Shockwave therapy was developed in Germany during the late 1960s. They began studying the effects of shockwaves on different body tissues. Initial clinical use of shockwave therapy was lithotripsy. This is a procedure developed in the 1980 to shatter kidney stones making them easier to pass. Then, shockwave therapy was introduced into cardiology to break apart calcified plaque in the coronary arteries.
In the 1990s, scientists began to study the effects of high energy shockwave therapy on the soft tissues. They found the shockwaves increased circulation around the injured soft tissues, and this stimulated cells to begin the regenerative process. Shockwave also overstimulated the nerves in the area of treatment, and this decreased the pain.
Shockwave therapy has undergone extensive research and is approved by the FDA. The research has shown that the mechanical pressure waves generated by the shockwave machine, when applied to the body tissues promotes healing. This occurs by stimulating blood flow to the tissues. The shockwaves mimic the forces experienced during a trauma and subsequently promote the healing cascade of the body.
This therapy enhances circulation and is excellent in musculoskeletal injuries where blood is not as prevalent such as tendons or ligaments. In these regions, the soundwaves stimulate collagen synthesis and release growth factors from the tissues to generate the healing process.
Common Injuries Treated with Shockwave Therapy
- Achilles Tendinopathy
- Bursitis of the Hip
- Tennis and Golfers Elbow
- Tendonitis of the Foot, Ankle Hip Shoulder
- Hamstring Strain
- Shin Splints
- Rotator Cuff Injuries Frozen Shoulder Plantar Fasciitis
- Osteoarthritis Hips, Shoulders Knees
- Stress Fractures or Non-Healing Fractures
- Overuse Injuries
Contraindication to Shockwave Therapy
- Use over major blood vessels and nerves.
- Pacemakers or implanted devices
- Open wounds
- Joint replacements
- Blood clotting disorders
- Complete rupture of tendons
- Blood thinners
- Brain or Lung areas
How Do Shockwaves Work?
- Shockwaves have a direct effect on local nerve endings resulting in decreased pain. The local nerve endings are overwhelmed that the activity decreases resulting in immediate pain reduction. The long-term pain reduction is a gate control mechanism where the nerves are basically recalibrated to overall pain perception and the result is long term pain control.
- Mechanical forces on the tissue from the wave has been shown to increase cell membrane permeability increasing the microcirculation and metabolism.
- The cavitation bubble is a result of the pressure wave in front of it. When these bubble collapse at the target ,the force has an impact on the tissue. This force breaks down calcific deposits.
- Shockwaves stimulate osteoblasts and are responsible for new bone production.
- Shockwaves stimulate fibroblasts that are responsible for healing connective tissues.
- Shockwaves promote neovascularization.
- Shockwaves stimulate the proliferation of tenocytes and osteoprogenitor differentiation, increase leukocyte infiltration, amplify growth factor and protein synthesis to stimulate collagen synthesis and tissue remodeling.
- Shockwaves disrupt and remodel plaques.
- Shockwaves generate a local inflammatory response with increased macrophage activity.
There are currently 3193 studies and articles on PubMed concerning the use of extra corporeal shockwave therapy for a myriad of treatment modalities in a vast number of medical conditions. Below is a few of the studies.
- Efficacy and Safety of Extracorporeal Shockwave Therapy in Chronic Low Back Pain: A Systematic Review and Meta-Analysis of 632 Patients
J Orthop Surg Res. 2023 Jun 24;18(1):455 PMID 37355623
Background: Extracorporeal shockwave therapy has been widely used for pain control in musculoskeletal disorders. Whether ESWT can relieve chronic low back pain and improve lumbar function is still unclear. We conducted a meta-analysis of relevant studies to comprehensively analyze and determine the efficacy and safety of ESWT for chronic low back pain.
Conclusion: This systematic review and meta-analysis found that ESWT provided better pain relief and improved lumbar dysfunction compared with the other interventions included and no serious adverse effects were found. We suggest that ESWT is effective and safe for treating chronic low back pain.
J Family Reprod Health 2023 Jun;17(2):93-99 PMID 37547776
Objective: Erectile Dysfunction is a common cause of sexual disorders in men with limited treatment options. This study aimed to determine the efficacy of low intensity extra corporeal shockwave therapy in patients suffering from ED.
