ESWT – A New, Affordable and Promising Therapy.

ESWT stands for “Extra-corporeal Shock Wave Therapy”. If you have a chronic joint or tissue pain that is continuing and has not adequately responded to therapies or treatment, or a case needing faster and deeper recovery from an injury, Shock Wave Therapy may be ideal for youFor example, some patients have painful arthritis in a joint and no way to slow the degeneration or stop itOthers have Frozen Shoulder, Plantar Fascitis or knee pain. In some of these cases, corticosteroids or surgery are being considered.  Rather than or prior to going that route, you may want to try a highly effective and FDA-approved therapy that has been proven to increase the rate of healing of certain joint and tendon problems.

Radial ESWT generator deliveiing shock waves to an elbow bursitis (An AI Simulation of a Radial ESWT generator delivering shock waves to an elbow bursitis.)

“Shock wave therapy is an exciting, breakthrough treatment option in the field of regenerative medicine.” While it is always exciting to add a new therapy in my practice, it is even more rewarding when the modality has such undeniably impressive results. Radial ESWT or r-ESWT can add improvement possibilities for many conditions effecting everyday people all the way up to professional athletes. For example, in addition to injuries and pre- and post- surgical cases. Check out these results with Rheumatoid Arthritis , for example, from the National Institute of Health (NIH).

From the Journal of Clinical Orthopedic Trauma, “Extracorporeal shockwave therapy (ESWT) – while around for over 20 years – has become a popular non-invasive therapeutic modality in the field of orthopedics and traumatology for the treatment of many musculoskeletal disorders, including problematic soft tissue wounds.” ESWT can provide safe, fast and effective pain relief and regenerative healing, without surgery, cortisone or needles. Bone repair, tendon repair, Tissue regeneration and healing can continue over 3-4 months – even up to 18 months post-treatment.

Here are some testimonials about our newest added therapy, r-ESWT or “Radial Shock Wave Therapy”. This concept is sometimes referred to as “Stem Cell” or “Stem Wave” or “Soft Wave” Therapy (although those are expensive trademarks and we do not call it that).

TVV: Amazing – I was limping for months when Dr. Sibilla sent me for a knee X-ray showing severe osteoarthritis.  This treatment took the pain away almost 100% on my first session and is allowing me to function fully. I am skiing with a season pass and working facilities management. I did six treatments and I plan to go back for installments when I need them.  I have now started having work on the shoulder which was limited after a ski injury and using a heavy tool bag at work.  This is a game changer.

BDL: I had frozen shoulder as a side effect of menopause and following a shoulder overstretch injury during exercise.  Nothing was working. The shock wave therapy allowed me to reach my bra strap in the back and was highly effective and easy.  I can put my sweater on again! It takes them less than 15 minutes and I can be done and back into my day. I have at least 90% recovery and it seems to be continuing to improve.

TP: Totally great. I have seen over the past months that this has really added alot to my rotator cuff tear recovery even after surgery. Exciting that it makes healing even better.  I am back to playing basketball.

A Physiotherapy Addition to Chiropractic Care

In a chiropractic clinic most often you can receive joint or soft tissue manipulations to help correct problems. Those corrections are intended to restore normal function or positioning, and then we want the body to be able to maintain that correction. Ultimately, it relies on the body. So what more can we add to help the body?

As you may know, Blue Heron Chiropractic and Dr. Dana Sibilla are an Advanced Practice chiropractic clinic, with Dr. Sibilla being a chiropractic orthopedist and neuro-muscular-skeletal medicine specialist.

Some clinics provide adjustments only, even through clothing.  At Blue Heron, we work at the skin level and add “adjunctive”  additional therapies to chiropractic manipulation, from an Orthopedic perspective. You may recognize these physiotherapies as therapeutic ultrasound, therapeutic massage, electrical stim, Graston myofascial release or even Cold Laser.


ESWT stands for Extracorporeal Shock Wave Therapy. This means shock waves coming from outside the body, projected and conducted into a joint or tissue (RSWT/r-ESWT stands for Radial Extracorporeal Shock Wave Therapy, and is radial is a delivery format of choice for ESWT). The shock waves are sound and force, and start a process creating beneficial changes at the tissue level.

The shock wave is created by an electric signal triggering a mechanism that creates a “snapping sound” or impulse. The force of the impulse is transmitted into the tissue through conductive ultrasound gel and a water bladder. This shock wave pulse is adjusted to have a specific depth, intensity, frequency and duration, specific for the area and the problem (“the Protocol”). The results are all about the Protocols. The machine is less important, the protocol setting and application carry the results.

