Generally about shockwave
Shock wave treatment is a fast, effective, well-proven and scientifically documented treatment method. Since the early 1990s, shock wave has been used to treat, among other things, athletes in sports medicine or more generalized to orthopedics and prolonged or chronic pain syndromes. Shock wave therapy was developed in the early 1980s to disintegrate kidney stones with minimal impact on surrounding organs and soft tissue. Due to various side effects, which turned out to be positive, it was realized that it also had a desirable effect on musculoskeletal pain syndromes and orthopedic indications. Today, the list of what shockwave is used for, is long and there is research in both orthopedics, urology, gynecology, neurology and dermatology. The main focus of this site will be on musculoskeletal disorders.
When the treatment method was relatively young, it was mainly in sports medicine and international top athletes that one could get a shockwave treatment. Nowadays, both at recreational level and top athletes, as well as people with general musculoskeletal pain syndrome, are treated. The International Society of Medical Shockwave Treatment ( ISMST ) has chosen to call the following six indications for "standard indications" as these indications are well proven in research:
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Plantar fasciopathy also called Heel spur
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Achillestendinopathy
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Patellar tendinopathy or Jumper's knee
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Trochanteralgia
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Lateral epicondylopathy or tennis elbow
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Tendinitis Calcarea
Scientific explanation model
It can be said that shock wave improves the body's own ability to heal. In the past, it was believed that a micro fracture was created in for example a tendon attachment which triggered an acute inflammation and consequent healing. Today it is known that no damage is caused in the tissue and thus no inflammation as a result. However, what has been seen indicates that a number of different processes involved in healing and regeneration of e.g. tendon and muscle tissue or bone tissue are triggered by the shockwave.
An applicator creates shockwaves that are transported into the pain area. The shock wave is usually divided into either focused shockwave or radial. Both methods stimulate the tissue with high energy. With radial shock wave, which is the most common method, the effect reaches relatively superficial (about 3-4cm) and with the highest energy at the skin. Then the energy is dissipated into the tissue with a conical shape. Focused shockwave has a focal point where the energy is highest. This can be adjusted as needed and can reach anything from superficial structures down to a few decimeters.
The energy emitted by the shock wave can cause a denervation of non-myelinated C nerve fibers, which in turn results in reduction of chronic pain. A depletion of substance P has also been noted, which gives a pain-relieving effect. This while stimulating blood circulation. Furthermore, an activation of stem cells (such as osteoblasts) has been noted, which induces healing and releases growth factors. New formation of vessels in the treatment area is probably also a large part of the explanation for good results.
