ESWT (Extracorporeal Shock Wave Therapy)

An ESWT system is a device with a handpiece, or applicator, that produces controlled acoustic pulses called shock waves. These are mechanical pressure waves, similar in nature to sound, not electric shocks. The energy and depth can be adjusted to suit the tissue being treated, from a tendon close to the surface to a deeper attachment near a joint. Different settings produce focused or radial waves, but in every case the goal is the same: to deliver a precise dose of mechanical energy to a specific area that is slow to heal.

At the start of a session the therapist locates the painful area and applies a thin layer of gel so the waves pass smoothly into the tissue. The handpiece is then pressed against the skin and delivers a series of pulses to the target. These pulses are thought to boost local blood flow, prompt cells to begin repairing, calm the nerves that carry pain signals and encourage healthy new tissue to form. By gently stressing a stubborn, chronically inflamed area, ESWT can effectively restart a healing response that had stalled. A typical course runs over several weekly sessions, and the therapist adjusts the intensity to keep treatment comfortable.

ESWT is most often used for chronic conditions such as tennis elbow and golfer's elbow, plantar fasciitis and heel pain, frozen shoulder, calcific shoulder tendons, Achilles and other tendon problems, and certain slow-healing fractures. It suits people whose pain has lasted for months and who would prefer to avoid injections or surgery if possible. It is not the right choice for every problem, so a specialist examines the area, reviews any scans and confirms the diagnosis before recommending it as part of a wider treatment plan.

Because ESWT is non-surgical and needs no anaesthesia, there is no operation and no real recovery time, and most patients walk out and continue their day. Many notice that pain eases and movement improves gradually over the course of treatment rather than after a single session. During the pulses some people feel a tapping sensation or mild discomfort at the treated spot, which the therapist can ease by adjusting the device. A little tenderness for a day or two afterwards is normal. As with any therapy, results vary from person to person, and ESWT works best combined with exercises and the rest of the rehabilitation programme.