonly treated with this therapy include:

  • PLANTARFASCIITIS
  • Heel pain
  • Heel spurs
  • Arch Pain
  • ACHILLES TENDONITIS
  • KNEE Patellar tendinopathy (jumpers knee)
  • ITB Syndrome Muscular and myofascial trigger points

 

The use of the Dornier Aries Smart Focus Extracorporeal Shockwave system allows a high level of control, precision and prescription of shockwave therapy.

Unlike cheaper ‘radial’ shockwave machines, the focusing ability of the shockwave beam in this machine allows acute delivery of the shockwave to the treatment area.

No, not all machines are the same.

HOW IS THE TREATMENT SESSION CARRIED OUT?

An ECSWT session is on site at Peak Podiatry and will take around 20 minutes. We do allow 30 min for all treatment consultations. The injured site is first identified, then precisely targeted using the ESWT focused beam. Shockwaves are then delivered in rapid succession, ramping up from low levels to therapeutic levels.

HOW MANY SESSIONS ARE NEEDED?

On average, 3-4 treatments, maximum 5 are usually required to deliver the required total energy dosage. The interval between sessions is usually 1 week and tissue healing is expected over 6-8 weeks.

WHAT DOES IT COST AND CAN I CLAIM PRIVATE HEALTH REBATES?

Each treatment is $165 per foot. Second foot at the same time less 20%. Yes you can claim from your private health fund if covered for Podiatry services. You will need to contact your health to confirm if and what level of rebate you may receive. The item code is F014 – Podiatry consultation.

ARE THERE SIDE EFFECTS OR RISKS?

ECSWT has proven itself too be a very safe procedure. Other than the discomfort during the session, there are no long term side effects. Rarely, some individuals experience temporary increase in pain which may be reduced by icing or using simple analgesia. Despite its excellent safety record, ECSWT is still regarded as a specialty modality and should be administered by experienced, trained medical personnel only. This allows the treatment specialist to individualize the treatment according to the severity, location and nature of the damaged tendon/ligament, and to calculate the dose / response benefit of the intervention. Shockwave Therapy has its best effect when it is done in conjunction with a structured rehabilitation program. To maximize the therapeutic benefits we suggest an:

  • Appropriate strength program
  • Addressing the underlying causal and risk factors
  • Addressing biomechanical dysfunction
  • Modifying exercise load

Should you have any queries regarding ECSWT please feel free to contact the podiatrists at the clinic on 93889999 or email admin@peakpodiatry.com.au