Helpie FAQ

Extracorporeal shock wave therapy (ESWT) uses acoustic pulses to treat certain musculoskeletal disorders. It is a well-studied and commonly used treatment modality for a variety of musculoskeletal conditions.

Shockwave therapy works in two ways.

1. It lowers the concentration of one of the chemicals needed for your body to perceive pain.
2. It interferes with the inflammation process, which may help to kickstart the healing process.

Shockwave therapy has a number of possible uses. Some of the more common ones are:

• Achilles tendinopathy (mid portion and insertional)
• Upper back pain
• Lower back pain
• Myofascial trigger points
• Psuedoradicular lower back pain
• Golfer's elbow (medial epicondylitis)
• Tennis elbow (lateral epicondylitis)
• Bone marrow oedema
• Plantar fasciitis
• Greater trochanteric pain syndrome
• Patella tip syndrome
• Medial tibial stress syndrome
• Osgood-Shlatter disease
• "Shin splints"
• Subacromial pain syndrome
• Calcifying tendinitis of the shoulder

This list is not exhaustive- there are many other possible uses for shockwave therapy. Please discuss with your Osteopath.

Shockwave therapy treatments usually last between 3 to 5 minutes. If your Osteopath believes it is necessary, they may also add Osteopathic techniques into your treatment plan.

8 or 9 out of 10 patients will experience significant relief of symptoms within 3 - 5 treatments.  

Depending on the site and severity of your condition, shockwave therapy can be uncomfortable. However, almost everyone can tolerate the treatment. In most cases, the pain will ease or cease within around 60 seconds, as the machine starts to do its job. A successful shockwave treatment is all about communication between the practitioner and the patient. You are free to communicate with your Osteopath at any time if the discomfort is too great. They can either make adjustments on the machine or discontinue treatment.

There are a number of shockwave machines on the market that are not actually capable of producing the bar pressure required to generate a change in the tissues. Due to these machines running at a lower bar pressure, they are often marketed as "painless". Whilst this may seem like a good thing, the reality is that in order for the full effect of the machine to be stimulated, there needs to be some depletion of one of the chemical pain messengers. In plain terms, machines that can't properly generate enough bar pressure to produce some level of discomfort won't disrupt the pain messangers enough to produce a therapeutic benefit. The Swiss DolorClast machine used at Lifespan Osteopathy is the only machine approved by the FDA due to its ability to demonstrate both safety and efficacy. I.e. treatments with the machine used in our clinic are not only safe, but they work. This means that whilst treatments may initially be uncomfortable, you can rest assured that the technology being used has been proven to the highest possible standard that it is actually effective. Finally, each of our practitioners have had the opportunity to have shockwave therapy performed on them. They know exactly what it feels like, and wouldn't perform any technique on you that they wouldn't have done themselves. So it's really not as scary as it sounds!

The short answer is- not much. It's possible that you may feel some discomfort following the treatment. Simple strategies such as rest and paracetamol may be helpful. Do not take anti-inflammatories (such as Nurofen or Voltaren), as these may interfere with the healing process kickstarted by the Shockwave therapy. Similarly, avoid icing the area. It's also advisable to rest from aggravating activities for 2-3 days following each session.

Studies have shown that 8 to 9 out of 10 patients will experience full pain and injury resolution for up to 9 years. This of course means that 1 or 2 out of 10 patients will not see such positive results. If you are not likely to respond to Shockwave therapy, it is usually apparent after the first 2 treatments. If you do not experience pain relief after the first 2 treatments, your Osteopath will discuss the possible next steps with you. As shockwave is considered a first line treatment for musculoskeletal conditions, patients who do not respond favourably may be candidates for more invasive treatments such as cortisone or surgery.

Shockwave cannot be used in the following groups of people:

• Pregnant women
• Children under the age of 18 years, except in the case of Osgood-Schlatter's disease
• People with blood clotting disorders
• People on blood thinners
• Treatment of of tissue with local tumours or local bacterial and/or viral infections
• Treatment of patients who have used cortisone within preceding six weeks

 

These are known possible risk of Shockwave treatment:

• Pain and discomfort during and after treatment
• Reddening of the skin
• Petechiae (tiny red, purple or brown spots on the skin)- usually resolves within 48-72 hours
• Swelling and numbness of the skin over the treatment area

There are also possible severe complications if Shockwave therapy is used incorrectly, or in the wrong patient groups. This is why a thorough initial consultation and screening process is necessary. The following are possible complications:

• Potential damage of the lung and gut tissue
• Potential rupture of pre-ruptured tendons
• Potential damage of ithe growth plates if used in children who are still growing
• Possible spread of malignant tumours
• Potential damage of articular cartilage

 

Prior to undertaking any Shockwave therapy, your Osteopath will conduct a thorough case history. This is to allow them to gain a full understanding of your injury, as well as any other important factors such as your medication regime (if any) and surgical history. This will help determine if shockwave is right for you. Your Osteopath will also most likely provide hands-on Osteopathic treatment. This is to ensure that the mechanics of the area being treated as working as efficiently as possible. This will allow for the best possible response to treatment. We take the time during your initial consultation to not only take the steps outlined above, but to give you a thorough explanation of what you can expect from Shockwave therapy. If your Osteopath agrees that Shockwave is the best treatment pathway for you, you may receive Shockwave Therapy at either your first or second consultation, depending on a number of factors in your case. If you proceed with Shockwave Therapy, we'll also schedule in your follow up appointments at the ideal intervals at the conclusion of your Initial Consultation, to ensure you get the best possible outcome.

No, a referral is not required for Shockwave therapy. However, as it is a proven tool in the management of chronic musculoskeletal conditions, you may be eligible for referral from your GP for a Chronic Disease Management plan if your condition has been present for more than 6 months. This will allow Medicare to contribute towards the cost of Shockwave therapy, although a gap fee will still apply.

Yes, as Shockwave therapy is administered by qualified, registered Osteopaths as part of an Osteopathic treatment plan, your usual private health fund rebates will apply if you have Extras cover. If you'd like to claim a Private health insurance rebate, please check with your individual fund prior to making an appointment to ensure that you are covered for Osteopathic treatment. We have HICAPS facilities to process all claims on the spot. Please note that Medicare rebates and Private Health insurance rebates cannot be combined to fund a single treatment.