Conclusion: The study showed efficacy of ESWT in a subset of patients with ED. After the treatment, no patients were found to have severe ED and only a few had moderate ED (9.7%) During the pretest, 9.7% had severe ED and 51.6% had moderate ED.
- The Effectiveness of Extracorporeal Shockwave Therapy for Midportion Achilles Tendinopathy: A Systemic Review Cureus 2022 Jul 18;14(7):e26960. PMID 35989757
Purpose: Achilles tendinopathy is one of the most common lower limb injuries in both athletes and the general population. Despite the plethora of conservative treatment options available for the management of Achilles Tendinopathy, as many as one in four patients will go on to require surgery. Extracorporeal Shockwave Therapy has emerged as a promising treatment option and has been successful in the management of other common musculoskeletal injuries such as plantar fasciitis. The aim of this systematic review was to evaluate the current evidence for the use of ESWT in the management of midportion Achilles tendinopathy.
Conclusion: There was consistent evidence that ESWT is a safe and effective modality for treating midportion Achilles tendinopathy as it reduces pain and improves function.
- Extracorporeal Shockwave Therapy for Foot and Ankle Disorders: A Systematic Review and Meta- Analysis
J Am Podiatr Med Assoc 2022 May-Jun; 112(3):18-191 PMID 34878537
Background: Extracorporeal Shockwave Therapy was first introduced into clinical practice in 1982 and has been a beneficial inclusion to the noninvasive treatment option of numerous orthopedic pathologies. However, clinical evidence of the use of ESWT for various foot and
ankle disorders has been limited. Therefore, the purpose of this study is to systematically review the literature to provide a critical evaluation and meta-analysis for the use of ESWT in foot and ankle disorders.
Conclusion: The current evidence has suggested that ESWT can provide symptomatic benefit to plantar fasciitis treatment with unremarkable side effects. Although analysis of the evidence has indicated ESWT can help manage plantar fasciitis, calcaneal spur, Achilles tendinopathy and Morton’s neuroma, more well defined studies are warranted to soundly and safely support its current use.
- Comparison of Extracorporeal Shock Wave Therapy and Ultrasound Guided Shoulder Injection Therapy in Patients with Supraspinatus Tendinitis
Clin Orthop Surg 2022 Dec;14(4):585-592 PMID 36518938
Background: The present study compared the clinical effect of extracorporeal shock wave therapy with that of ultrasound guided shoulder steroid injection therapy in patients with supraspinatus tendinitis. We hypothesized that the two treatments would show comparable results.
Conclusions: US guided shoulder injection therapy was not superior to ESWT therapy. Considering the complications and rebound phenomenon of steroid injections, interventions using ESWT may be a good alternative to treat patients with supraspinatus tendinitis.
- Impact of Soft Tissue Around the Knee on the Efficacy of Extracorporeal Shockwave Therapy in Knee Osteoarthritis
Medicine (Baltimore) 2022 Dec 16;101(50): e32334 PMID 36550919
Purpose: Knee osteoarthritis is the leading cause of knee pain in middle aged and older individuals. Extracorporeal shockwave therapy has been applied to treat patients with KOA to reduce pain and improve function.
Conclusion: ESWT can alleviate pain and improve knee function in patients with KOA and the soft tissue around the knee joint should also be an important reference factor in KOA treatment.
Juventix Regenerative Medical is an industry leader in the regenerative medical field.
Juventix is proud to announce our collaboration with Oceanus Medical Systems of Largo, Florida. We are pleased to offer,” The PhysioPro System”.
The PhysioPro System is a clinical grade shockwave therapy system to induce intracellular and extracellular reactions to assist in the healing and regeneration of soft tissue.
This system is FDA approved and easy to use with preprogrammed therapy protocols. The system is portable, light weight and has three applicators for different depths of treatments. The preset treatment protocols provide varied therapeutic applications for a multiple of musculoskeletal problems.
Juventix is also pleased to introduce the Fluent EDX shockwave system for erectile dysfunction. This is a compact, user-friendly, in-home device that provides a therapy solution for ED. This handheld system induces capillary regeneration and promotes increased blood flow into the corpus cavernosum of the penis. This targets the main cause of ED by producing low intensity and penetrating shockwaves. The EDX also has adjustable frequencies for moderate cases of ED and is also effective in the breakdown of plaque in cases of Peyronies Disease.
RESTORE, REVIVE, REGENERATE- JUVENTIX REGENERATIVE MEDICAL
Dr. Robert McGrath