Shockwave Therapy: Relieve Pain and Boost Healing

Guided DolorClast Therapy, Steve Bloor, Cornwall Shockwave

DolorClast Focus, focused shockwave therapy, cornwall shockwave

Shockwave Therapy:

The Sound of Healing
Shockwave Therapy is an efffective non-surgical treatment for most musculoskeletal conditions, which avoids the lengthy recovery process & risks inherent in undergoing invasive surgical procedures.

Swiss DolorClast Radial & Focused ShockWave Therapy is a clinically proven method of treating musculoskeletal disorders, supported by scientific randomised control clinical trials which go back over 35 years.

A world leading approach to applying Shockwave Therapy is Swiss Guided DolorClast Therapy, made by EMS (Electro Medical Systems of Nyon, Switzerland.

Cornwall Podiatry is one of only a few clinics in the UK to have the full selection of tools for applying Guided DolorClast Therapy, with:

DolorClast High Power Laser
DolorClast Radial ShockWave Therapy
DolorClast Focus ShockWave Therapy

What is Shockwave Therapy?

Shockwave therapy is a non-invasive treatment that uses high-energy sound waves to treat musculoskeletal injuries and conditions. Shockwave Therapy sends rapid, short, intense sound waves into damaged tissue to stimulate repair and regeneration, increase blood flow, and relieve pain. The sound waves cause a rapid rise and fall in pressure, which creates a compressive force on the tissue. This process, called mechano-transduction, converts the mechanical stimuli into a cellular healing response.

Fast pain relief and long-lasting healing - how does the body react to shock waves?

Firstly we need to understand how the sensation of pain is generated in the human body.

Initially, it is detected as sensory information by nociceptors located on free nerve endings; then, it is carried via A-delta and group C nerve fibres from the periphery to the dorsal horn of the spinal cord. This transmission of pain information is mediated by a number of neurotransmitters. Here, we will focus on one of them: Substance P.

During the shockwave therapy, an increased level of Substance P is also what is responsible for any discomfort or unpleasant sensations. Substance P and other neuropeptides are released from the peripheral ends of sensory nerve fibres and lead to a sensation of pain. Herein lies the answer! The longer the C-fibers are activated with shockwaves, the lower the concentration of this neuropeptide within the treated area. As a result, the nociceptors are no longer sufficiently stimulated. Less Substance P in the tissue leads to pain relief (because the transmission between injury and brain is ineffective) and inhibits the neurogenic inflammation process.

Shockwave therapy acts on the musculoskeletal system via molecular and cellular mechanisms:

First of all, it lowers the concentration of Substance P and brings about pain relief.
Secondly, it blocks the development of neurogenic inflammation, which plays an important role in the pathogenesis of tendinopathies such as Achilles tendinitis or plantar fasciopathy.
Thirdly, it activates the formation of primary muscle cells, cartilage & bone to repair damaged muscles, cartilage, tendon & bones and increases expression of the following growth factors:

VEGF (Vascular Endothelial Growth Factor), which plays an important role in angiogenesis. In this way, new blood vessels are formed to accelerate tissue healing.
PCNA (Proliferating Cell Nuclear Antigen) and eNOS (Endothelial Nitric Oxide Synthase), which are growth factors responsible for stimulating blood circulation. A better flow of oxygenated blood promotes tissue regeneration.

Fourthly, in regards to tendinopathy, there is another important molecule produced via the effects of shockwaves, which is lubricin. This mucinous glycoprotein is particularly important for tendinous structures as it facilitates tendon gliding. Lubricin expression is upregulated by both mechanical and biochemical stimuli.

In Summary:

What is Extracorporpeal Shockwave Therapy - or ESWT?

ESWT is a form of regenerative medicine, kickstarting the body's tisue repair healing responses.

How does it work?

Treatment produces an inflammatory response. The body responds by increasing metabolic activity around the site of pain. This stimulates and accelerates the healing process.Shockwaves break down scar tissue & possibly calcification as well. Transmission of pain is blocked by elimination of a neurosmaitter called Substance P.

What are the benefits of Shockwave?

Shockwave therapy stimulates the body's natural healing processes
There is actually an immediate reduction of pain
Patient's feel an improved ease of movement
Secondary effects are very minor
Shockwave therapy may also reduce the need for further surgery

How long does the treatment last?

Between 1,000 & 6,000 impulses are delivered at rapid speed per area treated in each session, which lasts 3-5 minutes per area.

There are two different types of Shockwave Therapy - Radial & Focused:

Radial Shockwaves radiate from a small applicator tip & pass into the body up to an effective depth of about 1cm. Radial is useful for treating superficial injuries like Achilles tendonitis and plantar fasciitis. Radial can be the most uncomfortable of the two to tolerate, so sometimes requires the use of Dolorclast High Power Laser as an analgesic pre-treatment.
Focused Shockwave works by concentrating 1,000 individual lower-power sound waves into a focused zone of high energy pressure deep inside the body, and are able to treat conditions at 1cm to 8cm depth from the skin's surface. Generally speaking, Focused Shockwave is more powerful than radial, though strangely more comfortable to tolerate during treatment.

How many treatment sessions will I need?

Research protocols state that between 3 & 6 treatment sessions are necessary at weekly intervals, however, additional treatments may be used if authorised by your podiatrist.

Does the treatment hurt?

You may feel some discomfort or pain during the treatment session. If you cannot tolerate the treatments, then settings can be adjusted.

What about after the treatments?

Generally there will be immediate pain relief, but there maybe some discomfort experienced later as part of the body's healing response.

What should I do if I am in pain after the treatment?

The Shockwave Therapy will trigger a beneficial inflammatory response, for this reason we advise against using anti-inflammatory medications. Also do not apply ice as we want the body to trigger the natural tissue repair processes. Any post treatment pain should subside within 24-36 hours. Use paracetamol if needed for pain control, if this is a medication you can tolerate well.

What if it feels good immediately following the treatment?

Even if it feels like you can exercise, we advise you to take it easy for 24 hours and rest.

What if it doesn't work immediately for me?

Although the immediate to short-term effects alone are excellent, the long-term effects of Shockwave Therapy can take up to 4-6 months to be fully realised. If you still have problems after this consult your podiatrist as additional treatments may be required, or a different treatment approach may be indicated.