There are two forms of shockwave: focused and radial. These forms differ in physical characteristics and their method of production. Focused shockwaves affect a small, precisely defined area, travel deeper and carry higher energy; whereas radial shockwaves affect a larger, more diffuse area, do not travel as deeply and carry less energy.
Focused shockwaves are employed in the treatment of bone disorders (eg. non-union fractures) or soft tissue calcifications, and require precise imaging, anesthesia and close supervision.
Radial shockwaves are used in the treatment of soft tissue injuries such as tendon related conditions, and promote tissue healing. These conditions include plantar fasciitis, patellar tendinitis (jumper’s knee), tennis/golf elbow and shoulder tendinitis.
Extensive research has been conducted to assess the efficacy of ESWT and while most have shown favorable outcomes, some have shown no benefit over placebo treatment.
ESWT has been shown to be a good non-invasive treatment option for orthopaedic conditions, and is an alternative worth undertaking for many patients who wish to avoid invasive treatments such as steroid injections or surgery.
Contraindications to ESWT include:
- Bleeding disorders or if taking anti-coagulation medications
- Infection in the treatment area
- Malignant disease in or near the treatment area
- Prosthetic device in the treatment area