Shockwave Therapy 

​Radial Shockwave Therapy (RSWT) is a non-invasive therapeutic technique that uses acoustic waves to deliver mechanical energy to targeted tissues in the body. This energy stimulates biological responses that promote tissue repair, reduce pain, and improve functionality.

 

Unlike focused shockwave therapy, which concentrates energy on a precise point (often used to treat kidney stones), radial shockwaves spread outward in a dispersive pattern, making them effective for treating superficial or broad areas of soft tissue.

 

The Science Behind Radial Shockwave Therapy

 

1. Mechanical Energy Delivery

 

RSWT generates high-energy acoustic waves using a pneumatic device. These waves are transmitted through a handheld applicator into the affected tissue. The radial pattern of these waves ensures that energy is distributed over a broader area, ideal for superficial musculoskeletal conditions.

 

2. Biological Mechanisms of Action

 

Radial shockwaves induce several cellular and molecular responses:

• Microtrauma and Cellular Repair: The mechanical waves create controlled microtrauma in tissues, which triggers the body’s natural repair mechanisms. This process increases cellular activity and promotes the growth of new blood vessels (angiogenesis).

• Cavitation Effect: The waves generate tiny gas bubbles within the tissue, which expand and collapse. This cavitation effect disrupts chronic scar tissue and calcifications, helping restore normal tissue function.

• Neovascularisation: RSWT stimulates the formation of new capillaries in ischemic (poorly oxygenated) tissue, improving oxygenation and nutrient supply to the affected area.

• Pain Modulation:

• Substance P Reduction: RSWT reduces levels of substance P, a neuropeptide associated with pain and inflammation.

• Gate-Control Theory: The mechanical pressure stimulates nerve endings, which may interfere with pain signaling pathways, providing immediate analgesic effects.

• Activation of Mechanotransduction: This triggers the release of growth factors like vascular endothelial growth factor (VEGF) and nitric oxide (NO), essential for tissue repair and inflammation reduction.

 

Clinical Applications

 

Radial shockwave therapy is particularly effective for chronic, soft-tissue conditions where traditional therapies have failed. Common conditions include:

• Tendinopathies: Chronic overuse injuries, such as Achilles tendinopathy, patellar tendinopathy (jumper’s knee), and lateral epicondylitis (tennis elbow).

• Myofascial Pain Syndromes: Trigger points and chronic muscular tension.

• Plantar Fasciitis: Degeneration and inflammation of the plantar fascia.

• Calcific Tendinopathy: Conditions involving calcium deposits, often in the shoulder.

• Scar Tissue and Adhesions: RSWT helps break down dense scar tissue and adhesions in soft tissues.

 

Scientific Evidence for RSWT

 

Numerous studies support the efficacy of radial shockwave therapy for chronic musculoskeletal conditions.

• Pain Relief: Clinical trials demonstrate a significant reduction in pain scores for conditions like plantar fasciitis and tendinopathies, often achieving a success rate of 60–80%.

• Functional Improvement: Patients report improved mobility and functionality in affected areas, attributed to enhanced tissue elasticity and reduced chronic inflammation.

• Long-Term Results: Studies show that benefits are sustained for 6–12 months or longer after completing therapy, particularly when combined with rehabilitation exercises.

 

Treatment Protocol and Patient Experience

 

1. Procedure

1. Preparation: The therapist identifies the area of pain and applies a conductive gel to optimize wave transmission.

2. Treatment Application: The applicator delivers radial shockwaves to the targeted tissue at a frequency (e.g., 8–15 Hz) and pressure intensity tailored to the patient’s tolerance.

3. Duration: Each session typically lasts 10–20 minutes.

 

2. Number of Sessions

Most treatment protocols recommend 3–6 sessions spaced 7–10 days apart. The total number depends on the severity and chronicity of the condition.

 

3. Sensations During Treatment

Patients may feel mild to moderate discomfort during the procedure, often described as a “tapping” or “pulsing” sensation. This subsides as the tissue adapts.

 

Risks and Contraindications

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Risks:

• Temporary redness, swelling, or bruising in the treated area.

• Mild post-treatment soreness, often resolving within 48 hours.

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While RSWT is generally safe, it is not suitable for everyone.

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Contraindications:

• Active infections or malignancies near the treatment site

• Severe osteoporosis or acute injuries (e.g., fractures)

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If you’re considering RSWT, consult a qualified therapist to determine if it’s the right approach for your condition.