A non-surgical medical treatment performed using high-energy sound waves for conditions such as heel spur, plantar fasciitis, and calcific tendinitis.
Indication
- Plantar fasciitis and heel spur (calcaneal spur)
- Calcific shoulder tendinitis (rotator cuff calcification)
- Lateral and medial epicondylitis (tennis/golfer's elbow)
- Achilles tendinopathy
- Patellar tendinopathy (jumper's knee)
- Trochanteric bursitis and certain chronic pain at tendon attachment sites
- Chronic myofascial trigger point syndromes unresponsive to conservative therapy
Preparation
- Examination by a physical medicine and rehabilitation specialist and imaging (ultrasound, MRI) evaluation
- Avoiding NSAIDs (anti-inflammatory pain relievers) for 24 hours before the procedure is recommended
- The treatment area should be clean and free of lotion
- Consultation with the physician if blood thinners are being used
How it's performed
- The patient is placed in the treatment position and the painful area is identified
- Conductive gel is applied to the treatment area
- The device head is placed in contact with the skin and focused shock waves are delivered
- A session lasts 15-20 minutes; 2000-3000 pulses are applied
- Generally one session per week, for a total of 3-5 sessions
- Anesthesia is not required; transient mild discomfort is normal
Post-procedure
- Avoid heavy activity for 24-48 hours after the procedure
- Full effect typically becomes apparent within 6-12 weeks
- Supported with stretching and exercise programs
- Follow-up examinations are planned at 1, 3, and 6 months
Risks
- Transient pain, redness, or tenderness at the treatment area
- Superficial age-related minor petechiae or hematoma (rare)
- Not applied in the presence of osteoporosis, pregnancy, or pacemaker
- Contraindicated in acute infection, malignancy, coagulopathy, and in children with open growth plates
- A 6-week wait is required if a steroid injection has been given to the area
FAQ
Is ESWT painful?
Mild to moderate discomfort may be felt. Intensity is adjusted to the patient's tolerance; most patients tolerate it well.
How many sessions are needed?
Generally 3-5 sessions, applied once per week, are sufficient. Full response is seen within 6-12 weeks.
Is there immediate relief?
There may be brief relief after the first session; lasting improvement occurs over weeks as the tissue regenerates.
Does it replace surgery?
It is a high-evidence treatment recommended to be tried before surgery in many chronic tendon disorders; outcomes vary by patient.
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