Extracorporeal Shock Wave Therapy

Abstract

The use of shock waves and radial pressure waves generated outside the patient’s body and delivered to the affected region to trigger the body’s mechanisms to initiate natural healing, called extracorporeal shock wave therapy (ESWT) is gaining worldwide recognition and the list of indications is increasing. ESWT is often considered when easier treatment modalities have failed. Many companies offer shock wave sources that use ballistic, electrohydraulic, electromagnetic, or piezoelectric transducers to generate either shock waves or radial pressure waves. Nevertheless, more research is still needed because the cellular and molecular working mechanisms for most ESWT modalities are not fully understood. In many applications evidence is still inconclusive, mainly due to short follow-up times, small sample sizes, different parameters and equipment used, subjective scores, and lack of treatment blinding. This chapter describes some representative ESWT devices and briefly covers results of clinical applications, such as pain relief therapy, and ESWT for patients suffering from plantar fasciitis, calcaneal spur, Achilles tendinopathy, tendinopathy of the shoulder, tennis elbow, patellar tendinopathy, spasticity, chronic pelvic pain syndrome, Peyronie’s disease, and erectile dysfunction. Comments on articles reporting bone and wound healing, treatments in dermatology, acupuncture, as well as ESWT to treat heart diseases are also included. A brief section of ESWT in veterinary medicine describes that devices designed to treat indications such as stress fractures, osteoarthritis, and injuries in tendons and ligaments of horses have been on the market for many years.