Shock wave therapy is an exciting new way of treating heel pain, achilles pain and a number of other sports injuries and long term tendon problems.
It is great for:
All of these conditions are otherwise hard to treat if they don't get better with physiotherapy and before shock wave therapy existed the next step would often be surgery.
It has a success rate of about 70-80%, so it does not work for everyone, but does help most people even when other treatments have failed. It is a great way to keep yourself away from an operation.
Shock wave therapy is a non invasive way of restarting the natural healing process allowing your body to repair itself. The common factor in all of these conditions is the chronic inflammatory process, which is a vicious cycle of pain and damage that is often seen in association with over use injuries. Shockwave therapy can convert this chronic inflammatory process into an acute inflammatory process much like a fresh injury, from which the body can usual heal itself.
Typically three treatments of about five minutes are required spaced over three weeks. The treatments are a bit uncomfortable, but no injections are required, and they are not nearly as painful as surgery.
Shockwave therapy is not available on the NHS in this area, however if you are insured then it should be fully covered by your private health insurance. If not Mr Willis-Owen can see you on a self funded basis. A new consultation costs £225 and course of three treatments costs in the region of £750 depending on your specific needs. To put this in perspective surgery typically costs about £4,000 and involves time off work and a lower success rate.
Most insurance does cover it, but some (typically AXA) do not, if this is the case there are ways around this which mean you may still be able to benefit from shock wave therapy. Mr Willis-Owen will discuss this with you at your consultation.
During shock wave therapy, a high-intensity sound waves are sent into the tissues of the body. This leads to all sorts of beneficial effects such as new blood vessel ingrowth, reversal of chronic inflammation, stimulation of new tissue growth and breaking down calcium deposits. For you it's about 5 minutes of quite noisy, and a little bit uncomfortable treatment to the sore area, three weeks in a row.
Some people feel some benefit right after the session, but then it may be sore for the next day or two. The full benefit of the treatment takes some time, with most people feeling much better by 3 months. It carries on improving up to a year. If it is sore the next day please don't take anti-inflammatories like Neurofen or Ibuprofen, as these can stop the shock wave from working well. You can take Paracetamol or Cocodaomol if you need to.
You are likely to feel reduced pain within minutes of starting the first treatment. You will be sore after each treatment, but it is important NOT to take anti inflammatories. The treatment works by stimulation of a 'pro-inflammatory state'. Most patients experience considerable benefit by 3 months from the first treatment, but studies show improvements continue up to one year from treatment.
No! There are a variety of types of shockwave treatment and ways to deliver the therapy. Mr Willis-Owen uses an brand new radial shockwave therapy which has a wealth of research for sports injuries. The type of hand piece determines how much energy can be given, and the newer ceramic hand pieces deliver more energy with less discomfort. Charles used to have an old "swiss dolocast" machine, but the new Stortz machine is much more comfortable and delivers more o the all important energy for less discomfort.
We suggest that whoever gives you shockwave therapy should be experienced in treating your condition with non operative, or surgical means so they can still help you if shockwave is not successful. Also you should be treated by someone auditing their results, for example using the ASSERT protocol. This is a requirement of the National Institute of Clinical Excellence. See below.
The reported success rates in scientific studies are about 75%, meaning that shockwave has a good chance of solving your problems, but not a guarantee. Mr Willis-Owen is enthusiastic about shockwave therapy but appreciates that it is not the solution for everyone. Fortunately Mr Willis-Owen has considerable experience on the surgical treatment of these conditions, so if shockwave therapy is not effective he is ideally suited to take your treatment to the next step.
NICE have looked a shockwave therapy and found it to be safe. The scientific evidence for efficacy is equivocal and as a result NICE have suggested that clinicians carrying out shockwave therapy should gather data on their patients in order to see how well it works. This sort of recommendation from NICE is very common indeed as it takes many years, and many patients to gather robust scientific evidence for any treatment.
For this reason Mr Willis-Owen may ask you to enroll in the ASSERT protocol which is a simple process used to assess how effective shockwave therapy has been.
Mr Willis-Owen carries out Shockwave Treatment at The Nuffield and The Harbour hospitals. A course of treatment is usually 3 sessions of 20 minute appointments each a week apart.