Understanding Shockwave Therapy

Extracorporeal Shockwave Therapy (SWT) is a technique used to treat several musculoskeletal diseases. It is especially notable in treatments involving medium to large tendons and their insertions on bone, such as:

• Plantar Fasciitis
• Achilles Tendinopathy
• Lateral Epicondylosis (Tennis Elbow)
• Golfer’s Elbow (Medial Epicondylosis)
• Retrocalcaneal Bursitis
• Tendonitis Calcifica (supraspinatus tendon, etc.)
• Tendinosis of the patella (Jumper’s Knee)
• Morton’s Neuroma
• Non-union Fractures/Chronic Stress

Shockwave therapy has been available since the mid-1990s, but it has only lately gained popularity with the introduction of low-energy shockwave therapy. Shockwave therapy is a treatment that promotes the body’s natural healing process. This treatment has also been demonstrated to directly affect local nerve terminals, resulting in a reduction in pain. Therefore, when deciding if you are a good candidate for shockwave therapy and which form is most likely to generate beneficial results in treating your condition, it is critical to grasp the difference between low-energy and high-energy versions.

High-energy Shockwave Therapy

High-energy SWT, also known as “real” shockwaves, are defined as brief (10 msec) high-energy pulses (5-100MPa) that breach the sound barrier, resulting in a shockwave. Our high-intensity shockwave technique directs the shockwave straight through the afflicted tissue, resulting in a variety of effects:

• Mechanical and tension forces on the tissue demonstrate an improvement in cell membrane permeability, boosting microscopic circulation and metabolism within the treated area. This stimulates healing and may result in calcific deposits dissolving.
• The pressure front forms a “cavitation bubble” behind it, which are little empty cavities formed by a pressure front. When the bubbles collapse, a force is created that has a mechanical influence on the treated tissue. This force contributes to the breakdown of calcific deposits lodged in injured tissue.
• Shockwaves activate osteoblasts, which are cells responsible for bone repair and new bone formation.
• Shockwaves can also activate fibroblasts, cells that are responsible for connective tissue mending, such as tendons.

Low-energy Shockwave Therapy

This form of shockwave is better defined as a pressure wave, and it varies from “true” shockwave technology in the following ways:

• Low-energy shockwaves move at a significantly slower pace and do not cross the sound barrier, resulting in the absence of a “true” shockwave.
• Low-energy shockwaves are longer, slower, and have a lesser intensity.
• In contrast to high-energy shockwaves, which concentrate on a target, radial pressure waves deviate from the source, resulting in less energy transferred to the tissue.

Because of the lower cost of low-energy shockwave equipment, many patients may believe they have undergone “true” shockwave therapy. Unfortunately, misinformed patients and uneducated practitioners frequently create this perception. As a result, there may be discrepancies in the efficacy of high-energy vs low-energy shockwave treatment. In general, the efficiency of SWT is between 60% and 80%. Compliance with treatment and rehabilitation advice is critical to attaining the best results.