Benefits of Shockwave Therapy

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Benefits of Shockwave

Shockwave may sound like a new game or dance move, but it’s actually one of the most exciting new technologies for treating painful musculoskeletal conditions. Even chronic conditions that haven’t responded well to other therapies are often improved with shockwave therapy. Shockwave is non-invasive and won’t keep you off your feet, making it an ideal therapeutic option for active people.

Technically known as “extracorporeal shockwave therapy,” shockwave therapy (SWT) is based on the physical principles of high-pressure sound waves. The famous story of the opera singer whose high note breaks crystal is an example of the power of sound waves. Luckily, all we need to know about sound waves for this discussion is that they can affect the environment they pass through. Used therapeutically, SWT delivers sound waves that are calibrated to promote healing.

How exactly sound waves change cellular activity and cell-to-cell communication is still an area of active research, but we know that SWT causes cells to respond as if an acute injury had occurred, without actually causing an injury. After SWT, cells focus their energy on promoting healing in nearby tissue, including skin, muscle, and even bone. Cells also produce fewer pro-inflammatory compounds after SWT, which reduces pain and swelling.

Types of Shockwave Therapy

There are two general types of shockwave therapy that have unique benefits for different conditions:

Focused SWT
- This type of therapy uses true acoustic shockwaves (soundwaves that move faster than sound) to target deeper muscle and bone. As the name implies, focused SWT is focused on a specific location under the skin. Just like in an amphitheater, sound waves can be strategically reflected for maximal effect, and focused shockwaves can be targeted very precisely.
Radial SWT
- Technically, this type of therapy isn’t “shockwave” therapy because the sound waves aren’t intense enough. However, even though it’s more appropriately known as radial pressure wave therapy, it is generally called radial SWT. Radial SWT uses less intense sound waves, so they can’t travel as far through tissue. This means they’re better for treating superficial conditions, like chronic lower back pain, some tendinopathies, and skin conditions.

Recent technological advancements have made combined focused and radial shockwave treatments available, and preliminary data suggests that the combination may be more effective than either treatment on its own.

An SWT machine is similar to an ultrasound machine, but they produce different types of waves. Like an ultrasound machine, SWT is non-invasive, and is performed using a hand-held wand and ultrasonic jelly. No needles, numbing agents, or drugs are used in SWT, and most people can return to their normal routine the same day.

In addition, SWT is incredibly safe. According to the FDA, in one clinical study of 172 people who received SWT for plantar fasciitis, only two people reported bruising and one person reported mild local swelling. No other complaints or complications were reported. Other studies have found similar levels of safety.

Applications of shockwave

The FDA has approved SWT for lateral epicondylopathy (tennis elbow) and plantar fasciitis (heel pain), but SWT has proven to be very beneficial for several other painful musculoskeletal conditions, including:

Calcifying tendinopathy of the shoulder (often related to rotator cuff injuries)
Carpal tunnel syndrome
Greater trochanter pain syndrome (lateral hip/glute pain)
Patellar tendinopathy (jumper's knee)
Achilles tendinopathy (pain in the tendon connecting your heel to your calf)
Bone nonunion (broken bones that aren’t healing properly)
Stress fractures
Lower back pain

The ability of SWT to heal bone is particularly noteworthy. Stress fractures are common in athletes and managing them can be very frustrating. SWT actually stimulates osteogenesis, or new bone development, so bones heal more quickly and with increased strength and density, reducing the risk for recurrence. SWT also promotes neovascularization, or new blood vessel development, which improves blood flow to tissue and increases metabolism.

The pro-healing effects of SWT are accompanied by anti-pain and anti-inflammation effects. Although the precise mechanisms aren’t clear, SWT reduces the amounts of two important pain signaling molecules: substance P (SP) and calcitonin gene-related peptide (CGRP). SWT may also directly affect the structure and/or function of specialized nerve cells that transmit pain signals to the brain, causing an overall reduction in pain sensation.

The ability of SWT to reduce pain and inflammation and speed healing has led to its use in acute injury care, particularly in burns and lacerations. SWT is equally beneficial for improving healing in chronic skin wounds that haven’t responded to conventional treatments (e.g. diabetic ulcers).

Chronic conditions that are caused by central nervous system dysfunction can also benefit from SWT. Clinical studies have shown that pain associated with postherpetic neuralgia is reduced after SWT, as is post-stroke muscle spasticity.

The benefits of SWT continue to be identified, and current research is evaluating SWT as a way to regenerate cardiac tissue in people who have had a heart attack. SWT is also a promising treatment for reducing pain associated with complex regional pain syndrome. SWT is even being employed in dermatology clinics for its ability to tighten and rejuvenate delicate facial skin.

Sports medicine specialists were early adopters of SWT, and their patients are infamous for being impatient with recovery. The consistently impressive results that SWT delivered to professional and elite athletes has led to its widespread adoption in the related fields of physiotherapy and interventional pain medicine.

Many specialists are now recommending that their patients try SWT before surgery. In addition, since it’s a non-invasive and non-pharmacological treatment, SWT can augment therapies like corticosteroid injections and regenerative therapies like platelet-rich plasma.