Application of shock waves to rat skin decreases calcitonin gene-related peptide immunoreactivity in dorsal root ganglion neurons

Repetitive low‐energy shock wave application without local anesthesia is more efficient than repetitive low‐energy shock wave application with local anesthesia in the treatment of chronic plantar fasciitis

“…When repeating shock wave application after 14 days in another experiment, the same authors described delay of reinnervation for as long as 42 days, significantly longer than after single shock wave application [54]. Takahashi et al [53] investigated the analgesic properties of lowenergy shock wave application (1000 impulses, EFD = 0.08 mJ/mm2). They analyzed changes in CGRP-immunoreactive (ir) neurons in the dorsal root ganglion (DRG).…”

“…These studies [32,33,37,53,54] indicate that shock waves may selectively lead to dysfunction of peripheral sensory unmyelinated nerve fibers without affecting nerve fibers responsible for motor function (large myeh a t e d fibers). For high-energy treatment, this selective destruction of unmyelinated sensory nerve fibers within the focal zone of ESWT may contribute to clinically evident long-term analgesia.…”

“…Use of a local anesthetic has been shown to alter local release of neuropeptides [5,29,39,49]. This alteration may well interfere with the neurogenic inflammatory response supposed to be provoked by low-energy shock wave application in animal experiments [37,53,54]. Use of local anesthesia has also been shown to be associated with a reduction of the local hyperemic response on neurogenic inflammation [ 131 which on its part may interfere with the production of neo-vessels and release of angiogenesis-related markers after low-energy ESWT [60].…”

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] .…”

Radial shock waves effectively introduced NF‐kappa B decoy into rat achilles tendon cells in vitro

“…14,15 Furthermore, it is reported that shock wave exposure to rat-footpad caused the degeneration and reinnervation of sensory nerve fibers innervating the skin 16 and decreased CGRP immunoreactivity in the dorsal root ganglion neurons. 17 The results of these reports indicate that the shock wave treatment functions on the tenocytes to stimulate tissue repair and also functions on the free nerve endings to inhibit neurogenic inflammation in chronic tendinopathy. However, there are few reports showing the effect of shock waves on the chemical inflammation that is related to the development of tendinopathy.…”