Extracorporeal shock wave therapy (ESWT) is the transcutaneous application of high-energy acoustic waves to break down tissue or to promote healing and repair. Focused ESWT involves the application of acoustic waves transmitted in a narrow or focused pattern. First used in the early 1980s, this type of ESWT emerged as a noninvasive treatment known as lithotripsy to eliminate kidney stones. In the decades that followed the advent of lithotripsy, researchers began to examine other potential clinical applications for focused ESWT and another form of shock wave therapy known as radial ESWT. In contrast to focused ESWT, radial ESWT acoustic waves are transmitted in a more diffuse, radial pattern. The proposed therapeutic mechanisms of action for ESWT include neovascularization (new blood vessels), tissue regeneration, and reduction of inflammation. These effects are thought to be mediated by enhanced expression of vascular endothelial growth factor, endothelial nitric oxide synthase, and proliferating cell nuclear antigen. Upregulation of chemoattractant factors and recruitment/activation of stem/progenitor cells may also play a role. These are all functions of healing in scientific terms.
The evolving list of diagnoses for which ESWT shows potential includes:
- Shoulder tendinopathy,
- Lateral epicondylosis*/epicondylitis
- Greater trochanteric pain syndrome
- Hamstring tendinopathy
- Patellar tendinopathy
- Medial tibial stress syndrome
- Achilles tendinopathy
- Plantar fasciitis*
- Knee osteoarthritis
- Fracture nonunion
- Spasticity of spinal and supraspinal origin (stroke, brain injury, multiple sclerosis, cerebral palsy)
*Device approved by the FDA but not covered by most insurance plans. We use the Storz Medical Equipment device because it is the standard of care. A consultation and exam by the doctor is necessary to make sure patient's conditions are right for this therapy. Pacemakers are a contraindication for treatment above the waist and pregnancy is a contraindication for all conditions.