Injuries and dysfunctional tissue tends to be “disorganized” – this treatment activates the mechanism to “reorganize” the tissue (the stem cells in the body know how to do this when activated). The image above is a depiction of a radial shock wave being transmitted into an elbow, helping to improve circulation and decrease pain in a case of bursitis.

The treatment is non invasive, but can reach deep inside tissues and structures, like joints, to activate the restorative properties in the tissue, such as circulation and stem cell activation. Basically, besides increasing circulation, the shock wave disrupts disorganized tissue altered by injury or pathology, and activates the body to reorganize the tissue the way it was designed to be. That’s how stem cell activation works.

This therapy can have reasonably dramatic positive results that can be seen almost right away, often right at the time of first treatment; patients report Pain reduction, more range of motion, and improved function. The regenerative activation then provides long-lasting results. Results with 3  properly-applied treatments of ESWT are often between 85 and 95 percent improvement. We have seen that consistently at Blue Heron Chiropractic.

It is suggested then, for example, that in cases such as unresponsive, incurable Osteoarthritis, that this treatment could:
– Slow down the degeneration and promotes collagen synthesis
– Reduce inflammation and decrease pain
– Imroves the remodeling and healing of bones and joint surfaces
– Increase circulation
– Dissolve the disorganized tissue
– Promotes the dissolution of calcified cells
– Activate the body’s mechanism to replace proper (reorganized) cartilage or tissue
– Has an analgesic pain-relief effect and promotes immediate Range of Motion increase.

Here is a video from Physiopedia of a provider delivering ESWT/RSWT to a case of plantar fascitis. It’s very similar to what we do, but we have expanded on these protocols and our system of application has ways (like introducing a silicone water bladder) of making the therapy even more tolerable and usable in deeper areas. Compared to this one, we will likely be using a slower frequency protocol and we will be using a conduction gel which does an even better job of getting the signals where we want them to go. Our device adds a water bladder which cushions bony surfaces for comfort.

What we are offering:

R-ESWT (Radial Extracorporeal Shockwave Therapy) using a non-focused (radial) ESWT (RSWT) shock wave impulse generator with the option of delivery through a water bladder for comfort.
– 4 to 6 treatments, lasting 8-15 minutes each for optimal results.   During the intro session, we will “Map” and scan your issue area in order to best target the area of interest. We will initially treat two week in a row, and then space treatments out depending on your results.
– How long does it take to recover after shockwave therapy? Once your treatment is finished, you’ll be able to go home and return to work and your normal daily activities straight away. You should avoid high impact exercise such as running or playing tennis for the first 48 hours after treatment.
– Cost: Same as a basic bundled chiropractic appointment (but this is not a basic chiropractic appointment): $75 per session (late 2023 proposal pricing). No pre-pay commitment or contracts are required.
– The treatment sounds a lot like someone snapping their fingers loudly and repeatedly, and feels like a deep, dull impulse. Patients typically report that, while occasionally “annoying”, it is not painful.
– Sound-damping headphones are worn during the session.
– Research suggests this treatment can be even more effective when we add in eccentric stretching and excerises. Since this is a chiropractic treatment plan, we are going to have this available.
– Self-Pay only. ESWT therapy is not covered by insurance (but the re-exam for reactivating patients may be a covered service – ask us).
– Some patients, with Cancer, pregnancy, full thickness tendon tears or pathologically compromised tendonscertain auto-immune inflammatory cases, infections, certain surgical tears or special sensitivities are not candidates for this;. We will screen you on your first session and talk about options.

What this machine is and is not:  It is not a “miracle cure”, although it can activate healing and improve function in ways that can seem miraculous – even when other attempts, like cortisone injections, may have failed.  Despite some clinics offering this as a miracle cure, we prefer to describe it as what it is – regenerative medicine.  Now it is true, there is not a lot of regenerative medicine out there.  But at the end of the day, this is simply a great modality with exceptional results when applied properly. Again, it is all about the protocols, and we are optimizing them all the time. Come check it out. Contact us for an appointment.

ACTIVE / INACTIVE PATIENTS. If you are an active patient, there is no required full re-exam to reactivate you (although sometimes this is in your best interest and we can talk about that). If you are not active – as in not seen within the last year. or this is a new problem – we do need to do a re-exam visit and get all our diagnoses and details up to date. New patients will need a full intake. What is most important is getting you the therapy, so we will provide this in an affordable format.

REACTIVATION “PROMOTION”: for the purposes of this promotion, if you are an established patient and your insurance does not cover a re-exam, we are willing to provide a focused re-exam to reactivate you, at the same cost as a basic bundled treatment or your first shock wave treatment ($75).  There is no commitment required. 

You can read more on our newest web page for ESWT Shock Wave Therapy.

Call now (503) 280-9759 and ask to discuss Shock Wave therapy with Doctor Sibilla.