Shockwave Therapy [What is it? How effective is it? Cost & Is it worth it?]

Frequently Asked Questions:

What is extracorporeal shock wave therapy?

• Shock wave therapy is a non-invasive method that uses pressure waves to treat various conditions in the body.
• These include plantar fasciitis, Achilles tendonitis, plantar fibroma pain, Achilles tendon, and muscle pain.
• Acoustic waves (aka shock waves) deliver a mechanical force to the body’s tissues.
• This can cause increased blood flow and blood vessels to develop in chronic and painful tissues.

What signs indicate this therapy is needed?

• Shock wave therapy may treat conditions such as degenerated tendons, Achilles tendonitis, plantar fasciitis, plantar fibroma formation, back of the heel, and bottom of the heel pain.

When should I avoid this therapy?

• Complications are infrequent with shock wave therapy.
• People with poor sensation (neuropathy) or hypersensitivity in the target area should not have this procedure.
• Feet & legs with open sores should also be avoided.
• Shock wave therapy is not used in patients with heart conditions or seizures.
• Shockwave therapy should not be used during pregnancy.
• Shockwave therapy should be discussed with your podiatrist before undergoing the procedure.

How does shockwave therapy work?

• A noninvasive probe is applied to the skin.
• An electrical charge creates an energy wave that is focused on the area of concern.
• The shock waves create a force on the tissues that may induce healing. This will allow the formation of blood vessels into the area.
• There is still developing evidence on how this procedure works.
• Some studies suggest that it may be that shock waves cause inflammation and improve blood flow to encourage the body to repair and heal itself.
• Studies do show that increased blood vessel formation does occur in the new tissue leading to tissue healing.

How is shockwave therapy performed during the appointment?

• Shock wave therapy is a non-surgical procedure.
• A probe is placed on the skin after a gel is applied to help conduct the shock waves.
• Low-energy shock wave therapy often is performed without anesthesia.
• Therapy is more successful with active patient participation, where the patient tells the therapist whether or not the probe is in the area of pain.
• One or more treatment sessions may be needed for chronic tissue problems to resolve.
• We like to perform on average 2-6 sessions within a 2-3 week period.

What happens after the procedure?

• Patients typically bear weight after treatment.
• Protected walking and running are allowed to occur immediately afterward.
• Although the first time, patients are advised to reduce physical activity for one to two weeks after treatment.
• There may be some initial soreness.
• Shock wave therapy may give good outcomes for some tendon problems or chronic degenerative conditions.
• Examples include Achilles tendonitis and plantar fasciitis.

Shockwave therapy potential complications:

• The main complications are pain and hypersensitivity at the site of treatment.
• These problems typically resolve with time.
• Pain and disability may persist when shock wave therapy is not successful.

Shockwave therapy may be useful in treating which disorder:

• Plantar fasciitis.
• Achilles tendonitis.
• Insertional Achilles tendonitis.
• Myofascial pain & pain of the myofascia.
• Tendinopathy.
• Posterior tibial tendonitis.
• Plantar fibroma.
• Arthritis, calcification & osteoarthritis.
• Bone spurs & heel spurs.
• Scar tissue.
• knee tendonitis
• Proximal hamstring tendinopathy.
• Morton’s neuroma.
• Bursitis & retrocalcaneal bursitis.
• Calcific tendonitis & calcific tendinopathy.
• Bottom of the heel pain & back of the heel pain.

Is there pain after shockwave therapy?

In our experience, after using shockwave therapy on hundreds if not thousands of patients, there is minimal pain after shockwave therapy.

The biggest predictor of pain after shockwave therapy is the degree of inflammation associated with treating the injury even before utilizing shockwave therapy.

This means that if there is a brand-new injury or bruise, this combined with shockwave therapy can cause some more soreness to develop.

On the other hand, chronic thick stiff scar tissue usually feels more loose and flexible almost immediately after using the radial shockwave therapy device.

We find very predictable improvement and minimal pain immediately after using shockwave therapy with the proper patient selection.

For most patients, shockwave therapy feels like a very effective massage that immediately leads to the tissue loosening up and feeling better.

Proper patient selection should prevent there from being any pain after shockwave therapy.

What does shockwave therapy feel like?

Patients frequently ask, “what does shockwave therapy feel like?”
Shockwave therapy with proper patient selection should feel like a vigorous massage.
We believe that shockwave therapy is best suited for chronic, stiff, and calcified soft tissue in the foot & ankle.

