Cowra Physiotherapy and Health Supplies are delighted to be able to offer our clients access to Extracorporeal Shockwave Therapy (ESWT) as a part of our suite of services. The research behind its use is strong and we are seeing this backed up in the cases we are seeing. It is the most impressive advance in treating a variety of conditions I have seen in my 20 years as working as a Physiotherapist. The technology has been around for over 10 years but has been cost prohibitive. In USA 3 treatment sessions have been priced at $1500 US. Machines originally costing over $60 000. The cost of the machines have come down and we are pleased to offer this service at NO EXTRA COST to our client. To our knowledge there are no machines used in Physiotherapy clinics in Orange, Bathurst or the central west (due to cost mainly). There are conditions that have not responded to any other treatment that are responding to ESWT. All therapists at Cowra Physiotherapy and Health Supplies are competent in using ESWT as part of our treatment routines. 

WHAT IS SHOCKWAVE THERAPY? 

ESWT, also known as Shockwave Therapy, or Radial Shockwave Therapy, provides treatments to patients suffering from a range of chronic conditions that are notoriously difficult to resolve. Shockwave treatment was originally developed to treat kidney stones (renal calculi) and is known as Lithotripsy treatment in this area of medicine. It was developed to provide an alternative to surgery in these patients. Some patients who had their kidney stones successfully treated also reported improvement in chronic musculoskeletal conditions in regions which were in the pathway of the shockwave treatment. 

HOW DOES SHOCKWAVE THERAPY WORK? 

The basic principles behind shockwave therapy are the high pressured acoustic shockwaves that travel through the skin to stimulate pain relief and tissue repair. 

WHAT CONDITIONS DOES SHOCKWAVE THERAPY TREAT? 

Shockwave Therapy has attracted several clinical research trials which have supported its use in the treatment of patients with the following conditions:

• Plantar Fasciitis/heel spur (calcaneal spur)
• Achilles tendinopathy 
• Gluteal tendinopathy
• Proximal hamstring tendinopathy
• Calcific tendonitis of the shoulder
• Patella tendinopathy
• Tennis elbow (lateral epicondylitis)
• Other forms of insertional tendinopathy
• Other musculoskeletal problems: 
• Muscle strains 
• Calcified Haematomas (“corkies”)  
• Shin splints 
• Osteitis pubis 
• Recalcitrant trigger points 
• Osgood Schlatter Disease 

Impressive results have been reported in cases that have been recalcitrant and failed to respond to treatment regimes including conventional approaches. What sets this treatment apart from traditional treatments is that it treats the musculoskeletal pathology instead of just offering symptomatic relief. 

WHAT DOES IT INVOLVE? 

The physiotherapist will pass the shockwave applicator over the injured area. While the stimulation may produce some discomfort, patients often feel immediate reduction of pain in the first 24 hours after treatment. 

HOW MANY TREATMENTS WILL I NEED? 

The therapy usually takes up between 3-5 sessions of 10 – 15 minutes. 

WHAT IS THE EVIDENCE? 

There are a number of trials, including randomised controlled trials, which support the use of Shockwave Therapy: 

• Rompe et al 2008, Eccentric Loading Compared with Shockwave treatment for Chronic Insertional Achilles Tendinopathy, Journal of Bone and Joint Surgery (America) 2008; 90: 52-61 
• Han et al 2009, Effect of Extracorporeal Shockwave Therapy on Cultured Tenocytes, Foot and Ankle International, 30: 93-98
• Furia et al 2007, Extracorporeal Shockwave therapy in the treatment of chronic plantar fasciitis and Achilles tendinopathy, Current Opinion in Orthopaedics 2007; 18: 101- 111
• Rompe, JD; Radial Shockwave Therapy- Where do we stand today?; Translation from Medical Special, Apr 2006