Nerve & Joint Pain
Nerve & Joint Pain
We use a personalized comprehensive approach of proven, opioid free, advanced therapies for rapid pain relief and optimal healing & recovery
About Focused Shockwave Therapy (FSWT)
Focused Shockwave Therapy (FSWT) is a non-invasive treatment method that uses high-energy acoustic waves to treat musculoskeletal conditions, particularly those involving chronic pain, tendon and muscle injuries, and certain joint disorders. This therapy is also known as
How Focused Shockwave Therapy Works:
Focused shockwave therapy uses mechanical energy in the form of high-intensity acoustic waves to penetrate tissues in the affected area. These acoustic waves travel through the skin and tissues, creating a mechanical pressure effect that stimulates healing and promotes tissue regeneration.
The process typically involves the following steps:
1. Generation of Shockwaves: The therapy device generates shockwaves, which are high-pressure sound waves with a rapid rise and fall in pressure. These waves are directed at the target tissue using a handpiece that is applied to the skin.
2. Focused Delivery: In FSWT, the shockwaves are focused at a specific point or region of the body. This is in contrast to radial shockwave therapy, which disperses the waves over a wider area. The focus of the waves allows for deeper penetration, targeting tissues at varying depths, such as tendons, ligaments, and muscle fibers.
3. Biological Effects: As the shockwaves pass through the tissues, they create several biological effects:
Microtrauma to the Tissue: The shockwaves cause tiny microtears in the affected tissue, stimulating the body’s natural healing response. This triggers an increase in blood flow, nutrient delivery, and the release of growth factors and cytokines that promote tissue repair.
Pain Relief: Shockwaves can help reduce pain by blocking pain receptors and stimulating the production of endorphins, the body’s natural painkillers.
Collagen Production: Shockwave therapy promotes the production of collagen, which is essential for the repair of damaged tissues such as tendons and ligaments.
Stimulation of Angiogenesis: Shockwaves promote the formation of new blood vessels, which can improve circulation in chronically injured tissues, accelerating the healing process.
4. Treatment Sessions: During a typical FSWT session, the patient is usually positioned in a comfortable way, and a gel is applied to the area to facilitate the transmission of shockwaves. The device delivers pulses of high-energy waves to the targeted region, typically for about 5–10 minutes per session, depending on the area being treated. The number of treatments required can vary, but patients often undergo a series of sessions (usually 3–6) spaced out over a few weeks.
Common Conditions Treated with Focused Shockwave Therapy:
FSWT is primarily used to treat musculoskeletal conditions, especially chronic conditions that do not respond well to other treatments, including rest, physical therapy, or medications. Some of the most common conditions treated with FSWT include:
- Tendinitis and Tendinopathies:
- Achilles Tendinitis
- Patellar Tendinitis (Jumper’s Knee)
- Rotator Cuff Tendinitis
- Tennis Elbow (Lateral Epicondylitis)
- Golfer’s Elbow (Medial Epicondylitis)
2. Plantar Fasciitis:
- A common condition involving pain and inflammation of the connective tissue at the bottom of the foot, particularly in the heel.
3. Calcific Shoulder Tendonitis:
- A condition where calcium deposits form in the rotator cuff tendons, leading to pain and restricted movement.
4. Myofascial Pain Syndrome:
- Trigger points in muscles that cause localized pain, often in the neck, shoulders, or lower back.
5. Bursitis:
- Inflammation of the bursa (fluid-filled sacs that cushion joints), often affecting the shoulder, elbow, or hip.
6. Chronic Muscle and Joint Pain:
- Conditions involving chronic soft tissue injuries, such as old sprains, strains, or joint stiffness.
7. Fibromyalgia:
- A condition characterized by widespread musculoskeletal pain, often with associated fatigue and sleep disturbances.
8. Non-union or Delayed Healing of Fractures:
- FSWT has been explored as a method to encourage bone healing in cases of fractures that have not healed properly or at all.
Benefits of Focused Shockwave Therapy:
1. Non-Invasive: FSWT is a non-surgical treatment option that does not require cuts or injections, which can reduce the risks and recovery time associated with invasive procedures.
2. Effective for Chronic Pain: FSWT is particularly effective for chronic musculoskeletal conditions, particularly when other treatments such as physical therapy, medications, and corticosteroid injections have not provided lasting relief.
3. Stimulates Natural Healing: By promoting blood flow, collagen production, and tissue repair, FSWT helps stimulate the body’s natural healing processes, allowing injured tissues to recover more quickly.
4. Minimal Downtime: After FSWT, most patients can resume normal activities almost immediately. Any discomfort or soreness that may occur post-treatment is generally short-lived.
5. Reduced Need for Medications: FSWT can help reduce reliance on pain medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs), by providing a more direct, non-pharmacological method of pain relief.
6. Improved Mobility: By reducing pain and promoting healing, FSWT can help restore function and mobility, particularly for patients with conditions affecting the tendons, muscles, and joints.
