What is ESWT?

ESWT is the latest highly effective and efficient non-surgical non-invasive treatment for a number of tendon, joint and muscle conditions, including

• Plantar Fascitis
• Tennis/Golfer’s Elbow (Radial Epicondylitis)
• Shoulder Pain (Calcific and Non-Calcific Tendinitis)
• Chronic Achilles Pain (Insertional Achilles Tendinopathy)
• Jumper’s Knee (Patellar Tendinopathy)
• Chronic Hamstring Pain (Proximal Hamstring Tendinopathy)
• Chronic Hip Pain (Trochanteric Tendinitis)
• Shin Splints (Tribal Stress Syndrome)

ESWT treatment uses focused acoustic waves to promote healing and revascularization while also breaking down scar tissue and calcifications. The micro-trauma caused by the acoustic waves induces repair and regeneration resulting in significantly reduced or eliminated pain in most patients.

While ESWT has only recently started gaining popularity throughout the United States, it has already received fairly significant wide-spread acceptance in Europe, Asia and Canada. The application of ESWT in musculoskeletal disorders has been around for more than a decade and a half, used initially primarily for treatment of sports related tendinopathies like proximal plantar fasciitis of the heel, lateral epicondylitis of the elbow, and calcific or non-calcific tendonitis of the shoulder. More recently, its use has expanded to the treatment of other conditions, including patellar tendinopathy (jumper’s knee) and Achilles tendinopathy. While technological and application protocols are continuously being improved on, the historical success rate has ranged from 65% to 91%.

Over the past 10 to 15 years in many parts of the world, ESWT has emerged as the leading choice for many different orthopedic disorders. The complications associated with ESWT are low and negligible. As such, not only is ESWT often more effective or at least comparatively effective to other treatment options, but it is completely non-invasive, avoiding surgery and/or painful injections.

What Does ESWT Treatment Involve?

Of course every patient is different, but ESWT generally involves 6-8 treatments at the office. Each treatment generally takes 10-15 minutes. A hand-held device, set to deliver acoustic waves to the proper depth, is placed against and moved around the problem area while several thousand acoustic pulses are delivered.

There is minor pain during the treatment. However, the intensity of the acoustic wave being delivered is always based on patient tolerance, meaning the intensity level is raised and lowered based on patient feedback and will not be administered at a level that is “painful” to the individual. There should be no pain from the ESWT after a treatment. Complications are rare. When there are complications, they generally consist of mild soreness and redness in the treated area. Occasionally, there may be minor bruising.

Does ESWT Provide Short-Term or Long-Term Benefits?

While ESWT provides significant short-term immediate benefits for most patients, its long-term benefits are what really separates it from other treatment options. An example of this is shown in a study reported in a 2010 edition of the publication Orthopedics. The study compared ESWT to corticosteroid injections in patients with radial epicondylitis (tennis elbow). A very conservative ESWT protocol was used, nevertheless the results were enlightening. After 4 weeks, the patients receiving corticosteroid injections experienced a 75.9% improvement in pain relief. Over time, however, this improvement declined. At 52 weeks, the improvement in pain relief by patients receiving the corticosteroid injections slipped to 43.1%. The effect was almost the opposite in patients treated with ESWT. At 4 weeks, there was a 44% improvement in pain relief. However, the benefits kept improving and maintained long after treatments ended, and at 52 weeks there remained an average 71.5% improvement in pain relief for patients treated with ESWT. The short-term and long-term results were similar for functionality and grip strength as well.