Radial Shockwave Therapy (RSWT) 

Are you one of millions of people who suffer from pain. If you are one of them, you know how chronic pain can become unbearable. Now there is an outpatient therapy which fights the causes of chronic pain without the need for injections, medication or surgery. 
Shockwave therapy is a non-surgical treatment targeted to specific damaged tissues. This type of treatment was first discovered many years ago and was used in breaking up kidney stones (lithotripsy). More recently however it has been found that shockwave can be very effective in the treatment of various sports injuries and musculoskeletal conditions. 
Radial Shock Wave Therapy (RSWT) is effective for many musculo-skeletal problems even when other therapies have proved ineffective. 
RSWT works by delivering impulses of energy, targeted to specific damaged tissues. The impulses are delivered through the skin as a shockwave that spreads inside the injured tissue as an aspherical ‘radial' wave. The shockwave is delivered to the tissue via a compressed air impulse exerted by the hand piece of the machine. 
The treatment then initiates an inflammation-like process in the tissue that is being treated. The body responds by increasing the blood circulation and metabolism at the treatment area which in turn accelerates the body’s own healing processes. This increase in the blood flow within the affected area, stimulates cell regeneration and healing, and decreases local factors which can cause pain. The shockwaves break down injured tissue and calcifications. 
Most conditions need between 3 and 5 sessions on a weekly basis to maximise the effect. It is commonly used and is accepted by many specialists as a useful option in some conditions. Most reports suggest it can be effective in 70-80 % of problems. This can be a very successful second line treatment for patients who fail to respond to appropriate physiotherapy or other conservative treatments. Like most treatments is often works best in combination with rehabilitation, physiotherapy, podiatry etc 
Conditions it is used for: 
Radial Shockwave Therapy treatment is a highly effective treatment available for patients with: 
• Tennis elbow 
• Calcified tendon issues of the shoulder 
• Golfer's elbow 
• Trigger point treatment (in muscles) 
• Pseudoarthrosis (non-union) 
• Lateral hip pain, (greater trochanteric bursitis) 
• Patellar tendinopathy (jumper's knee) 
• Medial tibial stress syndrome (shin splints) 
• Plantar fasciitis, including heel spurs 
• Achilles tendinopathy 
RSWT offers several advantages over more interventional procedures: 
• No anaesthesia is required and you can continue usual activities. Although you may  
need to refrain from sports activities whilst having treatment 
• RSWT is non-invasive - no surgery is required 
• Fast treatment - approximately 20 minutes per session, 4-5 sessions required 
• Fewer complications post treatment 
• Reported side effects are minimal 
• Significant clinical benefit can often be seen 6-8 weeks after treatment 
• In NICE guidelines (National Institute for Health and Care Excellence) 
• It is well tolerated by most patients and is a useful option to delay or avoid need for  
surgery in some cases 
What does the RSWT treatment involve? 
Before shockwave therapy is considered you will have a full clinical assessment. 
Contraindications or precautions to be aware of: 
• If you have a cardiac pacemaker please tell us prior to treatment as shockwave  
therapy may interfere with this 
• Cortisone injections should not be administered within 6 weeks prior to shockwave  
• Please tell us if you are on Warfarin or other blood thinning therapy, as shockwave  
therapy can cause some local bruising and bleeding in the treated tissues 
• If you have been diagnosed with cancer you should notify your clinician as RSWT  
treatment would not be appropriate 
• If you are pregnant RSWT should not be administered 
What happens during shockwave therapy? 
The physiotherapist determines the location of the pain by searching for painful points. These can also be localised using the hand piece.  
The area to be treated may be marked for accuracy, and a gel is applied to the skin, this improves the contact between the skin and the hand piece to allow the shockwaves to penetrate the body properly. 
The hand piece is placed on the painful area and shockwaves are released. In general, this is painless but sometimes it could be perceived as ‘unpleasant’.  
In a number of cases the physiotherapist will use a different treatment head. This combination of shockwaves and vibrations is also used for muscular disorders. 
Typically your first treatment will start with a low level of intensity and increase this to a point where you feel comfortable. Shock-wave therapy treatments are usually performed at weekly intervals. Each treatment session takes about 20 minutes and you may need between 3 and 4 treatment sessions (possibly 5 for resistant problems). 
What should I expect after the treatment? 
You will normally experience a reduced level of pain or no pain at all immediately after the treatment but a mild and diffuse pain can occur a few hours later. This dull pain can last for a day or two. Shockwave therapy initiates a pro-inflammatory condition in the tissue that is being treated. If necessary you may take non-prescription pain killers such as paracetemol, but do not take anti-inflammatory medication, or use ice on the treated area as these interfere with the body’s self healing abilities. 
It is important to highlight that we would expect positive clinical outcomes following treatment, however there is a chance that RSWT treatment may not improve your symptoms. 
If you would like to speak to any of us about the treatment then please do not hesitate to contact us on 01206 844410 
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