Extracorporeal shockwave therapy (ESWT) at Nuffield Health at St Bartholomew's Hospital

Who is Extracorporeal Shockwave Therapy suitable for?

Extracorporeal Shockwave Therapy treatment is a highly effective treatment available for patients with:

• Plantar Fasciitis
• Shoulder pain
• Tennis elbow
• Achilles Tendonopathy
• Trochanteric bursitis (Lateral hip pain)  

This can be a very successful second line treatment for patients who fail to respond to appropriate physiotherapy or other conservative treatments.

Shockwave therapy is a non-surgical treatment, and works by delivering impulses of energy, targeted to specific damaged tissues within the abnormal tendon. This increases the blood flow within the affected area, stimulating cell regeneration and healing, and decreasing local factors which can cause pain.

Before shockwave therapy is considered you will have a full clinical assessment. This may include an MRI or ultrasound scan.

What happens during shockwave therapy?

Your consultant will work with you to identify the exact area of pain and apply a gel-like substance to the area to promote the process.

A probe is pressed on to the affected area and the shockwaves are delivered through the skin. The impulses are delivered through the skin as a shockwave that spreads inside the injured tissue as an aspherical ‘radial' wave. These radial shockwaves initiate an inflammation-like response in the injured tissue that is being treated, and prompts the body to respond naturally by increasing blood circulation, the number of blood vessels and therefore metabolism in the injured tissue.

The shockwaves are felt as pulses which are a little uncomfortable but not painful. Typically your first treatment will start with a low level of intensity and increase this to a point where you feel comfortable. Patients are typically treated in an outpatient environment (not in theatre), and the procedure does not require any type of sedation or anaesthetic.

Shock-wave therapy treatments are usually performed at weekly intervals. Each treatment session takes about 20 minutes and you may need between 3 treatment sessions (possibly 5 for resistant problems).

After shockwave therapy

Many patients experience an improvement in symptoms almost immediately while others take several weeks to respond. You may notice a reddening or swelling of the area with some patients experiencing a brief increase in pain. It may take several weeks to see an overall benefit. It is suggested that your referring GP or surgeon reviews you at 6-8 weeks to assess your overall progress.