Safety and Side Effects:
Focused shockwave therapy is generally considered safe when performed by a trained practitioner, but like any treatment, it carries some risks. Side effects are usually mild and temporary. These can include:
- Mild Pain or Discomfort: Patients may experience some discomfort during or after the procedure, similar to a deep tissue massage. This is usually temporary and resolves within hours to a day.
- Redness or Bruising: Some patients may experience mild redness or bruising at the treatment site due to the shockwaves’ effect on blood vessels.
- Swelling: Some patients may notice mild swelling in the treated area, which typically resolves on its own within a day or two.
Contraindications:
FSWT is not suitable for all patients. It should be avoided in certain situations, including:
- Pregnancy: Shockwaves should not be applied to pregnant women due to potential risks to the fetus.
- Cancer: Shockwave therapy should not be used on areas with known or suspected cancer, as the mechanical pressure could potentially spread cancer cells.
- Infection: FSWT should not be used in areas where there is an active infection.
- Acute Inflammation: The therapy is generally reserved for chronic conditions, so it may not be appropriate for acute injuries where there is significant swelling or inflammation.
- Implants or Pacemakers: FSWT should not be applied over areas with metal implants or pacemakers, as the shockwaves could interfere with the devices.
Effectiveness of Focused Shockwave Therapy:
- Evidence-Based: Research supports the efficacy of FSWT for treating chronic tendon conditions like Achilles tendinopathy, patellar tendinopathy, and lateral epicondylitis. Studies have shown significant improvements in pain reduction, function, and mobility in patients receiving FSWT.
- Long-Term Benefits: The effects of FSWT are often long-lasting, with many patients experiencing sustained pain relief and improved function months after completing treatment.
- Combination Therapy: FSWT is often used in combination with other treatments, such as physical therapy, stretching, and strengthening exercises, to maximize its effectiveness.
Conclusion:
Focused Shockwave Therapy is a safe, effective, and non-invasive treatment for a wide range of musculoskeletal conditions, particularly those involving chronic pain, tendon injuries, and joint dysfunction. By stimulating the body’s natural healing processes through high-energy acoustic waves, FSWT can provide significant relief for patients who have not responded to traditional treatments. While results can vary, many patients experience reduced pain, improved mobility, and faster recovery times with this therapy. If you’re considering FSWT for a musculoskeletal condition, it’s important to consult with a healthcare provider to determine if it’s the right treatment for your specific needs.
| Feature | Focused Shockwave Therapy (FSWT) | Radial Shockwave Therapy (RSWT) |
|---|---|---|
| Shockwave Type | Focused (focal) acoustic waves | Radial (non-focused) acoustic waves |
| Energy Delivery | High-intensity, concentrated energy at a specific depth | Low to moderate-intensity energy spread over a wider area |
| Depth of Penetration | Deeper penetration (up to 6 cm or more) | More superficial (typically up to 3 cm) |
| Precision | Highly focused, targeted at specific tissues | Less focused, energy dispersed over a wider area |
| Treatment Target | Deeper tissues, such as tendons, joints, and bones | More superficial tissues, muscles, tendons, and ligaments |
| Indications | Chronic musculoskeletal conditions, deep tissue injuries, calcific tendinopathies, joint issues | Tendonitis, plantar fasciitis, muscle pain, myofascial pain |
| Pain Level | Higher intensity, may be more uncomfortable at the treatment site | Generally more comfortable, less intense |
| Treatment Duration | Shorter treatment time (5-10 minutes per area) | Slightly longer treatment time (10-15 minutes per area) |
| Frequency of Treatments | 3–5 treatments over a few weeks, depending on the condition | Similar frequency, 3–5 treatments per week |
| Intensity of Treatment | Higher intensity, deeper tissue effect | Lower intensity, more superficial effect |
| Side Effects | Mild bruising, discomfort at the treatment site | Mild redness, temporary soreness, skin irritation |
How Each Therapy Works:
1. Focused Shockwave Therapy (FSWT):
- Energy Delivery: In FSWT, shockwaves are delivered with high intensity and focused at a specific depth in the tissue. The energy is concentrated in a small area and then gradually dissipates, making it effective for treating deeper tissues like tendons, ligaments, and even bones.
- Penetration Depth: FSWT can penetrate deeper, typically up to 6 cm or more, making it suitable for targeting deeper structures like the rotator cuff or Achilles tendon.
- Mechanism of Action: FSWT stimulates tissue regeneration, improves blood circulation, and helps break down calcifications in tendons (such as in calcific tendinitis). The high-energy waves stimulate collagen production and promote the healing of damaged tissue by increasing metabolic activity in the affected area.
2. Radial Shockwave Therapy (RSWT):
- Energy Delivery: RSWT delivers low to moderate intensity shockwaves that spread out in a radial (circular) pattern. These waves are less focused and cover a wider area, making them effective for treating more superficial conditions or areas where precise targeting isn’t required.
