The History of Pulsed Wave Therapy Pulsed Wave Therapy commonly referred to as “Shockwave” Therapy is a relatively new form of treatment in the fields of orthopedic and rehabilitation medicine. The effect of true “shockwaves” was first documented during World War II when the lungs of castaways on merchant ships were noted to be damaged without any superficial evidence of trauma. It was discovered that the shockwaves created by deep sea depth-charges were responsible for the internal injuries. This created a great deal of interest and research into the biological effects of shockwaves on living tissue. The first medical treatment developed from this research was lithotripsy. This allowed “Focused” shockwaves to specifically target and essentially dissolve kidney stones without surgical intervention. Today, over 98% of all kidney stones are treated with this technology. The use of a modified “Radial” version of shockwaves to treat tendon related pain began in the early 1990s.
How is Radial Pulsed Wave therapy different than Focused Shockwave? Focused shockwaves have an intentional, controlled destructive effect on a specific site or point of impact, radial pulsed waves do not. A therapeutic, radial pulsed wave (radial shockwave) is nothing more than a controlled sonic pulse, much like an airplane breaking the sound barrier. The primary effect of a pulsed wave is a direct mechanical force as the wave’s energy passes through tissue. These waves are believed to cause a controlled impact on the tissue being treated. This results in a biological reaction within the cells of that tissue (inflammation), which triggers the body to accelerate its natural healing response, and increase blood flow to the injured site.
Focused Shockwaves treat 98% of all kidney stones. Focused shock waves target a specific point. Radial pulsed waves flow through a region.
Pulsed Waves are used to treat many orthopedic conditions, including:
• Plantar fasciitis (heel spurs)
• Chronic Inflammation
• Patellar tendinitis (jumper’s knee)
• Lateral epicondylitis (tennis elbow)
• Shin splints
• Medial epicondylitis (golfer’s elbow)
• Morton’ s Neuroma
• Thumb basal joint Arthritis
• Stress Fractures
• Shoulder tendinitis
Is it effective, can it help me?
Yes, there has been a lot of clinical research done that clearly shows Radial Pulsed Wave therapy is a highly effective treatment option for many conditions. We have listed some of the world’s leading research documents at the end of this booklet. The evidence overwhelmingly supports this therapy as a breakthrough technology in orthopedic medicine for the treatment of many musculoskeletal injuries. Radial Pulsed Wave therapy works without the use of drugs and stimulates the body’s natural self-healing process.
There is an immediate reduction of pain and improved ease of movement. Shockwave Therapy may even eliminate your need for surgery. Radial Pulsed Wave Therapy has proven to be one of the most effective treatments for heel spurs and other similar conditions Pulsed Wave Therapy accelerates your body’s natural self-healing process Immediate Results Unlike many other forms of therapy, with Pulsed Wave Therapy you will usually notice immediate results.
These often include:
• A significant reduction in pain
• An increase in your range of motion, improved mobility
• Your muscle tone is normalized
• Previously noticeable “knots” or tightness have become relaxed
How long does it take?
Typical treatments last 5 minutes per area that we are treating. In that time we typically deliver about 2000 pulses. Most conditions require multiple treatments spaced several days apart to allow your body to do its natural healing in between sessions. During your initial assessment our team will evaluate your specific condition to determine how many treatments you will need.
Is It Safe?
Yes. All studies done to date show that when Pulsed Wave Therapy is used for the appropriate conditions there are no negative health effects. However, there are certain conditions where Pulsed Wave Therapy is not recommended. These include coagulation disorders, therapy over cancerous regions or tumors, children in a growth stage and pregnancy. For this reason we take special care to assess your individual condition and medical history.
How does it work?
A small metal ball (projectile) is accelerated inside the handpiece using electro-magnetic propulsion until it impacts the stop plate. This collision generates a mechanical pressure wave. The wave of energy is transferred to the applicator head which then sends that energy through the body. Different sized ‘heads’ are used on the handpiece applicator depending on the type of treatment being delivered. The process is often loud, but rest assured that this is normal. The sound you hear is nothing more than the sound generated when the projectile impacts the stop plate in the handpiece.
There may be no immediate pain, but some patients experience a little discomfort, reddening or bruising 2 – 4 hours after the treatment. In some cases it can last up to 48 hours and in very rare cases, it may last up to 5 days.