This means chronic injuries that are not getting better, such as plantar fasciitis, Achilles tendonitis, plantar fibromas, scar tissue, benefit the most from radial shockwave therapy.

In these cases, almost immediately after, the patient should feel better, looser, like after a good massage.

Is shockwave therapy safe?

Shockwave therapy is FDA approved for conditions such as plantar fasciitis. It is generally considered a noninvasive and safe therapy.

Personally speaking, after thousands of patients and millions of cycles of shockwave therapy utilized, we have had minimal to no problems.

The biggest problem that we have seen is that if shockwave therapy is misused on fresh or recent injuries, this could cause slightly more pain.

With the proper patient selection, the side effects of shockwave therapy could be greatly reduced.

With proper patient screening and selection, the results have been extremely safe, cost-effective, and beneficial towards avoiding surgery.

Radial shockwave therapy is extremely safe compared to the risks of surgery for conditions like heel spurs, chronic plantar fasciitis, and chronic insertional Achilles tendonitis.

Can shockwave therapy cause damage?

Patients sometimes asked the question, “Can shockwave therapy cause damage?”
The answer to his question is that the FDA has approved shockwave therapy for conditions of the foot, such as plantar fasciitis.

We have listed numerous studies showing how effective, cost-effective, and safe radial shockwave therapy can be.

We are huge fans of radial shockwave therapy.

We believe that the chance of causing damage is minimal, and we have had very few problems. This is true especially compared to surgery for these conditions.

It is extremely safe compared to other invasive options like a cortisone injection.

Shockwave therapy for plantar fasciitis, Achilles tendonitis, scar tissue, plantar fibromas is very safe and effective.

What are the shockwave therapy risks?

Does radial shockwave therapy pose any risks? The answer is every type of medical therapy is never risk-free.

Shockwave therapy is FDA approved for foot and ankle conditions such as plantar fasciitis.

We list studies that show how effective shockwave therapy can be, how cost-effective it can be, and how beneficial the results and evidence for shockwave therapy can be.

We believe once weighed against therapy such as surgery and injections, shockwave therapy is by far the safest and low-risk option.

What is the difference between ultrasound and shockwave therapy?

Ultrasound usually consists of periodic oscillations with lower bandwidths.
Ultrasound therapy applies an alternating high-frequency load to the tissue, with a frequency range of several megahertz, thus leading to heating or tissue soreness at high amplitudes.

Shock waves are singular positive pressure pulses followed by small tensile wave components(in the direction of the shock wave propagation).
The shockwave is a forward-directed energy ideal for deep tissue without affecting the tissue in front of it.

Shockwave can be considered as more of a deep-focused forward-directed wave vs. ultrasound’s alternating more high-frequency range.

The working theory is that shockwave therapy can remodel tissue calcification, encourage tendon and soft tissue remodeling, and stimulate blood vessel development into this scar tissue (as mentioned in the studies above).

How much does shockwave therapy cost?

The biggest question most patients have is, “how much does shockwave therapy cost?”
The answer is shockwave therapy is generally not covered by medical insurance even though it is FDA approved.

• The cost of shockwave therapy is lower than a standard medical appointment.
  We offer different packages that are reduced in cost for more chronic injuries that may require more treatment.
  We believe that it is not much more than a standard co-pay or co-insurance for a standard insurance plan in some cases.

We reference studies above that show between 2-6 treatments over a period of approximately 2 weeks has shown the best results at 1 month in 3 months compared to other treatments.

The studies we reference above showed that shockwave therapy is more cost-effective when weighed against repeated doctor’s visits, time off work, and potentially laying plantar fasciitis or Achilles tendonitis surgical options.

• We would recommend scheduling an appointment with us and potentially even performing a non-obligation test session to see how well shockwave therapy will work for you.

We stand behind the benefits of radial shockwave therapy and are cold laser therapy. We will do our best to ensure that it is a cost-effective treatment for all of our patients and work with them to make their treatment successful.

Does shockwave therapy work for heel spurs?

• This scientific paper shows that shockwave therapy can have success in remodeling bone spurs in the lower extremity.
• We list and detail numerous studies regarding shockwave therapy for plantar fasciitis and heel pain above.
• Shockwave therapy is shown to be a very cost-effective, safe, and productive treatment option in treating the bottom of the heel pain and back of the heel pain.
• Studies are showing that heel spurs can be remodeled in the foot and ankle.