Shockwave therapy | Doctors & treatment information

Shockwave therapy is a gentle alternative to surgery for patients with acute and chronic pain in the musculoskeletal system. Even though the mechanisms of action are still being researched, there have been great successes in the treatment of some clinical pictures. In the 1980s, doctors used shock waves for the first time to break up kidney stones. Today, the procedure is also a recognized form of therapy in orthopaedics.

Find out more about shock wave therapy, how it works and when it is useful!

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Shockwave therapy - Further information

What is shockwave therapy?

Shockwave therapy is a non-surgical (non-invasive) treatment method in which high-energy shockwaves hit the body and exert their effects there. Shock waves are acoustic pressure waves that are generated outside the body (extracorporeally). The procedure is therefore also known as extracorporeal shock wave therapy (ESWT).

Orthopädische Erkrankungen der Gelenke
Area of application Joint diseases - shock wave therapy can significantly reduce pain. © freshidea / Fotolia

What types of shock waves are there?

Doctors differentiate between radial and focused shock waves depending on the form of propagation:

  • Radial shock waves act on the skin surface of an entire pain zone and are often used in physiotherapy.
  • Focused shock waves, on the other hand, are more energetic and penetrate deeper into the body. They are aimed precisely at one point on the body.

What effects do shock waves have?

When shock waves hit the diseased area of the body, they not only trigger mechanical stimuli, but also biochemical reactions. These manifest themselves in various processes:

  • Blood circulation is improved and the metabolism is stimulated.
  • The body releases active proteins, such as growth factors for regeneration and messenger substances for the metabolism (enzymes).
  • Bone growth is stimulated.
  • New tissue is formed.
  • Wound healing is promoted.

This stimulates the body's self-healing processes - a valuable effect for orthopaedic diseases and pain.

What conditions is shock wave therapy used for?

Originally used to treat kidney stones, shockwave therapy is now also used for other conditions. Shockwave therapy is used as a versatile form of therapy in urology, orthopaedics, surgery and dermatology .

Doctors mainly prescribe shockwave therapy for the following orthopaedic conditions:

How does shock wave therapy work?

Before shock wave therapy is carried out, you will want to know more about the shock wave therapy procedure .
First, the doctor determines the painful area of the body and marks it. Sometimes an X-ray or ultrasound examination is also carried out to determine the exact location of the condition. As a rule, the patient does not need anesthesia. Occasionally, the doctor will anesthetize the affected area locally (local anesthesia).

Stoßwellentherapie
Treatment with shock waves. Dan Race / Fotolia

The shock wave therapy device generates pressure waves and directs their energy into a hand-held device(transducer).
The doctor holds the transducer on the previously marked area and the shock waves are shot into the tissue under high pressure. Patients find the first shock waves particularly painful. However, the pain usually subsides over the course of the session. The doctor also makes sure that the pain is bearable.
The duration of a shock wave therapy session is usually between 5 and 15 minutes. Depending on the condition, the entire treatment usually consists of 1 to a maximum of 5 sessions.

What does the patient need to consider after the treatment?

Follow-up treatment is rarely necessary. If you are in pain after shock wave therapy, you can take painkillers and also cool the tissue. It is advisable to rest the affected body part for a few days. As a rule, however, you will be able to work without restrictions. Your doctor will tell you whether follow-up treatment is necessary and what this should look like.

Are there any risks or side effects of shockwave therapy?

Shockwave therapy is a form of treatment with few complications. In individual cases, the following side effects may occur:

temporary redness or swelling of the skin

  • Temporary increase in pain
  • Bruising (hematomas)
  • very minor bleeding of the periosteum
  • Slightly increased risk of further injuries such as tendon rupture

What are the chances of success with shock wave therapy?

The chances of recovery after shock wave therapy depend on the type of disease. In the case of a calcific shoulder or tennis or golfer's elbow, the treatment achieves complete freedom from symptoms or at least a significant improvement in pain in 75 percent of all patients. The success rate for patients with heel spurs is also high at around 65 percent. In general , shockwave therapy alleviates pain in all clinical pictures. However, there are patients for whom this form of treatment does not work.

Which patients should not undergo shock wave therapy?

Even though shock wave therapy is a gentle treatment alternative to surgery, the therapy is not suitable for every patient. Doctors rule out shockwave therapy in the following cases

  • in children, adolescents and pregnant women
  • in the case of blood clotting disorders
  • infections and severe inflammation of the bones and skin
  • malignant tumors
  • for people with pacemakers

Your attending physician will advise you and develop an individual therapy concept with you.

Costs of shock wave therapy

Private health insurance companies usually cover the costs in full if the doctor justifies the necessity of the therapy. In contrast, statutory health insurance companies do not usually reimburse shockwave therapy. They only approve a subsidy in individual cases. It is best to ask your health insurance provider whether they will cover the costs before treatment. A shockwave therapy session costs between 60 and 100 euros.

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