An experimental study on the application of extracorporeal shock waves in the treatment of tendon injuries: preliminary report

Electrohydraulic High-Energy Shock-Wave Treatment for Chronic Plantar Fasciitis

“…Several musculoskeletal entities that have been treated include calcific tendinitis of the shoulder, lateral epicondylitis, delayed union and nonunion of fractures, chronic plantar fasciitis, Achilles and patellar tendinopathies, and osteonecrosis of the femoral head [1][2][3][4][5][6][7][8][9] . Basic-science studies increasingly are providing an understanding of the physiologic mechanisms of pain relief (often immediate) and the modification and repair of the target tissue, which usually requires weeks to months to occur [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] . Extracorporeal shock-wave treatments have been applied to patients with chronic plantar fasciitis who have failed to respond to multiple conservative pharmacologic and therapeutic interventions [29][30][31][32][33][34][35][36][37][38] .…”

J. Leonard Goldner Award 2008: Effect of Extracorporeal Shock Wave Therapy on Cultured Tenocytes

“…6 There are several theories for explaining the mechanism of shock wave effect in various cells and tissues. 4,12 The mechanism of action possibly includes direct stimulation of the healing process, production of microcavitations, neovascularization, destruction of calcium, and neural effects. On the molecular level, these mechanisms may involve alterations in the permeability of cell membranes, which may prevent development of action potentials that transmit painful stimuli.…”

Extracorporeal shock-wave therapy in the management of chronic soft-tissue conditions

“…20 Most of the observed changes with the use of ESWT in man have been observed on examination of non-musculo- skeletal tissues, particularly the kidney, and most of the information available on the effects on musculoskeletal tissues is based on animal studies. [21][22][23] Studies of the effect of shock waves on tendo Achillis of the rabbit have indicated a dose-dependent effect, a transient inflammatory reaction and swelling of the tendon with 1000 impulses of higher (0.28 mJ/mm 2 ) but not lower (0.08 mJ/mm 2 ) doses. 24 Fibrinoid necrosis, paratenon fibrosis and marked inflammatory changes were seen with even higher doses (0.60 mJ/ mm 2 ).…”