Shockwave therapy is a multidisciplinary device used in orthopaedics, physiotherapy, sports medicine. Its main assets are fast pain relief and mobility restoration. Together with being a non-surgical therapy with no need for painkillers makes it an ideal therapy to speed up recovery and cure various indications causing acute or chronic pain.
MECHANISM OF ACTION
Shockwave is an acoustic wave which carries high energy to painful spotsand myoskeletal tissues with subacute, subchronic and chronic conditions. The energy promotes regeneration and reparative processes of the bones, tendons andother soft tissues. Shockwaves are characterized by jump change in pressure, high amplitude andnon-periodicity. The kinetic energy of the projectile, created by compressed air, is transferredto the transmitter at the end of the applicator and further into the tissue.
MEDICAL EFFECTS
Reversal of Chronic Inflammation
Chronic inflammation occurs when the inflammatory response is not completely halted. It can damage healthy tissue and results in chronic pain. Mast cells are one of the key components of the inflammatory process.Their activity may be increased by using pervasive acoustic waves. Mast cell activation is followed by the production of chemokines and cytokines. These pro-inflammatory compounds first enhance the inflammatory process and in the next step help restore normal healing and regenerative process.
Stimulation of Collagen Production The production of a sufficient amount of collagen is anecessary precondition for the repair processes of the damaged myoskeletal andligamentous structures. Shockwave therapy accelerates procollagen synthesis.The therapy forces the newly created collagen fibers into a longitudinalstructure which makes the newly formed tendon fibers more dense and stiff andcreates a firmer structure.
Dissolution of Calcified Fibroblasts
Calcium build-up is most often a result of micro-tears orother trauma to a tendon. Acoustic waves break up the existing calcifications.Shockwave therapy starts the biochemical decalcification of the calciumbuild-up of a toothpaste-like consistency and treats the tendon. The granularparticles of calcium are then removed by the lymphatic system.
Dispersion of Pain Mediator“Substance P”
Substance P is a neurotransmitter that mediates pain information through C-fibers. This neuropeptide is generally associated with intense, persistent and chronic pain. It relays pain messages to the central nervous system. Lowering the concentration of Substance P reduces the stimulation of afferent nociceptive fibers and thus reduces the pain.Decreasing Substance P, histamines and other nociceptive metabolites also helps inhibit development of inflammatory oedema. Acoustic waves generated by Shockwave therapy lower the Substance P concentration and trigger pain relief.
Release of Trigger Points
Trigger points are the principal cause of pain in the back,neck, shoulder and limbs. They are associated with palpable nodules in taut bands of muscle fibers and have extremely contracted sarcomeres. The dysfunctional sarcomeres contract so tightly that they begin to cut off their own blood supply. This causes the waste products to build up. Waste product build-up irritates the sensory nerve endings which then causes even more contraction. This vicious cycle is referred to as “metabolic crisis”. The assumed mechanism of action is that the delivered acoustic energy unblocks the calcium pump and thus reverses the metabolic crisis in the myofilaments and releases the trigger points.
INDICATIONS
Jumpers knee
Frozen shoulder
Supraspinatus Tendinopathy
Plantar Fascitis
Hip Pain
Tennis Elbow
Golfers Elbow
Iliotibial Band Sydrome
Medial Tibial Stress Syndrome
Low Back Pain
Neck Pain