The Electrophysical Forum aims to provide an interactive platform for questions, comments, discussion and opinion related to the use of Electro Physical modalities in therapy. It is supported by an Internationally renowned expert panel and a broad sphere of clinicians, researchers, educators and students. Active participation is welcomed.

Sign up to start posting >>>

Ask a question and get it answered by your peers and respected experts

Answer a question and be recognised, raising your international profile

Create a link to us from your website, blog or social media platform.

Radial Shockwave for cervical dystonia

I have taken on the care of a lovely active 83 three year old with scoliosis and cervical dystonia who was seeing a colleague of mine for a long time for regular massage (my colleague has now retired hence why I have taken on her care). This lovely lady has regular Botox injections for her dystonia given by a neuro consultant and, while I understand the Botox is for neurological release, the fact that the lady attends regularly for hands on massage for her soft tissues I was wondering if there was any benefit for trying radial shockwave on her. Even if it is not felt appropriate to use the shockwave, is there any advantage to using the massage head over manual therapy (apart from protecting my own hands’ joints!).

Thank you very much for your help with this matter. Anna (physiotherapist)

Anna Watson

10 months ago

Back to General Electrotherapy

Post a reply


Cliff Eaton
Cliff Eaton

Dear Anna Firstly, apologies for my tardy response but the alerts the panel normally receive for a new post are not coming through Prof Watson is quite right when he states that shockwave therapy (focused and radial) have both been shown to reduce hypertonia associated with spasticity. In those studies where increased ROM was the desired outcome Radial Pressure wave provided better outcomes. Unless you have had specific training, it is best to avoid the anterior and ant/lat aspects of the neck. You mentioned having a massage attachment (V-actor?). There is a suggestion that using frequencies of less than 20Hz can reduce muscle tone. So, to 'save your hands' this may be a good option Cliff

Prof Tim Watson
Prof Tim Watson

Anna. Thanks for your query. There is a range of soft tissue applications being developed for shockwave - especially in radial mode - but that having been said, I am not aware of anything in the dystonia arena - certainly not by way of published work. There are several groups who have used it - with reasonable benefit - in neuro conditions, primarily focusing on spasticity - which it certainly helps. Whilst I have no personal experience of this application, my hunch is to be extremely cautious especially if you are planning on an application in, on or around the neck (I assume you are treating a torticollis type of problem???) as that is an area where many modalities are advised to be used with caution +++. Someone else on the forum may have some direct experience which would be more informative than my views. Last comment is that when we reviewed the contraindication issues for the new edition of the textbook, almost all mopdalitied were identified as a 'local contraindication' to the anterior neck region - including shockwave - in case that helps? Tim

1-3 of 3

Reply to this discussion

You cannot edit posts or make replies: