What is Shockwave Therapy?

Shockwave therapy, also known as extracorporeal shockwave therapy (ESWT), involves delivering high-energy sound waves to injured tissues. These waves promote healing by:

• Stimulating neovascularization (formation of new blood vessels)

• Increasing collagen production

• Breaking down calcified fibroblasts

• Reducing substance P (a pain-mediating chemical)

• Activating stem cell proliferation

There are two main types of SWT:

• Radial shockwave therapy (RSWT): Dispersed, lower-energy waves that affect a broader area

• Focused shockwave therapy (FSWT): Targeted, high-energy waves for deeper tissue penetration

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Evidence-Based Benefits of Shockwave Therapy

1. Plantar Fasciitis

One of the most common conditions treated with SWT.

• Statistical Significance: A meta-analysis published in The Journal of Orthopaedic Surgery and Research (2018) analyzed 14 randomized controlled trials (RCTs) and found that SWT significantly reduced pain scores (VAS reduction of >60%) compared to placebo (p < 0.001).

• Long-term Relief: Another study in Pain Medicine (2017) showed pain relief sustained over 12 months in 80% of patients treated with FSWT.

2. Calcific Tendinitis of the Shoulder

A condition marked by painful calcium deposits in the rotator cuff tendons.

• A double-blind RCT published in The Journal of the American Medical Association (JAMA, 2003) showed that 71% of patients receiving high-energy ESWT experienced significant improvement vs. 36% in the placebo group (p < 0.001).

• Radiographic clearance of calcium deposits was also higher (86% vs. 50%).

3. Achilles Tendinopathy

Chronic Achilles tendon pain is notoriously difficult to treat.

• A systematic review in British Journal of Sports Medicine (2015) found SWT significantly improved function and pain relief, with effect sizes showing a moderate to large clinical benefit (p < 0.05).

• SWT was especially effective when combined with eccentric loading exercises.

4. Tennis Elbow (Lateral Epicondylitis)

A common overuse injury affecting the tendons of the forearm.

• In a randomized study published in Clinical Rehabilitation (2013), SWT led to a mean reduction of pain scores by 45% after 12 weeks (p = 0.002), compared to 18% in the control group.

• Function scores also improved significantly (p < 0.01).

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Advantages Over Traditional Treatments

Benefit	Shockwave Therapy	Traditional Options
Non-invasive	✅	❌ (e.g., surgery)
Short treatment duration	✅ (usually 3–5 sessions)	❌ (long-term rehab, medication)
Minimal side effects	✅	❌ (GI issues with NSAIDs, etc.)
Clinically proven efficacy	✅ (multiple RCTs)	⚠️ (variable success rates)