About Extracorporeal Shockwave Therapy (rESWT)

Radial Extracorporeal Shockwave Therapy or rESWT is a method of treatment for multiple tendonopathies.

This technology has been cleared by the FDA for treatment of plantar fasciitis and tennis elbow. Many studies have also utilized this treatment modality forachilles tendinitis patellar tendinitis, shoulder tendinitis, stress fractures and nonunion of fractures. Generally, this treatment approach has been used whenever angiogenesis (new blood vessel formation) might be helpful in encouraging soft tissue structure healing.

There are several theories as to how rESWT may or may not help promote better healing. The most accepted one is that the microtrauma of the repeated shock wave to the affected area creates neo-vascularization (new blood flow) into the area. It is this new blood flow that promotes tissue healing. Another theory is that in chronic pain, the brain has "forgotten" about the pain and is doing nothing to heal the area. By having shockwave therapy a new inflammatory process is created and the brain can react to it by sending the necessary body nutrients to the area to promote healing.

Prior to suggesting this treatment regimen for either plantar fasciitis or achilles tendinitis, other conservative treatments are typically rendered. For plantar fasciitis this might include steroid injections, oral nonsteroidal medications: or custom orthotics. For achilles tendinitis, initial treatment might include oral or topical nonsteroidal medications or physical therapy.

Contraindications for this procedure include arterial insufficiency of the lower extremities, internal placement of surgical screws or plates adjacent to the treatment area, as well as patients using blood thinning agents such as Coumadin.

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