Shockwave Therapy

Extracorporeal Shockwave Therapy or (ESWT), is a new technology being used by rehabilitation therapists to treat many pain conditions.

From the first investigation of the application of shockwaves in medicine until today is a very short time. During the Second World War it was observed that the lung of castaways was cracked because of the explosion of water bombs although no outer symptoms of violence existed. This was the first time that the influence of shock waves, created by the exploding bombs, on tissue was observed. From 1968 to 1971 the interaction between shock waves and biological tissue in animals was investigated in Germany. The result was that high-energy shock waves cause effects in the organism over long distances. It was observed that shock waves create low side effects on the way through muscles, fat, and connective tissue.

These investigations lead to disintegrate kidney stones with extracorporeal generated shockwaves. An idea was born in 1971 by Haeusler and Kiefer, and today Shockwave is being used world wide for a very different purpose. It wasn’t until 1980 that the first patient with a kidney stone was treated in Munich Germany with a prototype, and not until the early 90's that the first reports about shock wave therapy was used on tendonitis.

How Does it Effect the tissue?

In essence, shockwave is a mechanical pressure and tension force on the afflicted tissue. This has been known to create an increase in cell membrane permeability, increasing microscopic circulation to the tissues and the metabolism within the treated tissues. Both of which promote healing and subsequent dissolution of pathological calcific deposits. The force that the shockwave creates breaks down deposits of calcification that are found in joints, soft tissues and spurs. It also has been shown to stimulate osteoblasts thus resulting in advanced healing of bones as well as fibroblasts for healing of connective tissue (tendon, ligaments and fascia)

How Does it effect Pain?

Shockwave will create a short term pain reduction through hyperstimulation anesthesia, where the nerves sending signals of pain to the brain are stimulated so much that their activity diminishes, this is usually short lived. However, over time it is believed to stimulate the "gate-control" theory. It is sometimes thought of as activation; a sort of "reset" button that recalibrates pain perception.

The Research

Multiple research documentations can be found on the effectiveness and safety of shockwave therapy. Such as pain reduction, improved healing on knee function with better results than placebo during a twelve week period. Wound healing acceleration through neovascularization and tissue regeneration is an indication for safe, reliable, cost-effective and clinically effective treatment option.

All publications agree that ESWT show high efficiency with very low complications and side effects.

In a German study, 32 patients with plantar fasciitis were examined. Some were treated with ESWT; some with placebo ESWT.

Results: In the ESWT group, 88% were pain free or had good results. In the placebo group, 0% were pain-free and 33% had good results.

Conclusion: "The results of this study corroborate the value of ESWT for recalcitrant plantar fasciitis. As a non invasive technique with low side effects, it can complement the row of conservative treatments."

In the treatment of persistent tennis elbow, plantar fasciitis, calcifying tendinitis, and pseudarthrosis, our data show that extracorporeal shock waves may provide analgesic, resorptive and osteo-inductive reactions with nearly no side effects.