Proper Patient Selection for Shockwave Therapy

Shockwave therapy has emerged as a popular modality for different conditions, offering a non-invasive approach to managing various concerns, including musculoskeletal conditions, sexual health issues, and body contouring.

While several studies and anecdotal evidence have already contributed to proving its efficacy, safety, and well-tolerability, it’s important to be cautious in performing this treatment modality, observing relevant considerations, including performing meticulous clinical assessments before use.

This way, you’ll be ensured that you can make informed decisions about its suitability for your patients and can work with them better to come up with a suitable treatment plan for their condition.

So, in this article, we’ll discuss important considerations before recommending shockwave therapy to your patients, ensuring that patients are properly assessed for suitability to undergo treatment. We’ll also discuss the indications, contraindications, and side effects of ESWT.

Why Conducting a Patient Assessment Prior to Shockwave Therapy is Important

Extensive patient assessment is key to the success of the treatment, ensuring both optimal outcomes and avoidance of adverse results.

One anecdotal evidence about a patient suffering from chronic tendinopathy who received cortisone injections warned against an immediate provision of shockwave therapy after cortisone injections, recommending to wait at least 6 weeks after the injections before proceeding with shockwave therapy. This is to avoid possible adverse effects from other modalities, such as rupture of the tendon, to be falsely linked to shockwave use.

Suffice to say, it’s important to carefully evaluate each patient’s medical history, current condition, and any potential risk factors before recommending shockwave therapy. Proper patient selection and close monitoring during and after treatment are crucial to ensuring the safety and effectiveness of this modality.

Conditions Effectively Treated With Shockwave Therapy

Shockwave therapy has been widely used in the management of a variety of health conditions, and the results have been consistently promising. Shockwave therapy has been successfully used in the treatment of the following:

Musculoskeletal Conditions: Shockwave therapy has shown promising effects in treating musculoskeletal conditions, including injuries, tendinopathies, and fasciopathies, and joint pathologies. The high-energy acoustic waves stimulate the body’s natural healing processes, promoting the regeneration of damaged tissue and reducing pain and inflammation.
Body Contouring: Shockwave therapy can potentially be used in body contouring. It has shown promising effects in the improvement of the appearance of subcutaneous fat and cellulite.
Sexual Health-Related Conditions: Shockwave therapy has shown potential in treating sexual health conditions, including erectile dysfunction in men and primary dysmenorrhea in women. Because of this, patients experience an overall improved quality of life, with improvements not just in symptoms related to the sexual dysfunction, but also in terms of self-image and relationships.

It’s important to note that while shockwave therapy has shown promising results in these clinical applications, the specific indications, treatment protocols, and expected outcomes may vary depending on the individual patient’s condition, severity, and response to treatment.

Careful patient selection and close collaboration with patients and other healthcare providers are important for achieving optimal outcomes.

Understanding the Safety of Shockwave Therapy: Contraindications and Side Effects

Shockwave therapy, also known as extracorporeal shockwave therapy (ESWT), uses high-energy acoustic waves to stimulate the body’s natural healing process. While it has a proven safety profile, some patients may find it unsuitable because of certain conditions and factors.

Contraindications for Shockwave Therapy

Contraindications for shockwave therapy may differ as various evidence becomes more available related to its use. However, current consensus from different studies and the guidelines provided by the International Society for Medical Shockwave Treatment warned against individuals with the following conditions, advising practitioners to avoid recommending shockwave therapy to these patients:

Pregnancy: Shockwave therapy is not recommended for pregnant women, as the effects on the developing fetus are not well-established.
Coagulopathy or Anticoagulant Therapy: Patients with bleeding disorders or those taking anticoagulant medications may be at an increased risk of bleeding and hematoma formation during or after shockwave treatment.
Malignancy: Shockwave therapy should be avoided in patients with active malignancies, as the effects of tumor growth and progression are not well understood.
Infection: Shockwave therapy should not be performed on areas with active infections, as it may exacerbate the infection or delay healing.
Neurological Disorders: Patients with certain neurological conditions, such as severe peripheral neuropathy or spinal cord injuries, may not be suitable candidates for shockwave therapy due to the potential for nerve damage or altered pain perception.
Skeletal Immaturity: Shockwave therapy is generally not recommended for children and adolescents with open growth plates, as it may interfere with normal bone development.

