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Focused shockwave therapy for physiotherapists

At the moment physiotherapists from Austria are only allowed to use radial shockwave therapy and I was wondering if somewhere around the world physiotherapists are allowed to use focused shockwave therapy as well. I would be very grateful, if you could give/send me some information about that or tell me who I could contact to get more information concerning this issue.

Theresa Fuchs

2 years ago

Back to General Electrotherapy

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Cliff Eaton
Cliff Eaton

Dear Theresa Firstly please accept our apologies for not getting back to you sooner. Unfortunately for the second time now this site has been attacked by hackers. The site therefore has not been active and panel members are still not being notified of new posts. Why hackers wish to attack a site like this beggars belief! You have got me stood on my soapbox with this one!! The ISMST along with DIGEST who are the two international advisory bodies on Shockwave therapy stipulate that Physiotherapists are only allowed to use RPW. I have argued the case at conference and I was going to raise it again this year before Covid scuppered this year's conference. It appears to stem from tthe fact that most of the committee in each association are made up of Orthopaedic surgeons and doctors from Germany and Austria. In those countries Physiotherapists do not have the autonomy given to Physiotherapists in other countries. Doctors prescribe and Physiotherapists administer! If you look on the ISMST website, where they provide a list of indications they also provide a list of 'expert indications'. These include De Quervains, CTS, trigger finger. They say these should ONLY be treated with Shockwave by a doctor. I have been told this is because of a doctor's better knowledge of anatomy!! So you see why this topic rattles my cage. As long as your professional body says that Shockwave is within your scope of practice. Use which modality you feel most appropriate for your patient Finally just to comment on Dinesh's point. Use of USS can deter some therapist from using FSWT. Be aware though that USS is only really required for FSW generated by electropiezo technology. This is due to the very small focal point this generation creates. Electrohydraulic and electromagnetic FSW generation create much larger focal points so you do not have to be so precise in your Hope this helps Cliff


This link may help you to find the answer to your question:

Dinesh Verma
Dinesh Verma

Hi - As I know in many applications with Focused Shockwave - You may ideally need the guidance of Imaging Ultrasound and hence it becomes bottle-neck in some countries where imaging US is not allowed by regulatory authorities to be used by PTs.

Prof Tim Watson
Prof Tim Watson

Theresa. I have lectured on this topic in many countries round the world - and in some, as you say, therapists are only 'allowed' to use shockwave in a radial mode, whilst in others, they can use both focused and radial. In the UK for example, both are accessible to therapists. There was a claim - some years back - by Dr's, which essentially said that only Dr's should be allowed to use focused shockwave. I do not know on what basis the claim was made - somebody out there in the electrophysical community might know. There might be something in the professional regulations for different countries. Again, using the UK as an example, there is NOT a definitive list of modalities that can and can not be used - it would always be out of date with the advent of new treatment options. The professional body over here says that the therapist can use a device so long as they can demonstrate knowledge and competence in the normal way. Interested to hear from others who might have better insight. Tim

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