Frequently Asked Questions

Extracorporeal ShockWave Therapy or ESWT is a quick non-surgical procedure used to treat chronic plantar fasciitis, Achilles tendinitis, tennis and golfers’ elbow, shoulder tendinitis, trigger point issues, sore muscles, and other chronic tendinopathies as well as Erectile Dysfunction and some forms of body shaping. ESWT has been used for years internationally for conditions that occur in many areas of the body. In the United States, an FDA submitted study was performed on patients who suffer from chronic plantar fasciitis with or without the presence of a heel spur. The results revealed an incredible average reduction in pain of 92% with only one treatment. ESWT is attractive to patients because their condition can be treated extracorporeally; meaning outside of the body. Because the treatment is non-invasive, many of the expenses and risks of surgery are eliminated allowing the Pulse-Wave device to be used for many orthopedic, ED and musculoskeletal procedures.

Our own experience, as well as the study, shows an overwhelming success rate. In the study, a group of 150 patients was asked to rate their pain level on a scale of 1 to 10, with the average rating a 7.7 pain level prior to receiving treatment. After receiving one ESWT treatment, the patients were asked one year later to rate their pain level again on the same 1 to 10 scale. The patients who reported had an average pain score post-ESWT of 0.6. This is a 92% reduction in pain and a much higher rate of success than any non-surgical or surgical alternative. More importantly, ESWT is safe, easy to perform, has few contraindications and virtually no downside.

One of the most important benefits of ESWT is because conditions can be treated extracorporeally, meaning outside of the body. Since ESWT is non-invasive, there is no lengthy recovery period, virtually no time off from work or play and a no risk of causing further damage. The same cannot be said with surgery. During the treatment, you lie back comfortably with the area to be treated made easily accessible to the technician. The technician will make sure that you are always comfortable and all aspects of the treatment are explained to you throughout the procedure. An ultrasound scan is occasionally used to view and target the damaged area. During the treatment, you will hear repetitive clicking sounds, this is how ESWT works, do not be concerned. Technicians have performed thousands of ESWT treatments and are proficient at leveraging the analgesic effects of certain levels of shockwaves to make the treatment comfortable. If you are nervous or anxious, talk to your doctor or treatment coordinator. The goal is to always make sure you are at ease and relaxed during any procedure.

ESWT can effectively treat a wide range of musculoskeletal conditions. Pain involving the tendons and ligaments of the major joints such as the knee, shoulder, and elbow, as well as the plantar fascia and Achilles tendon, are common areas for ESWT treatment. The Pulse-Wave can also treat back pain, stress fractures, overuse injuries, shin pain, foot ulcer pain, hamstring pain and enhance bone healing, there are several published studies demonstrating the success of ESWT treating Erectile Dysfunction.

ESWT creates micro-trauma in the targeted area which forces your body to create new tissue cells, therefore, creating angiogenesis and neovascularization, fancy words for new blood vessels. Expect gradual healing to take place over days, weeks or months. Though not typical, some have mild soreness or bruising after treatment. Some patients experience complete pain relief from day one. Most will have noticeable to significant improvement by the thirteenth week. A second treatment protocol after sixteen weeks may be necessary for approximately 20% of patients. The injury and pain took time to develop, so one can expect healing to take time as well. The total healing time of the affected area may take up to one year. There are 45 predefined treatment protocols programmed into the Pulse-Wave device depending on the condition and if it is acute or chronic. The most attractive advantage of ESWT is that unlike surgery, you avoid getting worse before getting better. You do not need to plan a long time off from work or postpone events in your life for painful post-procedure recovery.

If you have had your condition for more than six months and have tried multiple conservative therapies with no results, it would be prudent to consider ESWT. It is natural to procrastinate and hope that the problem will go away on its own. However, in conditions such as tendinitis, continued use, and further degeneration can lead to a more serious and painful situation which can be more difficult to treat in the end. For example, every time that you feel pain when you place weight on your heel or lift something with your arm, it is because you are putting tension on already compromised tendon fibers. When the condition progresses to a rupture, ESWT is no longer an option and you will have no treatment alternative but to undergo invasive surgery. Additionally, if left untreated, you can experience new problems. With heel pain in your foot, you may naturally compensate by walking on your toes or limping to protect yourself from pain. These abnormal movements can in time cause strain to your knees, hips and lower back, or even worse, may result in the same condition in the other foot. Compensation issues occur whenever you have chronic pain left untreated. If your pain has just begun, you may be able to avoid developing a chronic, difficult to treat the condition by early intervention. Take care of yourself. Fix the problem, don’t delay.

