Extracorporeal Shockwave Therapy

ESWT - (Extracorporeal Shock Wave Therapy)

Observations made during World War II revealed that lung damage caused by the detonation of hydrogen bombs was not accompanied by any signs of external injuries. In other words, shock waves were able to travel to inner organs and tissue without causing major damage to connecting tissue, fat or muscles.

Based on a study commissioned by Germany’s Ministry of Defense to examine the effects of shock waves on biological tissue, the first touch-free in vitro fragmentation of kidney stones in a patient was used in 1980. It became the treatment of choice for renal and urethral calculi in the past two decades. Meanwhile the number of indications has increased to include gallstones as well as pancreatic and salivary duct stones.

The potential of using ESWT to fragment bone tissue and to alleviate pain was soon extended to the musculoskeletal system. Even though very different from kidney stones in terms of composition and structure, calcium deposits could respond favorably to the disintegrating effect of shock waves for the treatment of tendonitis calcarea of the shoulder. When lasting analgesia of the treated region was observed in the first applications, shock waves were also used for pain therapy, first in epicondylitis, then in other chronic insertion enthesiopathies.

Many traditional therapies – such as anti-inflammatory medications, steroid injections, physiotherapy, massage, acupuncture – can assist the body during the early, acute phase of an injury. But they are much less effective in helping the body to heal when an injury becomes chronic. ESWT is one of the very few technologies in any field of medicine that seems to work best when an injury reaches the chronic, non-healing state.

The Facts

the years clinical studies have brought evidence of ESWT’s efficacy in the three most common indications: epicondylitis humeri radialis, tendonitis calcarea and plantar fasciitis. But a number of scientists have also found ESWT to be effective to treat a series of other indications such as chronic wounds and infections as well as enthesiopathies such as patella tendon syndrome and chronic Achilles tendonitis. In certain studies, ESWT showed they could be effective in treatment of bone non-unions. Difficulties of protocols make these indications accessory.

ESWT is a compelling non-invasive treatment option for an expanding variety of musculoskeletal conditions that have failed to respond to conservative treatment, even in cases where surgery used to be the only option to combat pain and limited mobility. ESWT uses technology similar to lithotripsy in an attempt to relieve musculoskeletal symptoms in the affected area. By stimulating blood flow and reducing inflammation while interfering with the transmission of pain signals, ESWT has been found to alleviate pain, promote neovascularization and contribute to the formation of new bone tissue.

ESWT has been found to bring relief in most patients with just a few short treatment sessions, even in patients suffering from chronic pain. Two-thirds of plantar fasciopathy patients, for example, report significant relief from daily pain after just 12 weeks, 81 percent after 52 weeks, 94 percent no longer suffer from nighttime pain after just 12 weeks. 

More than 80 percent of treating physicians evaluate ESWT as good or very good.