Speed up the healing of your Tendon Problems!
Effective for a range of stubborn tendon problems including
Achilles Tendon, Plantar Fascia, Patella Tendon, Gluteal Tendon and Tennis Elbow pains.
£240 per 3 session treatment course.
(Covered by many Private Medical Insurance Companies)
What is Shockwave Therapy?
- Shockwave Therapy (Extracorporeal Shockwave Therapy- ESWT) is a non-invasive treatment that sends high energy soundwaves into a painful tendon via a hand-piece attached to a machine. This creates Shockwaves within the treated tissue and helps stimulate healing and reduce pain (see Frequently Asked Questions below for a more in-depth description).
- Evidence investigating Shockwave Therapy for tendon problems demonstrates successful outcomes in approximately 70% of cases.
What can you Treat with Shockwave Therapy?
Shockwave Therapy has been included in the NICE (National Institute for Clinical Excellence) Guidelines for a range of tendon problems:
- Plantar Fascia pain: Felt under the heel on the bottom of the foot.
- Achilles tendon pain: Felt at the back of the ankle.
- Patella tendon pain: Felt just below the knee cap.
- Gluteal tendon pain (commonly called Trochanteric bursitis): Felt on the outside of your hip.
- Tennis elbow: Felt on the outside of the elbow.
- Other Common Tendon problems that are commonly treated include hamstring, elbow, foot, ankle tendon problems as well as calcific tendonitis of the shoulder.
Shockwave Therapy – Part of a Comprehensive Tendon Management Service at Uxbridge Physiotherapy – Experts in Tendon Management.
Physiotherapy
Manual Therapy, Exercise and Education. Effective for many tendon pains.
Shockwave Therapy
– Stimulates healing and reduces pain in tendon problems present for more than 3 months.
Diagnostic Ultrasound Scanning
– accurate diagnosis of tendon problems if in doubt
– assesses the severity or extent of the injury
– rules out other potential causes of pain
Ultrasound Guided Steroid Injections
– effective pain relief in tendon problems not settling with Physiotherapy and Shockwave Therapy.
Diagnostic Ultrasound Scanning and Shockwave Therapy
Shockwave Therapy is useful for tendon-based problems. Your Physiotherapist will assess your problem. If they are confident that it is an appropriate tendon-based problem then Shockwave Therapy can proceed.
If there is some doubt over the diagnosis we may recommend a Diagnostic Ultrasound Scan before going ahead with Shockwave Therapy. This can be carried out at Uxbridge Physiotherapy by an experienced Physiotherapist qualified in Ultrasound Scanning. An Ultrasound scan will either confirm the suspected diagnosis in which case Shockwave Therapy can proceed, or identify other diagnoses in the area that may not be appropriate for Shockwave Therapy. In these cases Shockwave Therapy may not be indicated, and alternative treatment may be more appropriate. Diagnostic Ultrasound Scanning can therefore better guide treatment in these cases, and make sure you’re getting the most appropriate treatment.
Is Shockwave Therapy Appropriate for Me?
In some cases Shockwave Therapy may not be appropriate. We need to know if any of the points below apply to you. If they do we may still be able to modify the Shockwave Therapy e.g. reduce the power or direction. This can be discussed with your Physiotherapist:
- You are Pregnant.
- You have a Cardiac pacemaker.
- You have had a Corticosteroid injection in the affected area in the last 3 months.
- You have Cancer or Malignancy in or near the treatment area.
- Open wounds, skin rashes, swelling, inflammation or infection in or near the painful area.
- You have poor sensation or are hypersensitive in the area to be treated.
- You have vascular/blood vessel disease.
- You are taking blood thinning medication or have a blood clotting disorder.
- You have had a joint replacement in area to be treated.
- We can’t apply Shockwave Therapy over Lung tissue or Bone growth centers where bone growth is incomplete.
Frequently Asked Questions
We hope these will answer most of your queries but feel free to contact us should you have any further questions on 01895 717535 or at [email protected]
How Much Does Shockwave Therapy Cost?
Shockwave Therapy is a little more expensive than Physiotherapy sessions as it is a Specialist service. The cost of the machine and running costs of the machine are also factored into the price. We charge £240 for a 3-session course, this includes a full physical assessment. Additional sessions are charged at £80 if required. A number of Private Medical Insurance companies cover this treatment. You’ll likely need to speak to them to get specific authorisation for this (in addition to your Physiotherapy Authorisation). Discuss with your Physiotherapist if you need any guidance.
Can I Use My Private Medical Insurance to Cover Shockwave Therapy?
