Table 1 Variables of influence on the effectiveness of ESWT
VariablesDetails
Shockwave generation:16 17 19 20 29Site of most effects:

  • Focused shockwave

  • Depth

  • Radial pressure wave

  • Superficial

Energy level (mJ/mm2):16 29With an energy level of >0.6 mJ/mm2 therapy will be painful and macroscopic lesions will appear.16

  • low (<0.08)

  • medium (0.08–0.28)

  • high (>0.6)

Number of treatments, time interval between treatments and shockwave frequencyIf there is more than one treatment, effects will be cumulative.13
Whether or not anaesthetics are used.When using anaesthetics, a larger energy level can be used.16
Method of localisation:20

  • anatomical

Can be difficult with obese patients or when the anatomy is disrupted as a result of surgery.20

  • image-guided focusing

Very specific method; however, the site of the lesion is not always consistent with the site where the most pain is experienced.20

  • clinical

Shockwaves are applied directly to the site where the most pain is experienced. This method of localisation is not possible when using a local anaesthetic.20