How Does ESWT Work?
ESWT is one of the few medical technologies that performs best on people with chronic conditions that did not respond to conservative traditional therapy. ESWT accelerates the body’s own healing process in a number of ways:
- Through a process called cavitation, ESWT stimulates fibroblast and tenocyte production. Fibroblast or tenocyte cells make up your body’s connective tissues such as tendons and the fascia.
- ESWT diminishes pain by over-stimulating the nerves that send pain sensations to the brain.
- The procedure can break down pathological calcification deposits (also known as spurs). Depending upon your condition, this may or may not be the goal, but an interesting by-product. In all cases, ESWT is targeted at the condition that caused the spur, not the spur itself.
When Should I Consider ESWT?
If you have had your condition for more than six months and have tried three conservative therapies with no results, do not wait any longer to seek help. It is natural to procrastinate, but not a good idea for tendonosis conditions, since continuously using degenerative tendon tissue can cause further damage.
For example, every time that you feel pain when you place weight on your heel or lift something with your arm, it is because you are pulling against the tendon fibers. When the condition progresses to a rupture, ESWT is no longer an option and you will have no treatment alternative but to have invasive surgery.
Additionally, if left untreated, you can experience new problems. With heel pain in your foot you may naturally compensate by walking on your toes or limping to protect yourself from pain. These abnormal movements will, in time, cause strain to your knees, hips and lower back and, even worse, may result in the same condition in the other foot.
How is ESWT Different?
If tendonitis does not resolve by itself, oftentimes the help of treatments such as strapping, physical therapy, anti-inflammatory medications or cortisone injections assist in reducing the pain. When the condition is new it is called acute tendonitis. Acute tendonitis is an inflammation of the tendon. All of the treatments used at this stage are meant to rest the area or deal with the inflammation.
Those who do not get better in the “acute” phase have what is called chronic tendonosis. The difference between tendonosis and tendonitis is simple. Tendonitis is inflammation. Tendonosis is damaged tissue and is degenerative. You can use steroid injections repeatedly with no result if the problem has gone beyond inflammation. Surgery used to be the only option for tendonosis. ESWT treats tendonosis because ESWT forces the damaged tendon to heal.
Most important, those patients who have been inappropriately trying to treat inflammation are left to suffer in pain. Left untreated, a damaged tendon can get progressively worse and cause further biomechanical damage to other areas of the body from limping or improperly lifting. We see many patients who suffer back, hip or other pain as a direct result of the damaged tendon in their foot, arm or shoulder.
What Kind of Recovery Can I Expect?
ESWT forces your body to create new tissue cells in the damaged area. Expect gradual healing to take place over days, weeks or months. Though not typical, some have mild soreness or bruising after treatment. Some people experience no more pain from day one. Most will have noticeable to significant improvement by the thirteenth week.
A second treatment after sixteen weeks may be necessary in approximately 20% of patients. As it took time to create the injury, healing also takes time. Total healing of the affected area can take up to one year.
The best thing about ESWT is that unlike surgery, you avoid getting worse before getting better. You do not need to plan lengthy time off from work or your life for painful post-procedure recovery.