How effective is shockwave therapy?

What is the RESEARCH saying about Advanced Treatments like Shockwave?


There is important research about advanved treatment shockwave therapy. Shockwave therapy is a growing fielding with an exploding medical research database. This advanced treatment is beneficial for chronic injuries and stubborn pain conditions.
However: There are some conditions that it works for and other conditions that it does not.

Did you know? 

Shockwave does not work for all pain and problems. The research is continuing to evolve on this treatment and indicate conditions that respond the best! 

Whats the truth? 

Clinicians performing shockwave must educate patients on accurate expecations and prognosis. Shockwave therapy is NOT a cure all approach. It cannot cure all ailments but it is an effective modality that outperforms many other treatments in rehab clinics. Below we will outline some of the newer findings of the research.

The science….

A review ( 106 studies), identified the effectiveness and safety of shockwave therapy . This review found some very relevant findings:
  • Shockwave therapy is effective and supported by the data. 88% on radial and 82% of focused shockwave therapy showed positive results
  • Shockwave therapy is safe. There were no reports of serious adverse events
  • Application without sufficient energy adversely effects the outcome
  • There is no favour of radial or focused shockwave therapy
  • Optimal treatment protocol seems to be 2000 impulses at the highest energy tolerated

Review by Thiele found that:
  • Shockwave therapy is effective for tennis elbow
  • Surgery for tennis elbow should not be an option before repeated shockwave therapy

Mid portion Achilles (Korakakis)

  • Radial shockwave is comparable to eccentric exercises of the tendon
  • Radial shockwave is superior to wait and see approach

Insertional Achilles and Evidence 

  • Radial shockwave is superior to eccentric load training 
  • Suggested protocol: 2000 shocks, 2.5 bar, 3 weekly sessions

Some conclusions for Achilles and Shockwave: 

  • Radial shockwave is superior to placebo

Shockwave and Lateral hip pain:

  • Radial shockwave is superior to stretching and strengthening at short and mid-term follow-up in self-perceived recovery
  • Corticosteroid injection is superior to radial ESWT at short-term (1 month) 
  • Radial shockwave is  better than corticosteroid injection at mid-term and long-term follow-up

Shockwave and Knee Tendinopathy:

  • Focused shockwave is superior to anti-inflammatory meds, exercise, knee strap, modification of activity levels) at long-term follow-up (2–3 years).
  • Advanced treatment of focused and radial shockwave are effective.
Is there anything that suggests some research is lacking for ESWT? 
  • Research is steadily evolving and changing. There are limitations including the type of shockwave device being used, energy levels, patient profile, and targeted zone. All of these are hard to control in the literature. Importantly, clinicians can educate their patients and set out realistic expectations for treatment. 

Final Thoughts….

The field of regenerative medicine is evolving. There is a strong emphasis towards researching the effects on different conditions. There are many conditions that are being investigated. Shockwave is a powerful and advanced treatment that is continuing to evolve. 
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