What is focused shockwave therapy?

Focused pressure wave therapy (shockwave) has long been an effective method for breaking up kidney stones. In recent years the technology has been developed further and is now also used as a simple and effective physical treatment method – like “ordinary” pressure wave therapy - for long-standing tendon disorders and other musculoskeletal disorders. Treatment with shockwaves and pressure waves has documented effect in the treatment of, among other things, tendinitis, stress fractures, shin splints and erection problems

What are the most common complaints that can be treated with pressure waves (R-SW) and shockwaves (F-SW)?

Shoulder: Calcific shoulder and tendinitis in the shoulder. The most common is supraspinatus tendinopathy. (R- and F-SW)
Elbow: Tennis elbow and golfer's elbow (R- and F-SW)
Hip: Pain on the outside of the hip. (R- and F-SW)
Knee: Jumper’s knee and Runner’s knee (R- and F-SW)
Lower leg: Shin splints / traction periostitis (F-SW)
Ankle: Achilles tendinitis (R- and F-SW)
Foot: Plantar fasciitis and heel spur (R- and F-SW)
Men's health: Erectile dysfunction, curved penis, chronic pelvic pain (F-SW)

When is pressure wave therapy used?

Ordinary pressure wave therapy is used primarily for superficial chronic and subacute tendon disorders, also called tendinitis, as well as muscle tension. Focused pressure waves (shockwaves) also have a good effect on long-standing bursitis, shin splints, healing of bone tissue, and urological problems such as erectile dysfunction and chronic pelvic pain syndrome. Pressure waves are rarely used on brand-new/acute tendon injuries or bursitis.

How does shockwave therapy work?

An applicator is placed directly on the skin over the injured area so that a series of high-energy pressure waves are sent into the tissue. These waves provide a mechanical stimulus that gives a biological response with increased immune activity, increased blood circulation and increased release of growth factors, and in this way start a new healing process in the injured area. Put simply, this helps the body to start its natural healing process by replacing damaged tissue with healthy tissue.

Shockwave therapy generates higher energy via a shockwave that is targeted at a focal point. The shockwave moves the water content of the cells in the treatment area, and a small explosion-like state (cavitation) is achieved. This means that the treatment can be targeted at a specific depth, and much higher energy is achieved. In addition, treatment with shockwaves stimulates the formation of new blood vessels and opens up the permeability of the cell membranes, so that the cells in the damaged area are nourished and regenerate optimally.

Both treatments take place without risk of cell damage in the treated area.

A treatment with pressure waves or shockwaves is over fairly quickly. 4-6 minutes is a usual duration, and it is most often carried out with one week between treatments. The number of treatments needed is usually 3-5, but this can vary somewhat between individuals and depending on the purpose. The treatment should be combined with rehabilitation exercises or adapted training. If there is no change in pain, function or strength after 3 treatments, there is rarely reason to continue the treatment, and other measures should be considered. Neither pressure waves nor shockwaves are comfortable, but this depends somewhat on where you are treated. Some areas are more painful than others, but not so bad that you cannot tolerate the discomfort.

Which treatment is preferable?

It is important to note that shockwave therapy differs from traditional pressure wave therapy, so both types of treatment have advantages and disadvantages.

A pressure wave is a long wave that spreads over a larger area, with the greatest intensity in the superficial tissue and decreasing effect deeper in the tissue. This means an extremely good effect on muscle tissue and superficial tendon problems, and it has a treatment effect at tissue level.

A shockwave is a short, intense wave that causes a rapid rise in pressure in the area it hits, followed by a rapid return to normal pressure. This difference in the properties of the waves means that shockwaves have a more marked effect on the tissue (up to 50 times stronger than a pressure wave), can be targeted at almost any depth, and are used especially to treat deeper or more specific muscle and tendon injuries. Shockwaves have their effect at cellular and hormonal level, and for this reason have a good effect on many different types of tissue.

Muscle tension (less intense or superficial problems).
Pressure waves can be used to treat muscle tension and myofascial pain syndrome, especially when the pain is not too deep.
Tendinitis in tendons near the surface (e.g. tennis elbow, Achilles and knee).
Pressure waves are often used to treat tendinitis that does not involve deep tissue damage.

Common complaints treated with focused pressure waves (shockwaves):

Tendinitis in tendons at all depths.
Shockwaves are focused, and are more effective for deeper tendon injuries and chronic tendinitis, especially in more severe cases.
Injuries to bone (fracture/stress fracture) and the periosteum (shin splints).
Shockwave therapy stimulates faster healing of bone tissue and the periosteum.
Hip bursitis.
Shockwaves can be useful for deeper inflammation in the hip area.
Chronic muscle and tendon disorders (especially with long-standing or deep injuries).
Shockwaves can penetrate deeper into the tissue and stimulate healing of long-standing, chronic injuries to muscles and tendons.
Calcification of tendons.
Treatment with shockwaves is very effective at stimulating the breakdown of calcifications in tendons, which can be difficult to treat with other methods.
Men's health and urology.
Shockwaves stimulate increased formation of blood vessels in the penis in erection problems, and can target deeper muscles such as the pelvic floor in pain conditions.

Who cannot receive pressure wave and shockwave therapy?

If you have any of the following illnesses, conditions or medication use, you cannot have pressure wave therapy.

Pregnant women (treatment in the abdominal region).
Cancer patients (in the treatment area).
People with bleeding disorders.
People taking strong blood-thinning medication.
If you have had a cortisone injection in the injured area, you must wait 4-6 weeks before pressure wave therapy can begin.

Here you can see the list of practitioners who work at Behandlerverket (in Norwegian).