(when Shockwave may not be suitable)
While Shockwave is suitable for a large number of conditions both evidenced and experimental with minimal side effects, there are some conditions, also known as contraindications that means Shockwave is not an option.
Shockwave is unsuitable in the following circumstances:
- If you are pregnant
- If you have a blood clotting disorder (including thrombosis)
- If you are taking oral anti-coagulants
- If you have received a Steroid injection within 6 weeks
- If you have a Pacemaker fitted
- If tumours are present at the treatment site
- If you have an infection or skin abrasion at the treatment site
- If you are Under 18 (except in the treatment of Osgood-Schlatter disease)
Any treatment over an air-filled area such as the lungs or guts is also not possible.
This list is of course not exhaustive, and an assessment by a practitioner is always necessary. We know from experience there are certain treatments, conditions and individual histories that are likely respond better or worse to Shockwave, however in every assessment we look at the safety first.
There is an increasing amount of anecdotal evidence from practitioners across Europe and among professional sports teams, that the current recommendation where a condition isn’t treated until it’s been present for at least 6 months can be reduced. As the risks associated with this are few, people may be tempted to investigate this treatment earlier and some practitioners may agree, however other guidelines have more risks associated with them.
When presenting for one of the industry’s leading bodies I’m often asked the example ‘is Shockwave suitable in the ankle of a pregnant patient?’ The thought being that the local nature of the treatment shouldn’t affect other areas, however in this case, the advice should always be no based on the risk vs reward.
Shockwave has a very safe track record because practitioners adhere to the constraints and guidelines. While benefits can be discovered by pushing the boundaries, there should always be a safety first approach and for most of the general population, the contraindications are in place to protect people.
I was asked to treat a 70-year-old patient suffering from a chronic tendinopathy. I had treated a number of his staff over the years, he ran a natural health clinic on the south coast of the UK, a number of this staff had similar symptoms and had all responded very well to Shockwave so he was very optimistic.
Following an initial telephone conversation, he informed me that he had an Ultrasound scan to evidence the condition and confirm the diagnosis. He also reported a cortisone injection following this scan and I advised that we would, unfortunately, have to wait six weeks before we could begin treatment. The scan did detect a problem, and following a detailed Orthopaedic examination it was clear that we could not proceed, unfortunately the injection caused the tendon to rupture. Had we proceeded with the treatment he would have been in great pain and could have thought the rupture was caused by the Shockwave!
Even with matching symptoms, it’s important to be adequately screened and the final decision lies with your practitioner. Working with a good team can give you the confidence they have your best interests at heart.