Shockwave therapy, also known as extracorporeal shockwave therapy (ESWT), is a non-invasive treatment modality that has been used for musculoskeletal conditions since the 1980s. Shockwave therapy delivers high-energy sound waves to the affected area, which stimulates the body's natural healing response and can alleviate pain, reduce inflammation, and promote tissue regeneration.
In this essay, I will discuss the mechanism of action of shockwave therapy, the different types of shockwave therapy, the evidence supporting its use for musculoskeletal conditions, and the potential risks and side effects.
Mechanism of action
The mechanism of action of shockwave therapy is not yet fully understood, but it is thought to work by stimulating the body's natural healing response. The high-energy sound waves delivered by the shockwave device cause microtrauma to the affected tissues, which triggers the release of growth factors and other signaling molecules that promote tissue regeneration and repair.
Shockwave therapy also appears to have an analgesic effect, possibly by inhibiting the transmission of pain signals or by releasing endorphins. In addition, shockwave therapy may reduce inflammation by decreasing the production of pro-inflammatory cytokines and increasing the production of anti-inflammatory cytokines.
Types of shockwave therapy
There are two main types of shockwave therapy: focused and radial. Focused shockwave therapy delivers high-energy sound waves to a specific point in the body, while radial shockwave therapy delivers lower-energy sound waves over a larger area.
Focused shockwave therapy is typically used for chronic tendinopathies, such as plantar fasciitis, Achilles tendinopathy, and tennis elbow. The shockwave device is positioned over the affected area and a series of high-energy sound waves are delivered directly to the damaged tissue.
Radial shockwave therapy is often used for musculoskeletal conditions that affect larger areas, such as myofascial pain syndrome and trigger points. The shockwave device is moved over the affected area, delivering a series of lower-energy sound waves to the tissue.
Evidence for shockwave therapy
The use of shockwave therapy for musculoskeletal conditions is supported by a growing body of evidence. Numerous randomized controlled trials (RCTs) have demonstrated the effectiveness of shockwave therapy for a variety of conditions, including plantar fasciitis, Achilles tendinopathy, tennis elbow, and myofascial pain syndrome.
A meta-analysis of RCTs on shockwave therapy for plantar fasciitis found that shockwave therapy was significantly more effective than placebo or conservative treatments, such as stretching and orthotics. The study also found that shockwave therapy had a lower risk of complications than surgery.
Another meta-analysis of RCTs on shockwave therapy for Achilles tendinopathy found that shockwave therapy was effective in reducing pain and improving function. The study concluded that shockwave therapy should be considered as a first-line treatment for Achilles tendinopathy.
RCTs on shockwave therapy for tennis elbow have also reported positive outcomes. A study published in the American Journal of Sports Medicine found that shockwave therapy was effective in reducing pain and improving grip strength in patients with tennis elbow. The study concluded that shockwave therapy should be considered as a treatment option for patients who have failed conservative treatments.
Shockwave therapy has also been shown to be effective for myofascial pain syndrome. A meta-analysis of RCTs on shockwave therapy for myofascial pain syndrome found that shockwave therapy was effective in reducing pain and improving function. The study concluded that shockwave therapy should be considered as a treatment option for myofascial pain syndrome.
In conclusion, Extracorporeal Shockwave Therapy (ESWT) is an evidence backed, effective treatment for many musculoskeletal complaints. It is non-invasive and safe treatment that can stimulate the body's natural healing of a wide array of soft tissue ailments.
