FAQs
FOCUS SHOCKWAVE THERAPY
What is shockwave therapy?
Shockwave therapy is a non-invasive, safe way of transmitting high energy sound or pressure waves into the body at sites of damaged tissues, to increase the local blood supply and allow the body to stimulate its natural repair and healing processes. In doing so it can reduce pain associated with the damaged tissue.
Within modern medicine shockwaves have many therapeutic applications. They were initially utilised in human subjects back in 1980, with non-invasive targeting and disintegration of kidney stones (without inflicting damage on surrounding tissues). Since then, the indications for shockwave and pressure wave therapy have expanded enormously, particularly in the field of musculoskeletal medicine.
What is the difference between focused and radial shockwaves?
Both focused and radial shockwave treatments are commonly used in orthopaedic conditions, although radial shockwaves are technically pressure waves rather than a true shockwave. The two differ in the way the waves are generated; in the depth of tissue that they are effective at and in the conditions they optimally treat.
Focused shockwaves are high energy acoustic sound pulses capable of transmitting energy from a source to a remote location. They are similar to ultrasound but have much greater amplitude pulses than the continuous oscillations seen with ultrasound. They can penetrate up to 12cm of tissue and can deliver energy to a precise deep focal point within the body. As a result of the greater tissue penetration and small focal point, focused shockwave is useful for treating deeper tissues, areas of calcification and those next to bone.
Radial pressure waves are lower in energy and are more effective for superficial tissues with a large treatment area. The radial wave propagates outwards from the transducer, losing energy as it penetrates deeper into the tissues.
What is happening at a cellular level?
It appears that shockwave therapy seems to enhance the regenerative healing response by stimulating the local blood supply and supercharging the local metabolic activity. Scientific research suggests that at a cellular level the energy waves result in a process called mechanotransduction which can lead to:
- local dilatation and proliferation of blood and lymphatic vessels,
- release of the neurotransmitter Substance P to dampen any pain,
- an increasing in the permeability of the cells,
- a stimulation of stem cells.
In addition, it appears focused shockwave can lead to the release of specific tissue growth hormones and cause the release of nitric oxide, a powerful mediator that can promote new blood vessel growth.
Is shockwave suitable for everyone?
No, shockwave is not recommended for people who:
- are pregnant.
- are under 18 years old.
- are taking certain blood thinning medications other than aspirin, (please enquire directly).
- have a blood clotting disorder.
- have bone cancers or a cancer in or near the area.
- have received a steroid injection within 3 months to the affected body part.
- have a current deep vein thrombosis or haematoma near the treatment area.
- have an open wound or infected skin over the treatment area.
Does the treatment hurt?
Although it sounds painful, most people describe shockwave as like pulses against the skin and being mildly uncomfortable. Your clinician will be able to adjust the intensity of the shockwave device if it becomes too uncomfortable.
Focused shockwave tends to be better tolerated than radial shockwave, as the energy is delivered deep inside the body tissues. Due to the analgesic effect of focused shockwave, many patients report some immediate pain relief following treatment.
How long does each session last?
Focused shockwave treatments tend to be between 20 and 30 mins.
Radial shockwave treatments tend between 10 and 20 mins.
How many sessions do I need?
This depends on the condition being treated and the type of shockwave being used. Generally focused shockwave courses are about 4 sessions (longer for calcific tendonitis of the shoulder) and radial shockwave courses are about 5-7 sessions.
Courses must be completed in full to obtain maximal benefit.
Who will be administering the treatment?
Shockwave treatments are administered by fully registered clinical
professionals who are all trained in Shockwave therapy.
What should I wear to the sessions?
Patients should wear comfortable clothes which allow exposure of the body part to be treated.
Can I have shockwave if I am pregnant?
No this is not advised.
Can I have shockwave if I have a hip replacement in place?
Yes, focused shockwave is safe, but we generally advise at least 3 months after surgery.
How long after therapy am I likely to notice a difference in my symptoms?
Pain relief may be felt immediately but long-term effects of shockwave treatment can take up to 4 months. Pain relief is generally quicker with focused over radial shockwave.
Can I carry on with normal everyday activities after shockwave treatment?
You can go about normal day-to-day activities and light exercise soon after the procedure, but you should avoid strenuous exercise, stretches, high impact activities and heavy lifting for 48 hours.
Can I take anti-inflammatories (Ibuprofen, Nurofen, Diclofenac etc) before and after treatments?
Patients must avoid all anti-inflammatories and ice for the duration of the course of treatments including one week before any treatments start. Taking simple paracetamol is ok.
Can I apply anti-inflammatories gels after treatments?
No, it is important that anti inflammatory tablets or gels are not used during the whole treatment course, as this can reduce the effect of the shockwave therapy.
Are there any side effects from treatment?
Shockwave is a very safe non-invasive treatment used widely in the NHS and across elite sports clubs.
Mild side effects can include discomfort or pain felt during or after treatment, redness of skin, bruising, swelling, or numbness.
Who do I contact if there is a problem or I have a concern?
Please contact Pure Focus Clinic via email or telephone for non-urgent queries. For urgent matters please contact your GP or NHS emergency services.
Do I also need physiotherapy following treatment?
Tendon problems are best managed with a combination of shockwave therapy (to reduce the pain and initiate new blood vessel growth) as well as physiotherapy following the treatment sessions. The physiotherapy is designed to increase the strength of the tendon.
Your treating clinician will advise you of this and will issue you with some home exercises to do, as well as advise on the need for any formal physiotherapy sessions. These would be provided by experienced musculoskeletal physiotherapists at Total Physio Clinic, based at the Castle Country Club.
How long between each treatment?
For optimal response we generally book people in at weekly intervals for the course of treatment. Sometimes a 2-week gap is advised depending on the response.
Is there wheelchair access?
There is easier access to the clinic through a separate entrance – please advise at the time of booking.
How much do the shockwave treatments cost?
Course of 4 weekly focused shockwave sessions – £520 (£130 per treatment)
Course of 6 weekly radial shockwave sessions – £420 (£70 per treatment)
How do I pay for treatments?
Credit or debit card or cheque payments for the whole treatment course, are taken at the clinic prior to your first session. All UK cards including American Express are accepted.
Can I use my medical insurance for treatments?
No, unfortunately medical insurance payments are not supported.
Do I need to be a member of the Castle Country Club to have treatments?
No, not at all. However, there are special club memberships available for those wanting to attend the gym and country club during treatments – please ask for more information.
Can I have shockwave if I take aspirin?
Yes, you can carry on taking aspirin throughout the treatment course.
Can I have shockwave if I take blood thinning medication?
For radial shockwave, other than aspirin, shockwave treatments are not advised for people on blood thinning medications.
For focused shockwave, shockwave treatments are not advised for people on warfarin or rivaroxaban. Please speak to us about directly about shockwave therapy for people on other blood thinning medication.
