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Extracorporeal shockwave therapy (ESWT)

The use of shockwaves to promote healing after an injury

Cropped shot of belly of woman patient, having shockwave therapy treatment

Extracorporeal shockwave therapy (ESWT) involves the use of a medical device to pass shockwaves through your skin towards an injured part of your body. This encourages responses in the injured tissues that can enhance your natural healing process.

ESWT is a non-surgical procedure predominately used to treat conditions such as:

  • Achilles tendinopathy
  • Plantar fasciopathy (incl. heel spur)
  • Golfers elbow
  • Tennis elbow
  • Rotator cuff tendinopathy (including calcification)
  • Patellar tendinopathy
  • Hamstring tendinopathy
  • Greater trochanteric pain syndrome

ESWT involves the use of a medical device to pass shockwaves through the skin to the injured part of the body.

The shockwaves are generated by a projectile that is propelled at high speed inside a hand-held applicator. As the shockwaves enter the body, they initiate an inflammatory-like response in the injured tissue that is being treated.

This prompts the body to respond by increasing blood circulation, stimulating the body's natural healing process and breaking down calcium deposits in tendons.

What makes ESWT unique is that it is one of the very few technologies that seems to work best when an injury has become chronic (meaning it has lasted for over three months). ESWT appears to be able to jump start the healing process in chronic injuries and move them back into the acute phase of healing, which improves the chances of recovering.

ESWT is carried out at an outpatient appointment and requires no injections, medication or surgery.

It is usually offered after other conservative treatments, such as physiotherapy, have failed to improve symptoms.

It may be necessary to continue physiotherapy alongside your course of ESWT to get the best results. An assessment takes place before treatment is carried out to ensure it is appropriate.

It may be recommended to have an ultrasound scan or MRI Scan to determine the extent of your injury prior to commencing ESWT.

A course of ESWT usually requires three to four sessions, each taking about 30 minutes, which in addition to the ESWT treatment, includes advice on retraining weak muscles related to the injury.

Extracorporeal shock wave therapy or ESWT offers advantages over traditional surgical methods:

  • No anaesthesia
  • Non-invasive
  • No medication
  • No surgery
  • Fast treatment
  • Fewer complications
  • Virtually painless after treatment
  • Quick recovery and quick results

During the treatment, you will experience some pain/discomfort, but this should be bearable. Potential short-lived side effects after the treatment are:
  • Bruising
  • Swelling
  • Redness
  • Numbness in the area

There is a very small risk of tendon or ligament rupture. All risks will be discussed in full with the consultant/physiotherapist prior to the procedure.

ESWT treatment is not normally suitable for patients who:

  • Are pregnant
  • Have a tumour (at/near the site of treatment)
  • Have an infection at the site of treatment
  • Are undergoing anticoagulation therapy
  • Have a pacemaker fitted
  • Have had recent steroid injections (within the last 12 weeks)
  • Are under 18 years of age
  • Have a joint replacement or metal implant in the treatment area
  • Have a bleeding disorder (such as Haemophilia)

The treatment is administered in the outpatients department, as such you will be able to go home straight away.

If you are experiencing any pain or discomfort, you can take over-the-counter painkillers (however, you should not take any anti-inflammatory medications or apply ice as this can reduce the effects of the treatment).

You can return to your day-to-day activities immediately after treatment, but you should take it easy for 2-3 days following each treatment.

It is not uncommon for your pain to get a bit worse before it gets better during the course of treatment, this is because a healing response is being triggered.

While you may have ESWT weekly for three to four weeks, it can take three to four months after your final treatment for the full benefit of the treatment to be felt. During this time it is important to continue with your prescribed exercise programme Your physiotherapist will advise when it is safe to return to sporting activities.

Before starting ESWT, you will need a full physiotherapy assessment, which is priced from £64*. This is to ensure this is the most appropriate treatment for you.

A course of treatment usually requires 3 - 4 sessions. ESWT costs from £100 per session - this is based on a 30-minute appointment, this includes your ESWT treatment and any other physiotherapy, such as manual therapy, exercises required to help you get the best outcome from the treatment.

*This is a starting from price and varies by hospital. The exact price will be confirmed before booking.

When you choose to go private with Circle Health Group, you can expect:

  • Flexible appointment times and locations to fit your routine
  • Freedom to choose your hospital
  • Specialist physiotherapy equipment and imaging facilities at your fingertips
  • Specialist advice and exercises to follow in sessions and at home
  • Tailored services (your physiotherapist will build your programme around your needs)

If you would like to learn more about how ESWT could benefit you, call a member of our team directly.

Content reviewed by Circle physiotherapy team in June 2023. Next review due June 2026.

  1. Extracorporeal shock wave therapy, PubMed
  2. Extracorporeal shockwave therapy (ESWT), Physiopedia
  3. Shockwave therapy, NHS

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