Extracorporeal Shockwave Treatment (ESWT) - Overview

1. What is Extracorporeal Shockwave Treatment (ESWT)?
2. What is ESWT Used For?
3. How Does ESWT Work?
4. What Happens Before, During & After Treatment?
5. What are Alternative Treatments?
6. Is This Treatment Right for Everyone?
7. How Do You Get Treatment?
8. Do Insurances Cover Treatment?

1. What is Extracorporeal Shockwave Treatment?
Extracorporeal Shockwave Treatment is a non-invasive (no incisions) treatment that involves the delivery of high energy sound waves, or acoustical energy, to affected areas of the body to trigger the body's own natural repair mechanisms and stimulate healing. Extracorporeal Shockwave Treatment ('extracorporeal' meaning 'outside the body') is a safe and effective treatment option. The recovery period is shorter than traditional invasive surgery and the procedure eliminates many of the risks associated with traditional surgery. Extracorporeal Shockwave Treatment (ESWT) has been used effectively for many years around the world. It was first approved in the United States by the FDA in October 2000 for treatment of Plantar Fasciitis, a type of heel pain. The FDA subsequently approved ESWT for Lateral Epicondylitis, commonly referred to as Tennis Elbow, in March 2003.

2. What Is ESWT Used For?
ESWT has been used effectively worldwide to treat “insertional tendonathopies,” such as:
     • Heel Pain (Plantar Fasciitis)
     • Tennis Elbow (Lateral Epicondylitis)
     • Golfers Elbow (Medial Epicondylitis)
     • Shoulder Calcifications (Calcific Tendonitis)
     • Achilles Tendonitis
     • Knees (Patellar Tendonitis)
Millions of people suffer from pain caused by inflammation of tendons and other soft tissues attached to bones, commonly referred to as “insertional tendonathopies." ESWT has also been used to treat bone pathologies such as Delayed-Union and Non-Union Fractures - conditions where broken bones do not properly heal back together.    [Back to Top]

3. How Does Extracorporeal Shockwave Treatment Work?
The widely accepted theory is that Extracorporeal Shockwave Treatment (ESWT) causes micro-trauma and controlled injury at the affected area, thereby leading to the formation of blood vessels (revascularizatiion) which triggers the body’s natural healing process and repair mechanisms. Studies have shown a 60-80% success rate in significantly reducing or eliminating pain.     [Back to Top]

4. What Happens Before, During and After ESWT Treatment?
BEFORE: Patients will be instructed to discontinue medication containing aspirin or non-steroidal anti-inflammatory medications (e.g. Motrin) for several days before treatment (and most likely for up to 30 days following treatment) unless otherwise instructed by the treating doctor. Patients will be asked to stop eating and drinking a number of hours prior to treatment due to the use of anesthesia.

DURING: Treatment typically lasts 20 to 30 minutes and is performed on an outpatient basis in a surgical center. To avoid discomfort during treatment, most doctors administer a local anesthetic at the point of pain and perform the procedure with the patient under intravenous (conscious) sedation.

AFTER: Patients may experience discomfort in the treated area after the effects of anesthesia have subsided. Some bruising, swelling, and temporary numbness is normal and expected. In the immediate days following treatment, many doctors will recommend RICE – Rest, Ice, Compression, Elevation. For 1 to 2 weeks, patients may continue to have the same type of pain experienced prior to treatment.

For 4 weeks following treatment, patients are advised not to participate in stressful activities (e.g. jogging, heavy housework, yard work, participating in sports) involving the affected area. Patients can then typically resume normal activity. Heel pain patients are typically instructed to avoid flat shoes such as sandals and slippers; continued use of orthotics may be encouraged.

Healing is generally complete at about 12 weeks, although patients may continue to experience additional reduction in pain thereafter.    [Back to Top]

5. What are Alternative Treatments?
Most doctors will first pursue conservative treatment options to reduce or eliminate pain. Conservative treatment may include such measures as rest, non-steroidal anti-inflammatory medications (NSAIDs), steroid injections, over-the-counter pain relievers, physical therapy, and shoe inserts (for heel pain). When conservative treatment has failed, ESWT is increasingly being used to avoid traditional invasive surgery.     [Back to Top]

6. Is This Treatment Right for Everyone?
You should speak to your doctor about your specific medical condition to see if Extracorporeal Shockwave Treatment is right for you. ESWT is not recommended for use on pregnant women, children, anyone with a pacemaker, or anyone on anti-coagulant therapy or who has a history of bleeding problems.    [Back to Top]

7. How Do You Get Treatment?
Talk to your doctor about your specific medical condition to see if Extracorporeal Shockwave Treatment (ESWT) is right for you. ESWT is available in association with Shockwave Systems at surgery center locations throughout the state. Have your doctor contact Shockwave Systems for more specific information.