Best practices for extracorporeal shockwave therapy in musculoskeletal medicine: Clinical application and training consideration

Treatment of interspinous pain with extracorporeal shockwave therapy: a case report

“…Varying procedure protocols for ESWT have been reported in the literature for other conditions. 7 Nonetheless, the degree of improvement achieved using the ESWT procedure protocols in this case highlights a potentially effective and noninvasive treatment approach to interspinous-related LBP. Further work should include prospective studies aimed at determining the most efficient ESWT protocol, as well as the duration of benefits gained after ESWT for interspinous-related LBP.…”

“…Extracorporeal shockwave therapy works by stimulating collagen production and vascularization in the targeted region, which in turn leads to increased regeneration and tissue healing. 5,7 Studies in animals have shown neovascularization and upregulation of angiogenic and osteogenic growth factors at tendon-bone junctions 10 ; it is thought that ESWT may be more effective at these junction sites or entheses. Extracorporeal shockwave therapy can also provide patients with some degree of immediate pain relief, due to hyperstimulation analgesia and the degeneration of nerve fibers from small immunoreactive neurons.…”

“…5,6 Extracorporeal shockwave therapy is noninvasive and typically entails a varying number of consecutive treatment sessions to achieve maximum relief. 5,7 However, its use for interspinous pain has not been reported in the literature.…”

Utilizing Extracorporeal Shockwave Therapy for in-Season Athletes

“…R-SWT generates pressure waves that reach lower speeds and have lower peak pressure and therefore work on more superficial structures. On the other hand, F-SWT has the capacity to achieve deeper penetration from the site of application [ 11 ]. While both forms of ESWT have been used to treat a variety of conditions, the differences in their mechanistic effects may lead to different outcomes for a given condition.…”

“…ESWT has been shown to be effective in common athletic injuries, including plantar fasciitis [ 12 ], Achilles tendinopathy [ 13 ], medial tibial stress syndrome [ 14 ], and proximal hamstring tendinopathy [ 15 ]. Some of the potential side effects include post-procedural pain, skin erythema, skin bruising, hematoma formation, nerve irritation, and superficial edema [ 11 ]. ESWT has been known to be effective for the longitudinal management of musculoskeletal injuries and has a favorable safety profile, with recent work suggesting feasibility to support utilization of treatment in the care of in-season athletes.…”