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Shockwave Therapy

Extracorporeal shock wave therapy (ESWT) is a non-invasive  treatment in which a hand held device is used to pass inaudible, high-energy sound waves (shockwaves) through the skin, to the origin of the damaged area. 

Shockwaves are acoustic waves which can carry high energy to painful areas of the musculoskeletal system and they are used in a variety of subacute, subchronic and chronic conditions. The energy imparted by the shockwaves promotes regeneration and reparative processes of the bones, tendons and other soft tissues at the site of injury. 

The exact mechanism of action for ESWT is not fully understood but it is thought to result from its effects on multiple areas of the bodies inflammatory, neural and healing mechanisms-

  • Reduction in sensation of chronic pain (mediated by non-myelinated C nerve fibers) with early pain relief by depletion of substance P.
  • Blockade of neurogenic inflammation -playing an important role in the pathogenesis of insertional tendinopathies such as insertional achilles tendinopathy,  and plantar fasciopathy, etc.
  • Activation of mesenchymal stem cells (such as osteoblasts), thereby induction of healing.
  • Release of growth factors.
  • Improved blood circulation in the treated tissues.

Plantar Fasciitis

Four scientific randomised controlled trials have shown shock wave therapy is effective for plantar facsiitis. Three separate treatments spaced approximately a week apart are normally required, each lasting about 5-10 minutes. Significant resolution of pain takes up to 2 months after completing treatment. For private medical insurance purposes the treatment (CCSD) code is 3 sessions of T5780.

Achilles Tendinopathy

There is good evidence that ESWT works and in combination with an Eccentric Stretching Protocol, it is better than eccentric stretches alone. Three separate treatments spaced approximately a week apart are normally required, each lasting about 5-10 minutes. Significant resolution of pain takes up to 2 months after completing treatment. For private medical insurance purposes the treatment (CCSD) code is 3 sessions of T7250.