Extracorporeal Shockwave Therapy (ESWT) is a method of treatment used in physiotherapy to treat a variety of musculoskeletal conditions but primarily it is used to treat tendinopathies.

A shock wave is an intense but short energy wave travelling faster than the speed of sound, which is passed through the skin, directly over the injured site. Changes to the power and pulse-rate frequency of the shockwaves allows the therapist to control the intensity and depth of the treatment.

The shock waves stimulate biological changes in the soft tissues at a cellular level. This stimulates an inflammatory response, causing increased blood flow, neuromodulation of a painful stimulus and facilitation of the production of connective tissue growth factor and protein synthesis to generate collagen and tissue remodelling.

Shockwave is a preferred treatment for chronic conditions when conventional treatments have failed. Most protocols aim to see results within 3-5 sessions over 8-12 weeks, usually alongside a supporting exercise rehabilitation programme.

In the UK the National Institute for Health and Clinical Excellence (NICE) specifically recommends Shockwave for a selection of conditions where strong evidence and research has shown it to be a highly effective treatment option, these include lateral epicondylitis, subacromial pain syndrome (also known as rotator cuff disease), greater trochanteric pain syndrome, Achilles’ tendinopathy, and plantar fasciitis.

Additionally, the International Society for Medical Shockwave Treatment indicated that this type of treatment is also beneficial for myofascial trigger points, tendinopathies associated with the hamstrings, adductors, elbow, foot/ankle, and medial tibial stress syndrome (also known as shin splints).