Shockwave Therapy Contraindications
There are several conditions where general shockwave therapy should never be used (absolute contraindications). There are also several condtions where general shockwave therapy should only be used with expert advice and/or caution (relative contraindications). In addition, there are several contraindications to the specific use of shockwave therapy for ed.
Absolute Contraindications to Shockwave Therapy
- Lungs. Treatments must not be performed across any of the surface area of the lungs or in areas where the shockwave would be directed towards the lungs. This includes the heart, the thoracic spine and associated muscles, the sternum, the bulk of the pectorails muscles, the scapula, and the apex of the lungs under the upper fibres of trapezius.
- Eye. The delicate tissue of the eye could be adversely affected by shockwave.
- Brain. The destructive forces seen at shockwave transitions could damage and destroy brain matter.
- Major blood vessels. The major blood vessels in the neck and thigh should be avoided to prevent damage and potential catastrophic bleeding.
- Major nerves. Superficial major nerves like the brachial plexus, ulna/radial nerve should not be treated directly. However, treatment around these areas is acceptable.
- Open wounds/post surgical wounds. Wounds with or without stabilisation (glue, stitches, steristrips) should not be treated with shockwaves. Shockwaves can damage tissues and local circulation. This could lead to degradation of the wound, further bleeding and delayed healing.
- Implanted devices. Potentially, shock waves could damage implanted devices such as nerve stimulators causing unwanted effects and equipment failure. In addition, implanted hormone pumps could be triggered to release excess hormone by shockwave application.
- Open growth plates. There is a potential for shockwaves to damaged open growth plates. Shockwave settings that encourage growth may close the plates too early. Other shockwave settings could delay growth.
Relative Contraindications to Shockwave Therapy
- Genital area. Normally treatment round the genitals should be excluded, however this a relative contraindication as treatment for ED under the supervision of an expert practitioner is permissible.
- Pregnancy. An absolute contraindication for treatment to the stomach. Even low dose shockwaves can affect a foetus so shockwaves should not even be used to treat cellulite in the absencs of a negative test for pregnancy. However, pregnancy is a relative contraindication as, for example, treatment to the ankle would be acceptable.
- Anti-coagulants and clotting disorders. As shockwave can (at high pressure or frequency) cause bleeding, patients in this group should be treated with caution. Tissue damage can occur, resulting in skin petechiae (pronounced clusters of red and purple lesions) and disruption of the microvasculature.
- Joint replacements. Shockwaves have, under certain settings, been used to loosen previously implanted joints in preparation for a new implant. If his is not the desired outcome then shockwaves are contraindicated. However, other settings have been found to encourage bone growth around implanted joints. So shockwave therapy would be acceptable if this is the goal but contraindicated if not.
- Infection. Research continues into the use of shockwaves at the site of an infection. As shockwave therapy can increase cell production this may be a negative effect where there is infection. However, encouraging the growth of healthy tissue also occurs so there could be potential uses for shockwave therapy in treating cysts.
- Malignant tumours. research is on-going on shockwave to cancerous tissue could encourage cell growth but may also destroy the tissue which could be beneficial. Research is on going.
- Corticosteroid injections. There is some evidence to suggest that as steroid injections temporarily weaken an area. Shockwave Therapy to the same site could cause more damage. General recommendations vary between waiting one month and six weeks before application of shockwaves to an area that has been injected with corticosteriods.
Specific Contraindications to Shockwave Therapy for ED
- As above, implanted cardiac stents, heart valves and pacemakers, specifically remain on the exclusion list.
- As above, the therapy is not suitable for anyone having an infection in the groin area as the effects of the treatment are as yet unknown in this context. In most cases, though, this would usually be a temporary condition.
- If you have been advised not to undertake sexual intercourse, eg, following a Myocardial infarction (heart attack) and/or cardiac surgery.
- If you suffer from nerve damage depriving you of penile sensation, shockwave therapy is unlikely to be beneficial until that issue is resolved.
- If you are considering shockwave therapy following previous prostate surgery, please obtain clearance from your Urologist/Andrologist prior to contacting the Harley Street Men’s Clinic.
- You are under 18.
Please note that assessment by an expert practitioner is always necessary. We know from experience there are certain treatments, conditions and individual histories that are likely respond better or worse to shock wave therapy for ED. However, as an ethical provider, we look at the safety first in every assessment.