One of the non-surgical treatment methods that has come to the fore in recent years in the treatment of musculoskeletal pain, sports injuries, and certain urological problems is ESWT (Extracorporeal Shock Wave Therapy). Based on the principle of directing high-energy sound waves to the correct point, this method is used to reduce pain, accelerate tissue healing, and improve the patient's quality of life.
What is ESWT Shock Wave Therapy?
ESWT is a non-surgical treatment method based on the transmission of high-energy acoustic (sound) waves produced by a special device through the skin to the target tissue. It does not require skin incisions, does not require anesthesia, and is generally applied on an outpatient basis.
Working Principle
As the pressure waves generated by the device travel through the tissue, they create a biological stimulation in the target area. As a result of this stimulation;
- Blood circulation in the area increases and new vascularization is encouraged
- Cell regeneration and tissue repair are accelerated
- The sensitivity of nerve endings that transmit pain signals is reduced
- The dissolution of calcified or calcified tissues is facilitated
- The regression of chronic inflammatory processes is ensured
In Which Diseases Is It Used?
ESWT treatment has a wide range of indications. The most common conditions it is applied to are:
- Heel spur (plantar fasciitis)
- Tennis and golfer's elbow (lateral / medial epicondylitis)
- Calcification in the shoulder and calcific tendinitis
- Achilles tendinitis
- Patellar tendinitis (jumper's knee)
- Trochanteric bursitis and hip-related tendinopathies
- Myofascial pain syndromes and trigger point treatment
- Slow-healing or non-healing bone fractures
- Chronic muscle-tendon injuries and sports injuries
- In urology, erection problems and chronic prostatitis pain in selected patients
Advantages of ESWT
- It is a completely non-surgical and needle-free method
- It does not require anesthesia
- It can be applied on an outpatient basis in a short time
- The risk of side effects is generally low
- It provides an alternative to cortisone injections
- It increases the success rate by supporting physical therapy in chronic pain
- The patient can return to their daily life on the same day
- It does not carry the side effects of drug treatments
Treatment Process
Before the ESWT application, the physician evaluates the patient's complaints and requests imaging tests such as X-rays, ultrasound, or MRI when necessary. Once the diagnosis is clear, a treatment plan is created. It is usually applied in 3 to 6 sessions, with one session per week. Each session lasts approximately 10-20 minutes.
Application Phase
The patient is placed in the treatment position, the painful area is identified, and ultrasound gel is applied to the skin. The device head is placed on the target area and shock waves are sent. During the procedure, the patient may describe a feeling of mild pain or pressure, but this sensation is generally well-tolerated and the energy level of the device is adjusted according to the patient.
After Treatment
There may be temporary sensitivity or mild redness in the area after the application. Heavy sports activities and excessive strain are not recommended for the first 24-48 hours. The full effect becomes apparent within a few weeks, along with the tissue regeneration process.
Points to Consider
- ESWT is not applied in the presence of active infection, open wounds, or tumors in the treatment area
- Careful evaluation should be made during pregnancy and in people with bleeding disorders
- It is not applied directly to areas with pacemakers or large metal implants
- Patients using blood thinners must inform their physician
- Since the full effect of the treatment will be seen after the sessions are completed, the series must be completed
- Adherence to the exercise and physical therapy programs recommended by the physician increases success
Difference of ESWT from Other Treatment Methods
Options such as physical therapy, drug therapy, cortisone injections, and surgery are available for the treatment of chronic musculoskeletal pain. ESWT offers a valuable intermediate step between medication and surgery. Its effect may be longer-lasting compared to cortisone injections; furthermore, it can ensure that the recovery processes that may be experienced after surgery are completely avoided.
The success of the treatment depends on the experience of the practitioner physician, accurate diagnosis, and appropriate energy parameters. For this reason, ESWT must be planned by a specialist physician and after a holistic evaluation of the patient.
Frequently Asked Questions
- How is it understood how the patient responds to treatment? A decrease in pain intensity can be noticed from the first sessions; the full effect becomes apparent within 4-12 weeks.
- Does it have side effects? Generally, mild and temporary sensitivity, redness, or bruising may be seen; serious side effects are rare.
- Is it used for those who do sports? It is a widely preferred method for sports injuries.
- Is it enough to avoid surgery? In many patients, the need for surgery is eliminated; however, in some cases, it may need to be evaluated in conjunction with surgery.
Factors Increasing Success in ESWT Treatment
The success of ESWT treatment depends on correct patient selection, accurate diagnosis, appropriate device and energy parameters, as well as exercise programs accompanying the treatment. Stretching exercises, strengthening activities, and posture corrections applied during and after the treatment are important to ensure that the pain does not return in the long term.
The success rate of ESWT in conditions such as heel spur, tennis elbow, and shoulder calcification is quite high with the correct indication. The patient's active participation in the treatment process and the maintenance of the balance between rest and activity significantly increase success. Heavy sports activities or long-term exertion performed without physician recommendation can negatively affect the healing process; therefore, the treatment process must be managed in a disciplined manner.
In Which Patients Is ESWT Not Applied?
Although ESWT is generally a safe treatment method, it should not be applied in some cases. ESWT is not recommended in cases of pregnancy, the presence of an active tumor in the target area, severe coagulation disorders, children in the growth phase with open epiphyseal lines, and active infection in the treatment area. In addition, patients with prostheses or large metal implants in the treatment area should be evaluated carefully.
It is recommended that a cardiology consultation be performed before the application in people with serious heart disease or those using a pacemaker. For all these reasons, a detailed examination and imaging process should be planned first for every patient for whom ESWT is considered; the treatment must be applied under the supervision of an experienced physician. Correct patient selection is one of the most important determinants of treatment success.
ESWT Treatment at Koru Hospital
As Koru Hospital, we effectively apply ESWT treatment through the joint work of our orthopedics, physical medicine and rehabilitation, and urology units. With our modern shock wave devices, experienced specialist staff, and patient-specific treatment approach, we offer non-surgical solutions for chronic pain and tissue problems. Our goal is to support our patients in living a pain-free and active life, thereby accelerating their recovery processes.