A number of Private Medical Insurance companies cover this treatment. If it is covered under your policy, you’ll often be covered for a specific number of sessions. As it is a specialist service, you’ll likely need specific authorisation from your insurer, so calling your Medical Insurer will be necessary before treatment can go ahead. If in doubt call us on 01895 717535 or email us on [email protected] and we can advise.
How Many Sessions Will I Need?
It depends. As in most cases the longer you’ve had the problem, or the more severe the tendon problem, the more treatments you’re likely to need. As an average you will need 3-6 sessions. The first 3 treatments should be carried out weekly as a course. Subsequent sessions if required are likely to be spaced out. You will be advised on an exercise regime to compliment the effects of the Shockwave Therapy.
How Long Does Treatment Take?
Shockwave Therapy sessions take around 5 minutes to administer 2500-3000 shocks. Treatments take place as a course and occur weekly for the first set of 3 sessions. If more sessions are required, they are spaced further apart after this. Treatment takes place alongside physiotherapy rehabilitation and other treatment modalities for best outcomes.
How Long Does Treatment Take to Work?
This can depend on a number of factors such as severity of the tendon problem, how long the problem has been present and compliance with exercise. After the initial 3 Shockwave Therapy treatment sessions, pain may have improved significantly or just a little. While some patients have ‘magical’ results after Shockwave Therapy, commonly results are more gradual and can take several months to see the full benefit (this doesn’t mean you need Shockwave throughout this time).
Let me explain – the tendon problem being treated with Shockwave Therapy is a chronic condition (at least 3 months old). By nature, due to reduced activity, these painful tendons have had time to become less tolerant of load and activity, more sensitive (painful). and surrounding muscles weaker and less supportive. The longer this process has been going on, the longer it takes to reverse these changes. Whilst Shockwave Therapy can be effective at stimulating healing and reducing pain, it DOES NOT improve the tolerance of the tendon to activity. Exercise and activity are essential to change this, and this takes time. Shockwave Therapy does put your tendon in a better position to increase loading exercise and activity, by reducing pain and stimulating the healing process. This is the reason we strongly recommend following through a progressive strengthening programme with your Physiotherapist, so that improvements are long-term. It may take several months after the Shockwave Therapy to achieve best results.
Is Shockwave Therapy Painful?
Shockwave Therapy is a fairly intense treatment and can be painful. As a patient you will feel a series of very rapid ‘bumps’ on the skin. It is usually tolerable, but if you’re finding the treatment too painful, machine settings can be adjusted. One of the ways the treatment works is enhancing the healing process by causing local inflammation. For this reason we expect some pain during the session, with some soreness which may last for several days after treatment.
What should I do after Shockwave Therapy?
Your Physiotherapist will advise you on what level of exercise and activity to do post-treatment. There is usually no restriction to activity unless post-treatment pain and soreness is more pronounced. In this case reducing your activity slightly until pain has settled is sensible. We would generally advise not taking anti-inflammatory medication or using ice for the pain caused as a result of treatment, as this may dampen down the inflammation intentionally caused by the Shockwaves, and reduce their beneficial treatment effects. Simple painkillers such as Paracetamol may help this pain and will not hinder inflammation. Please check that you have no medical conditions that preclude taking this medication, and if in doubt please consult a medical professional.
Are there any side-effects to Shockwave Therapy?
Shockwave Therapy is considered to be a safe, non-invasive treatment. There can be some short-term side effects which are primarily related to the high energy nature of the treatment:
- Pain during treatment which may continue for several days.
- Rarely bruising in the area which should settle within a week.
- Temporary numbness in the area.
How Does Shockwave Therapy Work?
Often chronic tendon pains are thought to get ‘stuck’ cycling between differing stages of the healing process without completely getting through to a ‘fully healed state’. This results in frustrating achey pains and periods of flare ups. Shockwave Therapy aims to initiate a strong inflammatory response in the affected tissue. The body responds by increasing local circulation and metabolism which can accelerate healing processes. Additionally Shockwaves can cause micro-trauma at a cellular level and temporary stimulation of local sensory nerves, resulting in immediate pain relief. This is known as ‘hyper-stimulation anaesthesia’.
What happens during a Shockwave Therapy session?
After assessing your appropriateness for treatment your Physiotherapist will identify the painful area in your tendon by feeling around the area. Coupling gel is applied to the area of skin to be treated to improve transmission of the shockwaves. A hand piece attached to the Shockwave machine is then held against the skin and moved around the area radiating shockwaves into the target tendon. This will take approximately 5 minutes and administer 2500-3000 shocks. After treatment your Physiotherapist may assess your exercise regime or perform further manual therapy if appropriate.
If you have any questions about Shockwave Therapy feel free to contact us on 01895 717535 or at [email protected]