Extracorporeal shockwave therapy is used to treat a growing number of tendon, joint and muscle conditions. These include tennis elbow, where results in double blind studies are reported as excellent; chronic tendinitis of the knee and shoulder rotator cuff pain, achilles tendinitis, hamstring tendinitis and plantar fasciitis have also been treated successfully.

The above conditions are often difficult to treat using other methods and can become chronic. With ESWT patients report reduced pain and faster healing, without significant adverse side effects. ESWT is also used to promote bone healing and treat bone necrosis. It is an effective alternative to surgical treatment of non-healing fractures.
ESWT is used for wound healing and has shown positive results in short-term and long-term outcomes in diabetic patients suffering from foot ulcers.

Shock waves stimulate angiogenesis (new blood vessels) and neurogenesis (new nerve cells). The exact physiological mechanisms at this stage are poorly understood, but it appears that the cells undergo microtrauma which promotes the inflammatory and catabolic processes that are associated with removing damaged matrix constituents and stimulating wound healing mechanisms.

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Indications:

• Radial and ulnar epicondylitis
• Calcific tendonitis of the shoulder / shoulder problems
• Status post muscular injuries
• Chronic patellar tendonitis
  Jumper's knee
• Achillodynia
• Plantar fasciitis
• Heel spurs
• Myofascial trigger point treatment e.g. neck
• Myofascial trigger point treatment e.g. back, muscular back pain
• Bursitis Trochanterica
• Periostitis / shin splints (status post strain)

Contraindications:

• vascular diseases present in or near the treatment area
• local infections in the treatment area
• around malignant or benign tumours
• directly on cartilage surfaces or near the small facet joints of the spinal column
• directly over implanted electronic devices such as pacemakers, analgesic pumps, etc.
• in areas, in which mechanical energy in the form of vibrations may lead to tissue damage such as metal implants after a fracture

In general we advise against treatment

• if blood clotting disorders are present or the patient is receiving treatment that results in a change in the blood clotting behaviour
• during pregnancy
• on patients with neurological diseases resulting in impairment of the vasomotor function in the treatment area
• over air-filled cavities such as treatment on the thoracic spine, etc.
• on children, particularly around the epiphyseal plates

Care is required for patients

• with impaired sensibility
• with severe autonomic disorders
• under the influence of drugs and/or alcohol as circulatory stresses and inadequate treatment responses cannot be excluded.

Please consult the Instructions for Use for more information on indications and contra-indications and for warnings and recommendations.

The above indications and contra-indications originated from the Endopuls 811 User Manual 1650751-41.