Focused Shockwave Therapy
Utilising the latest technological advances to deliver a non-invasive therapeutic Piezowave
Neural / Neuropathic pain / Peripheral Neuropathies, Morton’s Neuroma, Nerve Entrapments
What it does: Clinical Goal
Shockwave therapy is being used experimentally and clinically to reduce neuropathic pain, improve nerve function, and reduce perineural fibrosis or entrapment in selected peripheral nerve conditions (e.g., Morton’s neuroma, diabetic neuropathy, carpal tunnel syndrome). The aim is pain reduction and functional gain without surgery.
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How it works
Proposed neural mechanisms include modulation of nociceptor threshold, promotion of angiogenesis and nerve regeneration, reduction of inflammatory cytokines, and improved local microcirculation; animal and human studies indicate ESWT can improve nerve conduction and reduce pain markers, but mechanisms remain under active research.
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Who is suitable
Selected patients with chronic peripheral neuropathic pain who have failed conservative care and who are unsuitable for or wish to avoid invasive nerve procedures may be considered. Not all neuropathies respond, success varies by diagnosis, chronicity and underlying pathology.
What to expect & Recovery
Treatment is targeted to the nerve or entrapment zone, the area is visualised and marked using diagnostic ultrasound. Sessions are short but can be uncomfortable. Objective improvements (reduced pain scores, better sleep, improved electrophysiology) have been reported up to 6 months in some trials. Multiple sessions (e.g., 3–6) are commonly used. Combined approaches (physio, neuropathic analgesics, glycemic control for diabetic neuropathy) improve outcomes.
Evidence
Early randomised controlled studies show promise: Pain and some electrophysiological improvement at 3–6 months, but the evidence base is still smaller and less consistent than for tendinopathy.
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Risks / special considerations
Because nerve tissue is involved, close clinician oversight is required. Temporary numbness or altered sensation can occur. Discuss alternatives and realistic expectations with your clinician.