Extracorporeal Shock Wave Therapy (ESWT)

• It stands for Extracorporeal Shock Wave Therapy
• We use devices that generate pulses of high-pressure sound that travel through the skin
• For reasons that are not fully understood, soft tissue and bone that are subjected to these pulses of high-pressure energy heal back stronger

• Is a safe and effective
• Non-invasive (no incisions) alternative that eliminates many of the risks associated with conventional surgery
• ESWT is indicated for patients who have experienced heel pain for six or more months and have not responded to conservative treatment
• ESWT delivers high-energy sound waves, or acoustical energy, to the affected area to create a micro trauma that promotes revascularization and triggers the body’s natural repair mechanisms
• Benefits of ESWT include non-invasive treatment, a high success rate, single to dual treatment protocol, and fast recovery with quick return to work and normal activities
• Studies have shown very high success rates in eliminating or significantly reducing pain
  

The Origins of this Treatment

• ESWT devices evolved from lithotripters (a.k.a. kidney stone shock wave machines)
• The discovery of the beneficial effects of ESWT came as German researchers were trying to determine what type of high-pressure pulses could be sent through the body to disintegrate kidney stones without causing harm to surrounding tissue. In laboratory animals and humans, it was discovered (with some surprise) that surrounding tissue would often heal back stronger

Uses of ESWT

• Physical therapists use ultrasound machines that warm internal tissue by high frequency sound waves, but the ESWT machines send higher-energy pulses 2 or 3 times per second rather than continuous lower-energy waves
• Electricity is not sent into the body
• The USA FDA has approved the use of some ESWT machines for heel pain and tennis elbow
• We usually use this for patients with heel pain or tennis elbows who have failed conservative treatment such as local injections and physiotherapy
  

What happens on treatment day

• On the day of the procedure, the patient will arrive at the treatment location approximately one half hour before the scheduled appointment
• There you will meet your physician and the ESWT technician
• You will recline in a comfortable chair or bed with your injured foot resting on a large, fluid-filled cushion
• Typically, the treatment area is numbed with local anaesthetic.
• After localizing the inflamed fascia, the injured heel receives several thousand shockwaves during this 20 minute outpatient procedure
• Post operatively patients are discharged directly home from the treatment centers
  

What happens after ESWT

• It may take as long as 12 weeks to see the full benefit of an ESWT treatment
• The beneficial effect of the high-pressure waves may be from the growth of new blood vessels ("neovascularization") in small cavities that are created by the pulses
• New blood vessels to an area of tissue would promote healing. 
  

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