Extracorporeal shockwave therapy

Extracorporeal shockwave therapy
Intervention
ESWT device (EMS Swiss DolorClast)
ICD-10-PCS	6A93
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Extracorporeal shockwave therapy (ESWT) is a treatment used in physical therapy, orthopedics, urology and cardiology. The shock waves are abrupt, high amplitude pulses of mechanical energy, similar to soundwaves, generated by an electromagnetic coil or a spark in water. Similar technology using focused higher energies is used to break up kidney and gallstones, and is termed lithotripsy. “Extracorporeal” means that the shockwaves are generated externally to the body and transmitted from a pad through the skin.

Extracorporeal shockwave therapy is used to treat a growing number of tendon, joint and muscle conditions. These include tennis elbow, where results in double blind studies are reported as excellent; chronic tendinitis of the knee and shoulder rotator cuff pain,achilles tendinitis, hamstring tendinitis and plantar fasciitis have also been treated successfully.

The above conditions are often difficult to treat using other methods and can become chronic. With ESWT patients report reduced pain and faster healing, without significant adverse side effects. However, the treatment has proven challenging to verify categorically in large controlled studies, in part because the therapist and patient are aware whether or not they are in the treatment cohort or the sham cohort. ESWT is also used to promote bone healing and treat bone necrosis. It is an effective alternative to surgical treatment of non-healing fractures.

ESWT is used for wound healing and has shown positive results in short-term and long-term outcomes in diabetic patients suffering from foot ulcers.

Chest pains associated with heart disease, known as angina have been treated successfully with ESWT. Studies have shown that the shockwaves promote the growth of new blood vessels or revascularization.

Since 2010 shockwaves have been used in urology, to treat chronic pelvic pain syndrome and erectile dysfunction. Unlike drugs, ESWT is non-invasive, does not have side effects, and promotes long-term healing. There are a growing number of double blind sham controlled studies that show success rates of up to 80%.