Proper Shockwave Therapy Patient Selection

Shockwave therapy is a popular modality for multiple indications, providing a non-invasive option for addressing various issues, including musculoskeletal, sexual wellness, and body contouring.

Many studies and anecdotal data have contributed to efficacy, safety, and tolerability; you should always be cautious when performing any treatment modality by observing relevant considerations, including thorough clinical assessments.

Patient selection criteria will ensure you make informed decisions about suitability and probable success while designing a treatment plan.

This article will assess essential considerations before recommending shockwave therapy, ensuring patients are adequately evaluated for treatment. We will review the indications, contraindications, and side effects of ESWT.

Conduct a Patient Assessment Before Shockwave Therapy

Thorough patient assessment is crucial to the success of ESWT, ensuring both optimal outcomes and avoidance of adverse results.

Anecdotal evidence from a patient suffering chronic tendinopathy who received cortisone injections warned against an immediate provision of ESWT until a minimum of 6 weeks after the injections, avoiding possible adverse effects, such as tendon rupture, incorrectly linked to shockwave use.

Before recommending shockwave therapy, it is essential to fully evaluate each patient’s medical history, current condition, and any potential risk factors. Proper patient selection and close monitoring during and after treatment are crucial to ensuring safety and effectiveness.

Conditions Effectively Treated With Shockwave Therapy

Shockwave therapy has been widely used in managing various indications, and the results are 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, fasciopathy, and joint pathologies. The high-energy acoustic waves stimulate the body’s natural healing cascade, promoting regeneration of damaged tissue and reducing pain and inflammation.
• Body Contouring: Shockwave therapy can potentially be used in body contouring, showing promising results in improving the appearance of subcutaneous fat and cellulite.
• Sexual Wellness-Related Conditions: ESWT has shown lots of promise in treating sexual health conditions, including erectile dysfunction in men and primary dysmenorrhea in women. Patients experience an overall improved quality of life, with improvements not just in sexual dysfunction symptoms but also in self-image and relationships.

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

Careful patient selection and close collaboration are essential for achieving optimal outcomes.

Shockwave Therapy Safety, Contraindications, and Side Effects

ESWT (Extracorporeal ShockWave Therapy), also known as Shockwave therapy, uses high-energy acoustic waves to instigate the body’s natural healing process. While it has a proven safety profile, some patients are unsuitable due to specific conditions and factors.

Contraindications for Shockwave Therapy

Contraindications for shockwave therapy may change as more evidence is presented. The current consensus from various studies and the guidelines provided by the International Society for Medical Shockwave Treatment flagged individuals with the following conditions, advising practitioners to avoid recommending shockwave therapy:

• 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 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

Everyone should also be adequately educated about the potential side effects of shockwave therapy, properly setting treatment expectations. Some previously reported side effects for some undergoing shockwave therapy:

• Pain and Discomfort: Some patients may temporarily feel pain or discomfort during and after the shockwave treatment, which can be addressed by taking pain medication or adjusting 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 ESWT Device for Safe and Effective Treatment

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

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 devices incorporate multiple safety features, such as real-time monitoring of treatment parameters and automatic shut-off controls, minimizing the risk of adverse events.
• Ease of Use and Customization: PulseWave™ devices are designed with user-friendly interfaces and intuitive controls, enabling tailored treatment regimens for specific patient needs.
• Proven Clinical Outcomes: PulseWave™ has been extensively tested and validated in studies, demonstrating its effectiveness in managing various conditions.

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

References

Contraindications — shockwave therapy. (n.d.). Shockwave Therapy. Source 

Indications | ISMST. (n.d.). Source

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.Source 

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