The National Institute for Health and Care Excellence (NICE) issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on 26 November 2003. NICE is currently updating this guidance. The new guidance will be published shortly. Until then the NHS should continue to follow the recommendations outlined in the current version of the guidance. The Interventional Procedures Advisory Committee (IPAC) will consider this procedure review and NICE will issue an interventional procedures consultation document about its safety and efficacy for 4 weeks’ public consultation. IPAC will then review the consultation document in the light of comments received and produce a final interventional procedures document, which will be considered by NICE before guidance is issued to the NHS in England, Wales, Scotland and Northern Ireland.
Status In progress
Process IP
ID number 148
Description Extracorporeal shockwave therapy (EWST) is a non-invasive treatment in which a device is used to pass controlled, short-duration acoustic shockwaves (low or high energy single-pulsed or sonic waves) through the skin to the affected area (target zone) to produce transient pressure disturbances, which fragment/break up calcium deposits. Ultrasound guidance can be used to assist with positioning of the device. Extracorporeal shockwave therapy may be applied in one or several sessions. Local anaesthesia may be used because high-energy ESWT can be painful. Different energies can be used and there is evidence that local anaesthesia may influence the outcome of ESWT. There is no standard treatment regimen. The mechanism by which this therapy might have an effect on tendinopathy is unknown.

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For further information on how we develop guidance, please see our page about NICE interventional procedures guidance