Radial Pressure Wave Therapy is a medical treatment that utilizes ultrasound technology to send high-energy radial pressure waves (RPWs) to the site of chronic pain. At the most basic level, RPW therapy stimulates new cell growth. It increases blood flow, stimulates muscle repair and regeneration, and increases metabolization at the cellular level. When you experience chronic pain, your body no longer recognizes that there is an injury to that area. As a result, it shuts down the healing process and you feel no relief. The sound waves penetrate deep through soft tissue, reaching a microtrauma or inflammatory condition. This reactivates the body’s natural healing response.

The energy emitted also causes the cells in the soft tissue to release certain bio-chemicals that intensify the body’s natural healing process. These bio-chemicals allow for the building of an array of microscopic new blood vessels in the soft tissue. RPW therapy applications include:

  • myofascial trigger points
  • disorders of tendon insertions
  • pulse vibration massage
  • pain and inflammation in orthopedic conditions
  • various musculoskeletal diseases
  • herniated, bulging, or degenerative discs
  • plantar fasciitis
  • recurring episodes or chronic neck or back pain
  • chronic headaches
  • neck or back injuries from a car crash

How is RPW performed?

The system includes a machine with an applicator like that of an ultrasound. The applicator is applied to the area and the ballistic waves are administered by movement over the affected area in a controlled motion. During the treatment, there may be some discomfort, but tolerable pain is helpful in isolating the injured areas. There is no need for anesthesia to be administered during the treatment, as opposed to high-energy shockwave therapy (lithotripsy). Patients treated with RPW may be active immediately and resume their normal routine the same day. Many patients find a significant and immediate reduction in their pain. Some patients will feel results gradually after each treatment. RPW advantages include:

  • short treatment time (a few minutes)
  • precise and targeted application
  • results in a few treatments
  • avoiding surgery with non-invasive treatment
  • avoiding unnecessary additional medications
  • effectiveness where other therapies have failed
  • affordability and safety

Are there side effects from RPW Therapy?

There have been very few side effects reported. Patients may feel some soreness in the treated area for a day or two afterward, like a bruise, but that’s normal and is a sign the treatment is working. There may also be some temporary numbness or tingling in the treated area.

What is the success rate of RPW shockwave therapy?

The majority of patients who use this treatment enjoy positive results. In clinical studies, about 91% of patients reported successful results, including a decrease in chronic pain, increase in mobility, and other health improvements. RPW has a proven success rate that is equal to or greater than that of traditional treatment methods, including surgery, without the risks, complications, or lengthy recovery periods. There are no incisions and no risk of infection, or scar tissue, like there are with surgery.

Is shockwave and ultrasound the same thing?

Shock waves are single, mainly positive pressure pulses that are followed by comparatively small tensile wave components. Ultrasound applies an alternating high frequency load to the tissue, with a frequency range of several megahertz which can lead to heating, tissue tears and cavitation at high amplitudes. Although both radial shockwave and ultrasound therapies were found to be effective in patients with plantar fasciitis, the statistical analysis showed that radial shockwave is significantly more effective than ultrasound therapy.

When should you not use RPW shockwave therapy?

Shockwave therapy should not be used if there is a circulation or nerve disorder, infection, bone tumor, or a metabolic bone condition. Shockwave therapy should also be avoided if there are any open wounds or tumors and during pregnancy.

How long does it take for RPW shockwave therapy to work?

Generally, it takes about 16 weeks after your treatment to experience the full benefits of shockwave therapy. Please contact us for additional information about Dynamic Physiotherapy’s shockwave therapy treatments and its benefits. You don’t have to live with pain anymore. Most indications require three to five treatments which are done three to ten days apart, depending on the patient’s tolerance and tissue response.

What should you not do after RPW therapy?

It is recommended that you refrain from any activity that stresses the treated area for 24 hours after a shockwave session, even if you have no pain after treatment. For example, if you have received shockwave for your Achilles tendon pain, we strongly recommended that you do not run for 24 hours after each treatment. Patients should not apply ice or take anti-inflammatories after shockwave treatment, as this will impact the inflammatory healing response and thus reduce the effectiveness of the shockwave treatment.

Why RPW instead of physical therapy?

Physical therapy is typically two to three times a week, for four to six weeks and you are usually at the facility for no less than an hour. More importantly, there is usually a co-pay required for every visit which can become costly. Over a six-week period the co-pays and time invested can add up quickly. The RPW treatments are only one to two times a week, for 15 -30 minutes if exercises are also performed after the physical medicine modality. This is a highly effective modality which is faster and can be more effective than physical therapy. The cost of the RPW treatments are usually less than the total of the PT co-pays. If you want to try to get faster results, and possibly save money, the RPW treatment for certain conditions may be the ideal option for you.

Treatment Applications

Treatment is performed directly on the skin but is non-invasive. The time allotted for a specific treatment will depend on the area and depth of the tissue being treated. This will normally fall within two to four minutes per area treated. The patient is in a supported position while keeping the tendon in a slightly stretched position. Treatment is applied to the specific painful spots in the chronic lesion site as well as fascia/trigger points.

  • Suggested Treatment Protocol: Tendinopathy/Calcification – 4000-6000 shocks
  • Suggested Treatment Protocol: Tissue Mobilization/Myofascial Release – 2000-4000 shocks

See more information provided by Chattanooga Group

Is RPW covered by insurance?

No, RPW is not yet covered by most insurance plans. Contact us for more information on how Tucson Chiropractic Center can make it affordable for you.

Plantar Fascitis and RPW

Plantar fasciitis is a common contributor to heel pain; however, there can be a number of other causes. These conditions include: trigger points in the quadratus plantae, soleus, gastrocnemius, or tibialis posterior; fat pad syndrome; tightness in the gastrocnemius and Achilles tendon creating tight plantar fascia; and disc herniation. Typically, plantar fasciitis is characterized by a stabbing sensation first thing in the morning after waking up and walking. Most often, people will get cortisone injections into the plantar fascia to relieve the symptoms. However, this is a short-term fix, and the plantar fascia is actually weakened by the steroid injection. A thorough examination can uncover the true root of the heel pain instead of just masking the symptoms. The ultimate goal is to alleviate the pain so you can get back to running, hiking, or whatever it is you’ve been missing out on.

The human body is amazing at compensation. When something is hurt or doesn’t feel right, the brain will take the path of least resistance and find a way to perform the same task using different movement patterns. The problem is that these compensation strategies can linger long after the pain is gone. And once they’ve become engrained, they start to overload certain areas of the body. This overload leads to microtrauma, and eventually macrotrauma.
A common issue with plantar fasciitis is the inability to properly control the foot through the gait cycle while walking or running. It most often involves the medial arch and the lateral arch. It can be difficult to pinpoint what is causing this lack of control in the foot. Is it the muscles in the leg or hip? Is it an old lower back injury? Is it the running form? Could it be the running shoes? There is no simple answer. It could be all of the above. You may need to learn how to properly stabilize your foot and your hip or, perhaps, learn how to create sufficient intra-abdominal pressure while running. We provide the exercises utilized to resolve plantar fasciitis and/or perform radial pressure wave therapy to resolve the condition. If symptoms persist, Dr. Rudnick co-manages care with specialists and physical therapists.

The treatment of plantar fasciitis should be geared toward returning the foot to the correct position so that everything is balanced, and the overload is eliminated. Determining and resolving the entire locomotor system within the kinetic chain of movement is the key to resolving the issue. Proper treatment allows for the foot to dissipate forces properly and relax the plantar fascia and surrounding musculature.