Tendinitis sometimes resolves by itself or with the help of treatments such as strapping, physical therapy, anti-inflammatory medications, or cortisone injections. When the condition is new (usually less than six months) it is called acute tendinitis. Acute tendinitis is an inflammation. All of the treatments used at this stage are meant to rest the area or deal with the inflammation. Those who do not get better in the “acute” phase have what is called chronic tendinosis. The difference between tendinosis and tendinitis is simple: Tendinitis is an inflammation. Tendinosis is degenerative or damaged tissue. If a patient has used steroid injections repeatedly over the course of 6-9 months with no long term resolution, the problem has probably gone beyond inflammation. Surgery was once thought to be the only option for tendinosis. ESWT treats tendinosis because ESWT encourages the damaged tendon to heal on its own.

The Pulse-Wave is our equipment of choice because it offers the highest, yet most variable, energy output. A physician can also incorporate ultrasound to view the damaged tissue and target the shock waves directly at, and only to, the damaged tissue. The Pulse-Wave is capable of performing both low energy and high energy treatments. Only high energy is FDA tested and approved for plantar fasciitis. High energy ESWT causes cavitation or micro-trauma to the tissue. This forces the body to lay down new fibroblast tissue and actually repair the tendon while also affecting pain receptors. There have been some manufacturers of devices that use unfocused pressure wave machines that try to position their machines as ESWT. Pressure wave devices are used for relaxing muscles and trigger point pain. They are not ESWT and do not produce the same results or function in the body. Insist on high energy ESWT with the Pulse-Wave.

Your certified Pulse-Wave therapy practitioner will perform a thorough examination and order any necessary diagnostic tests to determine the best course of treatment for your condition. Though this website focuses on ESWT, it is the goal of every doctor that uses the Pulse-Wave to provide the best possible treatment plan for your pain. A physician will provide a complete diagnosis and treatment plan. The doctor may recommend ESWT or another course of treatment. You will not have to guess if ESWT is right for you. The doctor can help you make your treatment decisions based on your individual condition. If ESWT is right for you, you do not need to delay treatment. We know you are in pain and know you wish to make every effort to schedule your treatment quickly and at a time convenient to your schedule. The sooner you receive treatment, the sooner you are enjoying your hobbies and active lifestyle again.

We use the Pulse-Wave device. In our opinion, Pulse-Wave is the highest quality state-of-the-art device on the market. Two of the main reasons why we use the Pulse-Wave device are: 1. The Pulse-Wave treats plantar fasciitis by sending the shock waves in through the tendon from the side of the heel. Other equipment sends the shock wave in from the bottom of the heel directing the shock waves up and into the heel bone. This bone impact is painful. Because we do not impact bone, we do not need to use unnecessary general anesthesia or IV sedation. 2. The Pulse-Wave is a high-energy ESWT machine with a wide range of settings and penetration depths. This allows the doctor and the technician to fine-tune the procedure to your individual diagnosis. Pulse-Wave treatment is not one-size-fits-all.

The physicians that employ the Pulse-Wave are truly state-of-the-art practitioners, and they are dedicated to eliminating the need for surgery. There are some surgically oriented practices that do not want to offer non-surgical treatments. You may find many physicians who are not even familiar with this treatment. We encourage you to share this information with your primary care physician and have him or her contact us. Doctors who offer this treatment are committed to avoiding unnecessary surgery and hospitalization for their patients.

No! The person in chronic pain has new hope with ESWT. Long-term sufferers finally have a non-surgical treatment option. If you have “tried everything” or even have just started to experience discomfort, don’t be discouraged, this is a new weapon to use against your pain.

Recently we have seen some manufacturers of physical therapy devices that are unfocused pressure waves trying to pass off their product as ESWT. Lasers and pressure wave devices are used for relaxing muscles and trigger point pain. They are not ESWT and do not produce the same results or function in the body. Insist on high energy ESWT with the Pulse-Wave for a curative procedure. High Energy ESWT with the Pulse-Wave is referenced in many studies and proven effective to repair tissue without surgery.