The treatment will trigger an inflammatory response, which is the body’s natural process of healing. For this reason, do not use anti-inflammatory medications or ice.
Even if you feel good, we recommend decreased activity for 48 hours following your treatments.
Does it Hurt?
If your treatment is on a “fleshy” area, you are not likely to feel any discomfort at all. Treatments on “boney” regions tend to be more sensitive. Your first treatment may be uncomfortable at first but most patients find it tolerable. As your body heals, you will find each successive treatment easier. If you are especially sensitive, adjustments on the Pulsed Wave machine can decrease the discomfort you feel.
An Internationally Proven Therapy Research References
⦁ Jan D. Rompe, Carsten Schoellner and Bernhard Nafe Evaluation of Low-Energy Extracorporeal Shock-Wave Application for Treatment of Chrinic Plantar Fasciitis J Bone Joint Surg Am. 2002;84:335-341.
⦁ L. Gerdesmeyer, H. Gollwitzer, P. Diehl, K. Radial Extracorporeal Shockwave Therapy (rESWT) in Orthopaedics Journal fur Mineralstoffwechsel, Zeitschrift fur Knochen- und Gelenkerkrankungen 11/2004
⦁ G. Spcca, S. Necozione, A. Cacchio Radial shock wave therapy for lateral epicondylitis: a prospective randomised controlled single-blind study Eur. Med Phy 2005, 41:17-25
⦁ Ludger Gerdesmeyer, Carol Frey et al Recalcitrant Plantar FasciitisRadial Extracorporeal Shock Wave Therapy Is Safe and Effective in the Treatment of Chronic Am J Sports Med 2008 36: 2100
⦁ Jan D. Rompe, John Furia and Nicola Maffulli Eccentric Loading Compared with Shock Wave Treatment for Chronic Insertional Achilles Tendinopathy. A Randomized, Controlled Trial J Bone Joint Surg Am. 2008;90:52- 61.
⦁ Charrin Jeanne Elisabeth, Noěl Eric Robert. Shockwave Therapy Under Ultrasonographic Guidance in Rotator Cuff Calcific Tendinitis. Joint Bone Spine 2001 May;68:241-4.
⦁ Chen Han-Shiang, Chen Liang-Mei, Huang Ting-Wen. Treatment of Painful Heel Syndrome With Shock Waves. Clinical Orthopaedics and Related Research. 2001 June;387:41-46.
⦁ Crowther MA, Banniester GC, Huma H et al. A prospective randomized study to compare extracorporeal shock wave therapy and injection of steroid for the treatment of tennis elbow. Journal of Bone and Joint Surgery. Jul 2002; 84(5): 678-679.
⦁ Daecke W, Kusniercsak D, Loew M. Long-term effect of extracorporeal shock wave therapy in chronic calcific tendinitis of the shoulder. Journal of Shoulder and Elbow Surgery. Sept-Oct 2002; 11(5): 476-480.
⦁ Decker T, Kuhne B, Gobel F. Extracorporeal shock wave therapy (ESWT) in epicondylitis humeri radialis. Short term and intermediate results. Orthopade. Jul 2002; 31(7): 633-636.
⦁ Gross MW, Sattler A, Haake M et al. The effectiveness of radiation treatment in comparison with extracorporeal shock wave therapy (ESWT) in supraspinatus tendon syndrome. Strahlenther Onkol. Jun 2002; 178(6): 314-320.
⦁ Haake M, Sattler A, Gross M, Schmitt J, Hildebrandt R. Comparison of extracorporeal shockwave therapy with Radiotherapy for supraspinatus tendinitis. Randomised Prospective Single Blind Trial with Two Sample Parallel Group Design. Ferdinand Enke Verlag, Stuttgart. 2001;139:397-402.
⦁ Haake M, Deike B, Thon A, Schmitt J. Importance of Accurately Focussing Extracorporeal Shock Waves in the Treatment of Calcifying Tendinitis. Fachverlag Schiele Und Schon , Berlin. 2001;46:69-74.
⦁ BÖddeker IR, Schäfer H, Haake M. Extracorporeal Shockwave Therapy (ESWT) in the Treatment of Plantar Fasciitis – A Biometrical Review. Clinical Rheumatology. Acta Medica Belgica, Brussels. 2001;20:324-330.