Treatment
Shockwave
Your first steps in the morning hurt at the heel. Or a tendon keeps troubling you whenever you put more strain on your arm or leg. If symptoms affecting a tendon or its attachment persist despite previous treatment, shockwave therapy may be considered.
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Understanding
A closer look
We discuss which tissue is affected, why symptoms are persisting and what role shockwave treatment might have in your case. The aim is to reduce pain and improve your ability to manage daily activities again.
What happens during shockwave treatment
Shockwave therapy delivers mechanical pressure impulses from outside the body into the treatment area. It is a procedure that does not require a surgical incision. The impulses are delivered through a treatment head placed against the skin.
We offer radial and focused methods. Radial pressure waves spread out from the treatment head; focused shockwaves concentrate energy in a target area. The appropriate method depends on factors including the affected structure and the specific question being addressed. The methods are therefore not interchangeable.
Which symptoms need to be assessed first
Pain at a tendon attachment and a tendon tear are different situations. Heel pain can also have several causes. Before recommending treatment, we want to understand which activities bring on the pain, how long it has been present and whether it followed an accident.
Your observations can be very helpful during the consultation: is the first step after resting particularly painful? Does movement become easier during an activity, or increasingly uncomfortable? Have you already tried exercises and, if so, how regularly and with what result? These details complement the examination.
Further information
When shockwave therapy may be discussed
In orthopaedics, shockwave therapy is studied and used for selected tendon and tendon insertion symptoms and certain calcium deposits. At OrthoCoast, both radial and focused shockwave therapy are part of our services. We assess which application may be suitable for you based on your symptoms and findings.
We also review your treatment so far. Perhaps adjusting your activities has been difficult, or an exercise programme did not fit well into your daily life. These are reasons to look more closely at the plan. Adding another method does not automatically resolve every cause of a longstanding problem.
What you should know about possible benefits
For selected conditions, shockwave therapy can reduce pain and improve function. For example, controlled studies of longstanding pain on the sole of the foot that had not responded to previous treatment found benefits for both radial and focused shockwaves compared with sham treatment. The two methods were investigated in separate studies. Outcomes included the first steps in the morning and daily activity. Which results are relevant to you depends on your diagnosis and the method used.
If we agree on treatment, we set a clear goal and a time to review progress. Perhaps you would like to put weight on your foot more easily in the morning or carry out a particular activity for longer. Useful symptom relief can make the next step in rebuilding movement and tolerance of activity easier. Together, we check whether this goal is being reached and how the plan should continue.
How treatment fits into your daily life
With longstanding tendon symptoms, getting the level of activity right often plays an important role. If you return immediately after treatment to the same excessive strain, an important part of the problem may remain. Equally, avoiding all activity permanently is not always helpful.
We want to discuss which activities should be adjusted initially and which movements remain possible. Shockwave therapy is considered as part of a treatment plan. The other measures included depend on your diagnosis.
Your contacts at OrthoCoast
Shockwave treatment at OrthoCoast is provided by Priv. Doz. Dr. med. habil. Richard Kasch, Dr. med. Christoph Jährling and Björn Weidemann. If you have received a recommendation, bring the findings on which it is based or describe your previous treatments.
You can initially arrange the appropriate medical assessment through ‘Appointments & enquiries’. For follow-up appointments already discussed and approved, use your personal booking route.
What to expect and next steps
How to prepare for your appointment
Bring existing reports and an up-to-date medication list. Please tell us about blood-thinning medication, a possible pregnancy, recent infections and conditions affecting the planned treatment area. We discuss which details are particularly important for the specific procedure when explaining the treatment.
Please do not stop medication yourself. Also let us know if you have recently had an injection or another treatment in the area. This allows us to take treatment intervals and any special considerations into account when planning.
During and after treatment
The treatment area is identified and the treatment head is placed against your skin. You may feel the pressure impulses clearly, and they can be uncomfortable. Please tell us how the treatment feels. It needs to suit what you can tolerate and the medical plan.
Local discomfort, redness or bruising may occur afterwards. Your individual treatment discussion includes which reactions can be expected and when you should contact us. We also clarify how to approach work, sport and agreed exercises over the following days. A blanket break from sport would not be appropriate for every condition.
What matters for your decision
Costs and further appointments
Before treatment, we clarify the planned scope and how it will be billed. Whether costs can be covered depends on factors including the indication and the requirements that apply. The general availability of a method does not mean that every use is reimbursed.
For services you pay for yourself, you receive specific cost information beforehand. If you have German statutory health insurance and are paying for the service yourself, you receive a cost estimate and sign the self-funding agreement before we provide it. We discuss the number and spacing of further sessions with you; these are individual and may depend on your progress during treatment.
Our doctors in this specialty
Priv. Doz. Dr. med. habil.Richard Kasch
Specialist in orthopaedics and trauma surgery
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Dr. med.Christoph Jährling
Specialist in orthopaedics and trauma surgery
DVO-certified osteologist
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Björn Weidemann
Specialist in orthopaedics and trauma surgery
DVO-certified osteologist
View profileYou can discuss with these doctors whether the treatment may be suitable for your concern. Your goals, questions and expectations are part of that discussion.
Frequently asked questions
Is the treatment suitable for every painful tendon?
No. The nature and cause of your symptoms need to be assessed first. The decision also takes account of other health conditions, previous measures and possible reasons not to use the treatment.
How many sessions will I need?
We decide this based on the specific treatment and your progress. A fixed number given without knowing your condition would not be a reliable personal recommendation.
Can I return to my normal activity straight afterwards?
Please follow the advice discussed with you individually. The appropriate level of activity depends on the structure treated, your work and your sporting activities.
What should I do if my symptoms get worse?
Let us know about any marked or persistent worsening before attending another treatment appointment. For severe acute symptoms, use the routes to medical help described in the patient services section.
Sources and further information
Your next step
