SHOCKWAVE

THERAPY

More impact in less time

Shockwave Therapy

What is Shockwave?

Shockwave therapy is a non-invasive treatment that utilises acoustic wave pulsations to stimulate blood circulation and tissue healing at the injured area.

There are 2 types of shockwave:  focus and radial pressure.

The type of shockwave therapy used at the clinic is radial pressure  – designed to treat more superficial areas such as the hand and elbow. 

Shockwave works by delivering kinetic energy onto the skin and into the target area. This energy interacts with the surrounding tissues stimulating new blood vessel formation, collagen production and the break down of existing calcifications, which in turn reduces pain and restores movement [1]. 

As shockwave therapy accelerates tissue repair and growth, it may help to speed up recovery and reduce treatment time and cost.

Shockwave

We are the only hand therapy clinic in Victoria & Australia to offer shockwave therapy.

Shockwave therapy is beneficial for a variety of conditions as supported by the latest research.

Shockwave therapy is considered safe with minimal side effects as compared to other forms of invasive treatment such as cortisone injection and surgery. Most people will experience pain relief or an improvement following the first session. Some may experience temporary tenderness or swelling over the treatment area, which usually subsides after a few days.

Lateral Epicondylgia

Shockwave therapy is widely used for the treatment of tennis elbow. A systematic review in 2021 reports shockwave therapy outperforms laser and ultrasound therapy [2]. Meta-analyses of randomised controlled trials (RCTs) indicate that shockwave therapy is superior to and safer compared to cortisone injection [3,4].

Trigger finger

Shockwave therapy is as effective as cortisone injection for trigger fingers that are actively correctable [9].

Spasticity

Shockwave therapy has a positive effect on reducing the level of spastic hypertonia of the upper limb muscles in chronic stroke [12,13].

Carpal Tunnel Syndrome

A 2019 systematic review shows that shockwave therapy improves symptoms and outcomes [5]. A few sessions of shockwave therapy are beneficial for mild to moderate carpal tunnel syndrome with longer-term effects as compared to cortisone injection [6,7,8].

Dupuytren’s disease

Shockwave therapy improves pain and patient satisfaction during the nodular stage or early onset [10] and is effective in the short and medium terms [11].

Scars

Shockwave therapy provides similar outcomes for keloid scars as compared with steroid injection [14].

How many sessions do I need?

As the effect of shockwave therapy is cumulative, a course of 3 to 6 weekly sessions is required to experience its benefits.

Is Shockwave Therapy for me?

Shockwave therapy is beneficial for an array of subacute and chronic conditions but it may not be suitable for some individuals. 

Contraindications include acute inflammation, pregnancy, blood-clotting disorders, nerve dysfunction, cancer, pacemaker, implants and if you have just received a cortisone injection for less than 6 weeks. 

Please note that Shockwave Therapy is only available at our Epping clinic.

References:

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d’Agostino, M. C., Craig, K., Tibalt, E., & Respizzi, S. (2015). Shock wave as biological therapeutic tool: From mechanical stimulation to recovery and healing, through mechanotransduction. International Journal of Surgery, 24, 145-153.

Karanasios, S., Tsamasiotis, G. K., Michopoulos, K., Sakellari, V., & Gioftsos, G. (2021). Clinical effectiveness of shockwave therapy in lateral elbow tendinopathy: Systematic review and meta-analysis. Clinical Rehabilitation, 2692155211006860.

Yao, G., Chen, J., Duan, Y., & Chen, X. (2020). Efficacy of extracorporeal shock wave therapy for lateral epicondylitis: A systematic review and meta-analysis. BioMed Research International, 2064781.

Xiong, Y., Xue, H., Zhou, W., Sun, Y., Liu, Y., Wu, Q., Liu, J., Hu, L., Panayi, A. C., Chen, L., Yan, C., Mi, B., & Liu, G. (2019). Shock-wave therapy versus corticosteroid injection on lateral epicondylitis: A meta-analysis of randomized controlled trials. The Physician and Sportsmedicine47(3), 284–289. 

Kim, J. C., Jung, S. H., Lee, S.-U., & Lee, S. Y. (2019). Effect of extracorporeal shockwave therapy on carpal tunnel syndrome: A systematic review and meta-analysis of randomized controlled trials. Medicine98(33), e16870.

Atthakomol, P., Manosroi, W., Phanphaisarn, A., Phrompaet, S., Lammatavee, S., & Tongprasert, S. (2018). Comparison of single-dose radial extracorporeal shock wave and local corticosteroid injection for treatment of carpal tunnel syndrome including mid-term efficacy: A prospective randomized controlled trial. BMC Musculoskeletal Disorders, 19(1): 32.

Ke, M. J., Chen, L. C., Chou, Y. C., Li, T.Y., Chu, H. Y., Tsai, C. K., & Wu, Y. T. (2016). The dose-dependent efficiency of radial shock wave therapy for patients with carpal tunnel syndrome: A prospective, randomized, single-blind, placebo-controlled trial. Scientific Reports, 6, 38344.

Xu, D., Ma, W., Jiang, W., Hu, X., Jiang, F., Mao, C., Wang, Y., Fang, L., Luo, N., Li, H., Lou, Z., & Gan, K. (2020), A randomized controlled trial: Comparing extracorporeal shock wave therapy versus local corticosteroid injection for the treatment of carpal tunnel syndrome. International Orthopaedics, 44(1), 141-146.

Yildirim, P., Gultekin, A., Yildirim, A., Karahan, A. Y., & Tok, F. (2016). Extracorporeal shock wave therapy versus corticosteroid injection in the treatment of trigger finger: A randomized controlled study. The Journal of Hand Surgery, 41(9), 977-983.

Knobloch, K., Hellweg, M., Sorg, H., & Nedelka, T. (2021). Focused electromagnetic high-energetic extracorporeal shockwave (ESWT) reduces pain levels in the nodular state of Dupuytren’s disease-a randomized controlled trial (DupuyShock). Lasers in Medical Science.

Notarnicola, A., Maccagnano, G., Rifino, F., Pesce, V., Gallone, M. F., Covelli, I., & Moretti, B. (2017). Short-term effect of shockwave therapy, temperature controlled high energy adjustable multi-mode emission laser or stretching in Dupuytren’s disease: A prospective randomized clinical trial. Journal of Biological Regulators and Homeostatic Agents31(3), 775–784.

Dymarek, R., Taradaj, J., & Rosińczuk, J. (2016). The effect of radial extracorporeal shock wave stimulation on upper limb spasticity in chronic stroke patients: A single–blind, randomized, placebo-controlled study. Ultrasound in Medicine & Biology, 42(8), 1862-1875.

Li, G., Yuan, W., Liu, G., Qiao, L., Zhang, Y., Wang, Y., Wang, W., Zhao, M., Wang, Y., & Wang, J. (2020). Effects of radial extracorporeal shockwave therapy on spasticity of upper-limb agonist/antagonist muscles in patients affected by stroke: A randomized, single-blind clinical trial. Age & Ageing49(2), 246–252. 

Wang, C., Ko, J., Chou, W., Cheng, J., & Kuo, Y. (2018). Extracorporeal shockwave therapy for treatment of keloid scars. Wound Repair & Regeneration26(1), 69–76.

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