- Penetration Depth: Radial shockwaves typically penetrate up to 3 cm, which makes them ideal for treating more superficial injuries or conditions affecting muscles, tendons, and ligaments near the surface of the skin.
- Mechanism of Action: RSWT works by stimulating blood circulation, cellular metabolism, and tissue healing. It can also reduce muscle tension, improve lymphatic drainage, and promote pain relief by blocking pain signals at the nerve level.
Ideal Conditions for Focused Shockwave Therapy (FSWT):
FSWT is most commonly used for conditions that require deeper penetration or affect deeper tissues. It’s particularly effective for treating chronic conditions where other treatments (such as physical therapy or medication) may not have provided sufficient relief.
- Chronic Tendon Conditions:
- Calcific Tendinopathy (e.g., shoulder calcifications)
- Achilles Tendonitis
- Patellar Tendonitis
- Plantar Fasciitis (in cases with deeper tissue involvement)
- Rotator Cuff Injuries
- Joint and Bone Conditions:
- Trochanteric Bursitis (hip pain)
- Knee Osteoarthritis
- Hip Pain (from labral tears or osteoarthritis)
- Myofascial Pain Syndrome (when pain is located deeper within muscle tissues)
FSWT can also be useful in treating bone-related conditions, such as stress fractures or non-union fractures, because the focused energy can promote bone healing by stimulating osteoblast (bone-forming cell) activity.
Ideal Conditions for Radial Shockwave Therapy (RSWT):
RSWT is better suited for more superficial injuries or musculoskeletal issues that don’t require deep tissue penetration. It is effective for conditions involving muscles, ligaments, or tendons that are located closer to the skin’s surface.
- Superficial Tendon and Ligament Injuries:
- Plantar Fasciitis (mild to moderate cases)
- Lateral Epicondylitis (Tennis Elbow)
- Medial Epicondylitis (Golfer’s Elbow)
- Achilles Tendonitis (milder cases)
- Muscle Pain and Spasms:
- Myofascial Pain Syndrome
- Trigger Points (muscle knots)
- Muscle Strains
- Joint Conditions:
- Shin Splints (medial tibial stress syndrome)
- Knee Pain (superficial tendinopathies or bursitis)
- Skin and Soft Tissue Conditions:
- Cellulite Treatment
- Scar Tissue Breakdown
Benefits of Focused Shockwave Therapy (FSWT):
- Deep Tissue Penetration: FSWT can reach deep tissues and bone structures, making it ideal for chronic tendon issues, calcifications, and joint conditions.
- High-Energy Focus: The focused energy helps promote collagen production, stimulate healing in deep tissues, and break down calcifications.
- Effective for Chronic Conditions: FSWT is often effective for chronic tendon injuries or bone-related issues where the injury has been present for an extended period.
Benefits of Radial Shockwave Therapy (RSWT):
- Less Discomfort: RSWT tends to be more comfortable for patients compared to FSWT, as the shockwaves are less intense and cover a wider area.
- Superficial Treatment: RSWT is ideal for treating more superficial conditions like muscle tightness, minor tendonitis, or conditions affecting tissues close to the skin.
- Quicker Recovery Time: Since RSWT is generally less intense, patients may recover more quickly and experience less post-treatment soreness.
- Less Risk: With its lower intensity, RSWT carries a lower risk of causing bruising or discomfort compared to FSWT, making it a good option for individuals who are sensitive to intense treatments.
Pain and Side Effects:
- FSWT: The higher intensity of FSWT means it can sometimes be more uncomfortable, particularly when treating deeper tissues. Patients may experience mild discomfort, redness, or bruising at the treatment site. However, any side effects are generally temporary.
- RSWT: RSWT is generally less painful and causes fewer side effects, although some mild skin redness or temporary soreness can occur. The discomfort is usually mild and resolves quickly.
Treatment Duration and Frequency:
- FSWT: Sessions typically last 5–10 minutes for each area treated. The frequency of treatments is usually 3–5 sessions, spaced a few days apart. The exact number of treatments depends on the severity and chronicity of the condition.
- RSWT: Sessions tend to last 10–15 minutes per treatment area. Like FSWT, 3–5 sessions are typically recommended, but because RSWT is less intense, treatments may be spaced more frequently depending on the patient’s response.
Conclusion:
Both Focused Shockwave Therapy (FSWT) and Radial Shockwave Therapy (RSWT) are effective treatments for musculoskeletal conditions, but they are best suited for different types of injuries and patient needs.
- FSWT is better for deep, chronic conditions, such as calcific tendinopathies, deep joint pain, and issues requiring precise targeting of deeper tissues. It’s the preferred option for more severe cases of tendonitis, tendon injuries, or bone-related problems that require deeper penetration.
- RSWT is ideal for superficial conditions, like muscle strains, mild tendonitis, and trigger points. It is generally more comfortable, with fewer side effects, and works well for general musculoskeletal pain and
Focused Shockwave Therapy (FSWT) FAQs
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