Post-stroke spasticity, often shortened to PSS, is one of the most common complications I see in patients after a stroke. Spasticity happens when the brain’s control over muscle activity is disrupted.
This leads to stiffness, resistance to movement, and in some cases, joints that feel locked in place. Because of this, even very simple tasks, such as opening your hand, becomes difficult and painful.
Studies have found that spasticity occurs in anywhere from 19% of stroke survivors (Sommerfeld et al., 2004) to as high as 92% (Malhotra et al., 2011). Other research estimates it affects about 38% of people in the first year following a stroke (Watkins et al., 2002).
That’s why I want to talk about a treatment that is showing promise in stroke rehabilitation shockwave therapy.
What Is Shockwave Therapy?
Shockwave therapy, sometimes called extracorporeal shockwave therapy (ESWT), is a non-invasive treatment that uses acoustic waves to break down calcified trigger points in muscles, tendons, and soft tissue. These waves set off biological responses such as improving blood circulation in the affected area.
There are two main types of ESWT. Focused shockwave therapy delivers energy deeper into the tissue and is often used when we need to reach specific structures below the surface.
Radial shockwave therapy, on the other hand, spreads out more broadly and affects shallower tissues, making it useful for larger surface areas.
In my clinic, I use the Intelect® RPW 2 system. This device allows me to deliver shockwaves with precision and adjust the intensity based on your comfort and treatment goals. A session lasts just 10 minutes.
What Research Says About Shockwave Therapy For Post Stroke Spasticity
Most upper limb spasms after a stroke are flexor spasms, which make it difficult to use the arm and hands. Severe spasms can even cause shoulder pain or shoulder-hand syndrome. Researchers have been studying shockwave therapy as a way to ease this problem.
One of the earliest studies was done in 2005 by Manganotti. They treated 20 stroke patients with upper limb spasticity, applying 1,500 shockwave pulses to the forearm flexor muscles and 3,200 pulses to the hand muscles at a low energy setting.
The results showed that muscle tension in the wrist and finger flexors dropped immediately after treatment, and the improvement lasted up to 12 weeks, especially in the finger muscles. Importantly, there were no harmful effects reported during the study.
Other clinical studies confirm that ESWT can reduce muscle tone in the shoulder, elbow, wrist, and fingers. For example:
- Troncati et al. found improvements in spasm and joint motion that lasted up to 6 months after treatment in hemiplegic patients.
- Li et al. showed that shockwaves applied to both agonist and antagonist muscles could relieve spasticity and pain for at least 4 weeks.
- Other smaller studies showed improvements in wrist and finger spasm using the Modified Ashworth Scale, with benefits lasting up to 3 months.
Taken together, this research shows that ESWT is effective at lowering spasticity in the upper limb after a stroke. The improvements often last weeks to months, and in some cases up to half a year.
Final Thoughts
I tell my patients to think of ESWT as one tool in the toolbox. To get the best results, it should be combined with other treatments such as chiropractic adjustments and therapeutic exercises.
In my clinic at Wheat Ridge, CO I’ve seen how adding shockwave therapy into a care plan can help patients recover better post stroke.
Schedule your first visit today or Call (720) 573-4910 and take advantage of our $97 New Patient Special, which includes a full consultation, x-rays, and a Doctor’s finding.
FAQs About Shockwave Therapy
Does shockwave therapy really help with spasticity after a stroke?
Yes. Multiple studies have shown that ESWT can reduce muscle tone in the upper limbs after a stroke. Patients often report that their arm or hand feels looser and easier to move. While it’s not a cure, it can make daily tasks less painful and more manageable.
How many sessions of shockwave therapy are needed for spasticity?
Most patients need between 3 and 6 sessions, spaced out over several weeks. Each session lasts about 10 to 20 minutes. The exact number depends on the severity of spasticity and how your muscles respond to treatment.
How long do the effects of shockwave therapy last for spasticity?
Research shows improvements can last from a few weeks to several months. In some studies, benefits continued for up to 6 months. To maintain progress, sessions are combined with exercise and chiropractic adjustments.