Shockwave Therapy
Shockwave Therapy in Edmonton
What is shockwave Therapy?
Extracorporeal Radial Shockwave Therapy is an advanced non-invasive treatment technique. A series of low-energy acoustic pulse waves penetrate the skin and treat the tissues without medications. The use of the shockwave in healthcare has grown in recent decades. Therapists primarily used Shockwave therapy to remove unwanted calcium deposits such as kidney stones and gallbladder stones in the 1980s. In the 2000s, Radial Shock waves were developed and introduced in physical therapy for rapid pain relief and tissue repair due to injuries. It requires minimal treatment sessions and treats the pathology’s underlying cause.
What is unique about Shockwave Therapy?
- Improved quicker results (3-6 visits)
- Accelerates the natural healing process
- No medication and can prolong or avoid surgery
- No anesthetics required
- Minimal or no side effects
How does Shockwave Therapy work?
Innovation Physical Therapy Plus uses the latest Chattanooga RPW 2 Shockwave Therapy Machine. In RPW 2, collisions of a launched projectile inside the applicator against the impact body (Transmitter) convert the kinetic energy into acoustic energy that produces pressure waves. The motion of the impact body transfers to the tissue at the point of skin contact, which is the highest energy concentration. The pressure waves propagate divergently into the underlying tissue in the form of radial pulse waves.
The mechanical energy of the shockwave converts into biochemical energy in the cell and extracellular matrix. The mechanical irritation of cellular matric (Mechanotransduction) and production of gas-filled bubbles (Stable Cavitation) results in the release of many biochemical mediators such as Nitric oxide. It accelerated an immune and inflammatory response, increasing blood circulation (Vasodilatation) and new blood vessel formation (Neo vascularization).
How is shockwave therapy applied?
First, the physiotherapist will complete an assessment to confirm the appropriateness of the treatment application for your condition.
A therapist places a wand-like handheld device over the specific treatment areas, and soundwaves get delivered through several thousand gentle shocks through a coupling media. There is no need for any anesthesia. The treatment time is short, ranging from 2-5 min. The total number of sessions would vary from 3-6 times, and we recommend one treatment session per week for better results.
Focused Vs Radial Shockwave Therapy
Focused waves can be directed at a minimal point with high intensity and go deeper. Radial waves impact a larger but shallower area, suitable for treating superficial musculoskeletal issues like tendons. There has been confusion about the effectiveness of the two different shockwaves. The research findings show no significant difference in the effectiveness of these two types of techniques in musculoskeletal conditions. When applying the most tolerable energy output within medium intensity ranges, Radial Shockwave has been found effective in pain relief and tissue regeneration in many superficial musculoskeletal conditions with a better, safer overall effectiveness in the treatment.
Physiological Effects:
- Increase of membrane permeability with the acceleration of weakened cells removal
- Activation of self-defence system (production of Cytokines and Free radicals release (Nitric Oxide and Substance P)
- Histological changes such as the restructuring of adhesions, increased fibroblasts, and collagen
- Reorganization, increase in capillaries and thickening of the paratenon have been observed in healing tendon
What effects to expect from a treatment?
- Pain reduction, analgesic effect
- Reduction of muscle tension
- Better range of motion
- Improvement of blood and lymphatic circulation
- Remodelling and reabsorption of calcifications (calcium builds up in body tissue, causing the tissue to harden)
- Strengthening of connective tissue
- The increased cell regeneration process
- Pro-inflammatory action – Positively regulates the inflammation
- Reduced inflammatory cells in an injured area
- Regenerates damaged tissue
- Promotes the development of new blood vessels
- Stimulates new nerve cell growth and tissue healing
- Reboot the healing process stalled in chronic conditions
- Effects on Tendon:
- Tenocyte proliferation
- Tendon tissue regeneration
- Tendon remodelling
- Facilitate Tendon gliding
- Some common tendon conditions are:
- Tendonitis: inflammatory response is seen at a specific site.
- Tendinosis: Chronic tendon pain upon abnormalities on imaging, i.e., intratendinous degeneration with no inflammation on CT, Radiograph or MRI.
- Tendinopathy: Pain with impaired performance, inflammation and intratendinous changes
Some conditions treated with Shockwave Therapy.
Foot and ankle pain:
- Plantar Fasciitis,
- Achilles Tendinopathy
- Greater Trochanteric Pain Syndrome
- Retrocalcaneal Bursitis
- Morton’s Neuroma
- Heel spurs (Calcaneal Spurs)
Hip and Knee pain:
- Bursitis
- Patellar Tendinopathy
- Iliotibial Band Syndrome
- Pes anserinus pain syndrome
- Medial Tibial Stress Syndrome (shin splints)
- Calf Hypertonicity/tight muscles
- Proximal Hamstring Tendinopathy
- Patellar Tendinosis (Jumper’s Knee)
Neck and back pain:
- Lumbalgia - Facet/SI joints
- Cervicalgia
- Chronic muscular pain
Shoulder pain:
- Shoulder impingement
- Rotator cuff tendinopathy
- Calcific Tendonitis (supraspinatus tendon, etc.)
Elbow pain:
- Lateral Epicondylosis (Tennis Elbow)
- Medial Epicondylosis (Golfer’s Elbow)
Wrist and Hand pain:
- Carpal Tunnel Syndrome
- Post-surgicalal tightness and scars
Chronic Stress/Non-union Fractures
Erectile dysfunction
Possible temporary side effects:
- Swellings
- Erythemia (Redness)
- Slight discomfort during the treatment (Can be minimized by changing the application settings as needed)
- Slight worsening after the first treatment but then a significant resolution
Covered with extended benefit plans
Currently, most insurance companies and extended benefit plans cover the treatment with Shockwave Therapy as a part of Physical Therapy.
What to expect after the first treatment?
Many people experience good pain relief after the first session. It is common to notice temporary soreness, redness, and mild swelling due to the inflammatory and immune response. Our physiotherapist will assess you after the shock wave therapy session and provide you with the other appropriate treatments, such as specific therapeutic exercises, activity modification and necessary home exercise programs.
Contraindications
Certain conditions are not appropriate for Shock Wave Therapy. Some of the most common are:
- Circulation disorders
- Nerve disorders
- Bone tumours
- Cancer
- Pregnancy (applications on the back)
- People on certain medications, such as blood thinner
- Corticosteroid injection (Can be treated with Shockwave six weeks after injection)
- Polyneuralgia
- Acute inflammation
- Thrombosis
- Over nerve roots/spinal cord
- Over lung tissue
- Over a Growth Plate