Shockwave therapy

Shockwave therapy is a very useful, non-invasive, safe and effective treatment for a variety of tendon problems, plantar fasciitis and heel pain.

I had a partial knee replacement at the Harbour hospital in December 2023. My surgeon Charles Willis-Owen was truly amazing! He made the whole process really straightforward and relatively painless! He was very supportive of I had any questions or issues. The nurses and physios were all very kind and caring.

What is Shockwave Therapy?

Shock wave therapy is a non-invasive way of treating heel pain (plantar fasciitis), Achilles pain, and a number of other sports injuries and long-term tendon problems. Its got great success rates and is very safe compared with the alternatives.

It is great for:

  • Achilles tendonitis
  • Plantar fasciitis/heel pain
  • Tennis elbow/golfers elbow
  • Patellar tendonitis
  • Quadriceps tendonitis
  • Iliotibial band friction syndrome (ITBFS)
  • Trochanteric hip pain
  • Other tendon problems

All of these conditions can be stubborn and hard to treat if they don’t get better with physiotherapy, and before shockwave therapy existed the next step would often have been surgery!

It has a success rate of about 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. Since I have been using shockwave the number of operations I have to do for these conditions has fallen to near zero!

How does shockwave therapy work?

Shockwave 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 overuse injuries. Shockwave therapy can convert this chronic inflammatory process into an acute inflammatory process much like a fresh injury, from which the body can usually heal itself.

Typically three (but sometimes up to six) treatments of about five minutes are required spaced over consecutive weeks. The treatments are a bit uncomfortable, but no injections are required, and they are not nearly as painful as surgery.

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How much does it cost?

Shockwave therapy is not currently available on the NHS in this area, however, if you are insured then it is often fully covered by your private health insurance. If not I can see you on a self-funded basis. A new self-pay consultation costs £275 (£260 if paid on the day of your appointment) and a course of three treatments costs in the region of £780 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.

What happens during shockwave therapy treatment?

During shockwave therapy, high-intensity sound waves are sent to the tissues of the body. This leads to all sorts of beneficial effects such as new blood vessel ingrowth, a 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 to six 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 good improvement by 3 months. It carries on improving for up to a year. If it is sore the next day please don’t take anti-inflammatories like Nurofen or Ibuprofen, as these can stop the shockwave from working well. You can take Paracetamol or Co-codamol if you need to.

What are the benefits of shockwave therapy treatment?

  • Clinical studies report a success rate above 75%
  • Much cheaper than surgery
  • No anaesthesia required, no drugs, no injections
  • Just 3 – 6 sessions of 5-minute treatments

How long does it take to work?

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 a considerable benefit by 3 months from the first treatment, but studies show improvements continue up to one year from treatment.

I had a partial knee replacement at the Harbour hospital in December 2023. My surgeon Charles Willis-Owen was truly amazing! He made the whole process really straightforward and relatively painless! He was very supportive of I had any questions or issues. The nurses and physios were all very kind and caring.

Are all shockwave treatments the same?

No! There are a variety of types of shockwave treatments and ways to deliver the therapy. I use a high-quality (expensive) radial shockwave therapy which has a wealth of research for sports injuries. The type of handpiece determines how much energy can be given, and the newer ceramic handpieces deliver more energy with less discomfort. Unfortunately, there are a lot of very cheap machines available which are sold as shockwave machines but don’t work at all! Each year I see many patients who have had shockwave elsewhere which has not been real shockwave at all.

Frequently asked questions

In most parts of the country, shockwave therapy is available on the NHS and it is delivered by physiotherapists. You usually need a referral from a specialist. In Bournemouth, unfortunately, the service has been a bit stop-start and at the time of writing, there is no shockwave machine in the NHS.

If shockwave doesn't work for you then we have to resort to the other options of injection therapy or surgery. This is really rare, and in the first instance, we sometimes do a second round of shockwave therapy.