Shockwave Therapy (ESWT)

Storz Extracorporal Shockwave Therapy (ESWT)

What is Shockwave Therapy?

Extracorporal Shockwave Therapy (ESWT) works by sending acoustic waves through soft tissue and fluid, where they impact areas with a change in impedance, like the interface between bone and soft tissue. The shock waves can break down tissue, break up calcium deposits, and cause an inflammatory response that may stimulate healing.

ESWT was first used in the early 1980s as a non-invasive treatment for kidney stones called lithotripsy. There are multiple types of ESWT devices, including focal and radial devices, which produce shock waves with different intensities.

ESWT is generally considered safe and well-tolerated, but like any medical treatment, there can be some side effects. These side effects are usually mild and temporary.

The most accepted manufacturer of shockwave devices worldwide is the device made by Storz in Switzerland, which is the machine offered at Parr Foot & Ankle Specialists.

The Karl Storz Group was founded in 1945 by Dr Karl Storz. For many years, Storz manufactured endoscopes and surgical instruments, and was fascinated by finding tools to allow surgeons to look inside the human body. Storz was one of the pioneers of using fiber optics to improve visibility with his endoscopy devices. Very bright light generated by an external light source is introduced into the body through a flexible fiber optic light cable. This principle of “cold light illumination” paved the way for modern endoscopy. Dr. Karl Storz then decided to become an early adopter of shockwave therapy and developed the precursor to modern-day musculoskeletal shockwave therapy in 1988. If you’d like to see a fascinating timeline of shockwave therapy as it was revolutionized and improved by the Storz Company, you can read about it here.

Shockwave Therapy created in Germany by Dr. Karl Storz

Effectiveness of ESWT for Foot and Ankle Indications, Including Peripheral Neuropathy: Research Summaries

Below are summaries of relevant research studies demonstrating the effectiveness of Shockwave Therapy (ESWT) for various foot and ankle conditions, including its emerging role in peripheral neuropathy:

Plantar Fasciitis

• Study 1: A randomized controlled trial (RCT) conducted on 245 patients with chronic plantar fasciitis compared ESWT to placebo. The ESWT group showed a 60% reduction in pain after 12 weeks compared to 24% in the placebo group. Functional improvement was significantly greater in the ESWT group.
  • Reference: Rompe JD, et al. Journal of Bone and Joint Surgery. 2002.
• Study 2: A meta-analysis reviewed 14 RCTs involving 1,400 patients. ESWT demonstrated a statistically significant improvement in both pain and functionality at 12 weeks and one year post-treatment, particularly when low-energy ESWT was used.
  • Reference: Gerdesmeyer L, et al. BMJ. 2008.
    

    Make an appointment to start getting relief of your Plantar Fasciitis with Shockwave Therapy (ESWT) today!

Achilles Tendinopathy

• Study 1: A prospective cohort study evaluated 50 patients with chronic non-insertional Achilles tendinopathy treated with ESWT. After six weekly sessions, 72% reported a reduction in pain scores and improved physical function at the 12-week follow-up.
  • Reference: Vahdatpour B, et al. Foot & Ankle International. 2018.
• Study 2: An RCT compared ESWT with eccentric loading exercises in patients with insertional Achilles tendinopathy. ESWT showed superior pain relief at six months, while both treatments yielded similar functional outcomes.
  • Reference: Furia JP, et al. Clinical Orthopaedics and Related Research. 2006.

Make an appointment to start getting relief of your Achilles tendonitis with Shockwave Therapy (ESWT) today!

Morton’s Neuroma

• Study: A case series investigated 25 patients with Morton’s neuroma who underwent three sessions of low-energy ESWT. Patients reported a mean pain reduction of 48% and improved ability to wear regular footwear after treatment.
  • Reference: Fridman R, et al. Journal of the American Podiatric Medical Association. 2015.
    

    Make an appointment to start getting relief of your Neuroma pain with Shockwave Therapy (ESWT) today!

Peripheral Neuropathy

• Study 1: A randomized clinical trial on 60 diabetic patients with peripheral neuropathy assessed ESWT’s impact. Patients received six weekly sessions of low-energy ESWT, resulting in significant improvement in pain scores, sensory function, and nerve conduction velocity compared to the control group.
  • Reference: Lee SH, et al. Diabetes Research and Clinical Practice. 2020.
• Study 2: A systematic review and meta-analysis examined 10 studies on ESWT for neuropathy. The analysis confirmed its efficacy in enhancing peripheral nerve regeneration, reducing pain, and improving blood flow to affected nerves.
  • Reference: Zhang Y, et al. Frontiers in Neurology. 2023.
• Study 3: A pilot study on 30 patients with diabetic neuropathy treated with ESWT showed improved vibration sensation, reduced neuropathic pain, and enhanced quality of life after four weekly sessions.
  • Reference: Rasti Z, et al. Journal of Diabetes and Its Complications. 2022.
    

    Make an appointment to start getting relief from your Neuropathy with Shockwave Therapy (ESWT) today!

Chronic Ankle Pain

• Study: A case-control study on patients with chronic post-traumatic ankle pain showed that ESWT provided a 55% improvement in pain scores and 40% enhancement in ankle mobility at a six-month follow-up.
  • Reference: Zhai L, et al. Journal of Orthopaedic Surgery. 2017.

Non-Union Fractures

• Study: A multicenter trial assessed ESWT for non-union fractures in the foot and ankle. After three high-energy sessions, 76% of patients achieved bone healing within six months, with reduced pain and improved weight-bearing capacity.
  • Reference: Schaden W, et al. Journal of Orthopaedic Trauma. 2001.

These studies collectively highlight the efficacy of ESWT for various foot and ankle conditions. While its benefits for chronic conditions like plantar fasciitis and Achilles tendinopathy are well-established, emerging research suggests promising outcomes for peripheral neuropathy and other nerve-related conditions. Further large-scale studies are needed to refine treatment protocols and confirm long-term benefits.

Make an appointment to start getting relief with Shockwave Therapy (ESWT) today!