Potential Side Effects of Shockwave Therapy

Patients should also be properly educated about the potential side effects of shockwave therapy, to set their expectations about the treatment. Here are the side effects previously reported for those who have underwent shockwave therapy:

Pain and Discomfort: Some patients may temporarily feel pain or discomfort during and after the shockwave treatment. This can be addressed by taking pain medication or making adjustments to the treatment plan.
Skin Irritation: Some patients may develop mild skin redness, swelling, or bruising at the treatment site, which usually resolves within a few days.
Nerve Irritation: In rare cases, shockwave therapy may cause temporary nerve irritation or numbness, which should be closely monitored and addressed if persistent.
Tendon or Ligament Damage: While uncommon, shockwave therapy may cause minor tears or damage to the targeted tendon or ligament, especially in patients with pre-existing conditions or poor tissue quality.

PulseWave™: Reliable Shockwave Therapy Device for Safe and Effective Treatment

Shockwave therapy has emerged as a valuable non-invasive treatment option for various health conditions, including cellulites, musculoskeletal conditions, and sexual health dysfunctions, offering the potential to stimulate the body’s natural healing processes and improve patient outcomes.

However, it’s crucial to be aware of the potential contraindications and side effects associated with this therapy, ensuring that it is only recommended for good candidates for this treatment modality. Careful patient selection, close monitoring, and collaboration with other healthcare providers are essential for achieving the best possible outcomes with shockwave therapy.

At RegenOMedix™, we’re committed to providing healthcare professionals with the most reliable and effective shockwave therapy solutions. Our PulseWave™ device delivers high-energy acoustic waves with precision and consistency, ensuring safe and effective treatment for your patients.

Some key features that make PulseWave™ a trusted choice for shockwave therapy include:

Advanced Acoustic Wave Technology: PulseWave™ utilizes state-of-the-art acoustic wave generation technology, allowing for the precise targeting and delivery of high-energy shockwaves to the desired treatment area.
Comprehensive Safety Features: Our device incorporates multiple safety features, such as real-time monitoring of treatment parameters and automatic shut-off mechanisms, to minimize the risk of adverse events and ensure patient safety.
Ease of Use and Customization: PulseWave™ is designed with user-friendly interfaces and intuitive controls, enabling healthcare professionals to tailor the treatment parameters to the specific needs of each patient.
Proven Clinical Outcomes: PulseWave™ has been extensively tested and validated in clinical studies, demonstrating its effectiveness in the management of a wide range of musculoskeletal conditions.

Contact us today to explore the wide uses of PulseWave™ and how we can work together to effectively incorporate it into your practice.

References

Contraindications — shockwave therapy. (n.d.). Shockwave Therapy. https://shockwave-therapy.co.uk/contraindications

Indications | ISMST. (n.d.). https://shockwavetherapy.org/indications/

Knobloch K, Kraemer R. Extracorporeal shock wave therapy (ESWT) for the treatment of cellulite–A current metaanalysis. Int J Surg. 2015 Dec;24(Pt B):210-7. doi: 10.1016/j.ijsu.2015.07.644. Epub 2015 Jul 22. PMID: 26209782.

Prijmeni, J. (n.d.). Updated ESWT Guidelines are available! | ISMST. https://shockwavetherapy.org/updated-eswt-guidelines-are-available/

Tenforde AS, Borgstrom HE, DeLuca S, McCormack M, Singh M, Hoo JS, Yun PH. Best practices for extracorporeal shockwave therapy in musculoskeletal medicine: Clinical application and training consideration. PM R. 2022 May;14(5):611-619. doi: 10.1002/pmrj.12790. Epub 2022 Apr 14. PMID: 35187851; PMCID: PMC9321712.

Xing, R., Yang, J., Wang, R., & Wang, Y. (2021). Extracorporeal shock wave therapy for treating primary dysmenorrhea. Medicine, 100(5), e23798. https://doi.org/10.1097/md.0000000000023798