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What is Shockwave Therapy?

Updated: Aug 22

Shockwave therapy (SWT) is a new modality that uses high-energy sound waves to stimulate healing. SWT is non-invasive and can be used in combination with other treatments. The evidence for SWT is growing, and it is becoming an increasingly popular treatment option for conditions such as tendonitis, plantar fasciitis, and heel spurs. One of the advantages of SWT is that it is generally well tolerated by patients and can be used in combination with other treatments such as physical therapy.


If you are suffering from a chronic musculoskeletal condition, shockwave therapy may be worth considering. Shockwave therapy can help with the following conditions.

• Plantar Fasciitis

• Achilles Tendinopathy

• Retrocalcaneal Bursitis

• Lateral Epicondylitis (Tennis Elbow)

• Medial Epicondylitis (Golfer’s Elbow)

• Calcific Tendonitis (supraspinatus tendon, etc.)

• Patellar Tendinosis (Jumper’s Knee)

• Morton’s Neuroma

• Chronic Stress/Non-union Fracture


Shockwave therapy has been available in Canada since the mid 1990’s. Recently the introduction of low energy SWT has increased the popularity of it’s use. SWT stimulates the body’s natural healing process and also has been shown to have a direct effect on local nerve endings which helps decrease pain. It is important to understand the difference between low energy and high energy SWT and which type will be the most beneficial in your treatment.


High energy SWT or “true” shockwaves are classified as short duration (approx. 10msec) high energy pulses (5-100MPa) that break the sound barrier resulting in a shockwave. Our high energy shockwave technology allows the shockwave to be focused directly through the affected tissue resulting in several effects.


Mechanical pressure and tension have long been known to promote healing and increase cell metabolism. However, recent studies have shown that these forces can also help to dissolve calcific deposits. Calcific deposits are a common cause of pain and restricted movement, and they can be difficult to treat. However, by applying mechanical pressure and tension to the affected area, it is possible to increase cell membrane permeability and improve microscopic circulation. This, in turn, helps to dissolve the calcific deposits and restore normal function.


This therapy is a safe and effective treatment for calcific deposits, and it may provide relief from pain and other symptoms. The cavitation bubble is a small empty cavity created behind a pressure front. When the bubble collapses, it creates a resultant force that has a mechanical impact on the treated tissue which helps to break down calcific deposits embedded in damaged tissue. Cavitation bubbles can be created by sound waves or by other means.


Shockwaves stimulate osteoblasts that are cells responsible for bone healing and new bone production. Shockwaves also stimulate fibroblasts that are cells responsible for healing of connective tissue such as tendons.


SWT relieves pain by doing two things. The first is what is known as hyperstimulation anesthesia. When local nerve endings are overwhelmed with a large number of stimuli, their activity diminishes. This results in a short-term reduction in pain. The second mechanism is known as the gate-control mechanism. In this case, local nerves are stimulated in such a way that they recalibrate their perception of pain. This results in a longer-term reduction in pain.


There are three different mechanisms for generating high energy shock waves resulting in three different types of SWT device:

• Electromagnetic shockwave (Sonocur and Dornier Epos machines)

• Piezoelectric shockwave (Piezoson) * Electrohydraulic shockwave (I.E. HMT OssaTron machine) Low energy shockwaves are generated by a radial pressure wave (I.E. Storz and Dolorcast machines).


Shockwaves are acoustic waves that travel faster than the speed of sound. They are commonly produced by explosions or sonic booms, but can also be generated artificially. Shockwaves are often used for medical purposes, as they can break up kidney stones or relieve pain from conditions such as tendinitis. However, not all shockwaves are created equal. Some devices produce what is known as a low-energy shockwave, which is a type of pressure wave that travels more slowly and does not break the sound barrier.


While low-energy shockwaves are less intense, they can still be effective for certain medical applications. In addition, low-energy shockwaves diverge from the source, meaning that less energy is applied to the tissue. As a result, low-energy shockwave therapy can be a safe and effective treatment option for various conditions and can normally be an outpatient treatment.


Low energy shockwave machines give many patients the impression they have received “true” shockwave therapy. Low energy shockwave machines are not as expensive and there are certainly differences in the effectiveness of high energy vs low energy shockwave therapy. In general, the effectiveness of SWT is between 60 % and 80%.


It is very important to comply with treatment and rehabilitation recommendations to achieve the best results. We offer both high and low energy SWT and to determine the best course of treatment for a patient, you will need to consult with one of our experienced doctors or therapists.


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