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Extracorporeal shockwave therapy, or ESWT, is a form of treatment for some musculoskeletal conditions. It utilizes the application of high-intensity radiation and is thought to promote healing. There are two different theories as to how extracorporeal shockwave therapy is an effective means to help in the healing process.
First, it is thought that small injury to the area, referred to as microtrauma, creates new blood flow, or neo-vascularization to the area. This new blood promotes healing. The second theory as to how extracorporeal shockwave therapy is an effective healing tool is the body does nothing to help heal chronic pain because it has simply forgotten about the area. ESWT creates new inflammation. Inflammation is the body’s protective response to irritants, infections and injuries. The brain then realizes there is an injury to the area and sends nutrients to promote healing.
Extracorporeal shockwave therapy as a method of treatment is only approved by the FDA, or Food and Drug Administration, for heel spurs, tennis elbow and plantar fasciitis. Steps are being taken for this treatment option to be available for things like kidney stones, various tendinitis conditions such as in the shoulder, patella or knee cap, and shoulder, stress fractures and shoulder calcifications.
Heel spurs are a painful inflammatory response in the heel of the foot caused by excessive wear and stress to the plantar fascia. The plantar fascia is a thick web of connective tissue that supports the arch of the foot. Plantar fasciitis, on the other hand, is a painful inflammatory response in the plantar fascia which results in pain in the heel and arches of the foot.
Tennis elbow, also known as lateral epicondylitis, is where the outer portion of the elbow becomes sore and tender. It is commonly seen in tennis or racket sport players, but can occur to anyone after prolonged stress to the area. Tendinitis conditions that may be helped by extracorporeal shockwave therapy in the future are simply inflammation responses of the tendons. Tendons are the band of connective tissue that connects muscles to the bones.
In order to be considered for extracorporeal shockwave therapy, pain must be experienced for at least six months. Other treatment options must also have been attempted without relief. The procedure is performed under local anesthetic as an outpatient or in a doctor’s office.
After the extracorporeal shockwave therapy treatment, the use of anti-inflammatory methods of pain relief cannot be utilized as the body has prompted a new inflammation process to promote healing. Common pain relieving options include acetaminophen with or without codeine. Relief from the musculoskeletal condition can occur immediately. Some patients, however, do not experience relief for several weeks or months following the procedure.