Extracorporeal Shock Wave Therapy Immediately Affects Achilles Tendon Structure and Widespread Pressure Pain Thresholds in Healthy People

Abstract

Objective Extracorporeal shockwave therapy is a common clinical treatment for tendinopathy, yet negative effects on tendon structure have been shown in animal studies. This study aimed to investigate the effect of extracorporeal shockwave therapy in healthy participants (i.e., no Achilles tendon pain or pathology). Design This study examined the effect of three bouts of weekly extracorporeal shockwave therapy for 3 wks in 13 healthy participants. Outcomes measures assessed were as follows: (a) Achilles tendon structure, quantified using ultrasound tissue characterization (before and 3 hrs after extracorporeal shockwave therapy), (b) pressure pain thresholds, over the Achilles tendon and common extensor tendon origin (before, immediately after, and 3 hrs after extracorporeal shockwave therapy), and (c) hop pain (before and immediately after extracorporeal shockwave therapy). Results There was a significant reduction in echo type I (P < 0.05) and increase in echo type II (P < 0.05) at 3 hrs after the first extracorporeal shockwave therapy session that recovered to baseline levels before week 2. There were no significant changes in ultrasound tissue characterization echo pattern observed in subsequent sessions. There were increased pressure pain thresholds immediately after extracorporeal shockwave therapy at the common extensor tendon origin but no significant change at the Achilles tendon. Pressure pain thresholds returned to baseline at 3 hrs after extracorporeal shockwave therapy. There were no significant changes in pressure pain threshold in subsequent sessions. Conclusions Extracorporeal shockwave therapy resulted in transient changes to tendon structure and widespread hyperalgesia.

Line- and Point-Focused Extracorporeal Shock Wave Therapy for Achilles Tendinopathy: A Placebo-Controlled RCT Study

“…This might be based on a reversible subclinical tendon bundle damage, which turns into baseline at T2. 2,3,21 However, the monitoring capacity of UTC might be limited with inconclusive association between UTC echo types and clinical outcome. 29 The results of the present study need to be interpreted in light of the following limitations.…”

“…There are many theories 21 , 33 regarding the biological effect of ESWT like the activation of biological cascades through mechanical stimulation of shock waves, which may induce proliferation of tenocyte and collagen synthesis. Novel ultrasound imaging modalities evaluating tissue elasticity or providing semihistological information may help in a better understanding of the underlying mechanisms.…”

Effects of extracorporeal shock wave therapy combined with Wuqinxi exercise on cervical motor function in patients with subacute mechanical neck pain

“…34 The pain symptoms were more effective relieved Based on our results,the neck pain symptoms of the participants in the control group with ultrasound therapy was improved,but the assessment of the intervention group were superior to the control group.the immediate effect in the intervention group were signi cant,which may be due to the immediate effect of ESWT.Studies have shown that ESWT can increase the pain threshold of healthy people after one session, and last for 3 hours. 35 Luan S et alreported that the VAS of patients with neck pain decreased signi cantly after one session of ESWT,showing the same analgesic effect as Dry Needling. 36 Gezginaslan M conducted randomized controlled trials with 7 sessions of ESWT with an intensity of 0.26 mJ/mm 2 ,and found that the VAS and Pittsburgh Sleep Quality Index (PSQI) in the intervention group were better than traditional physical therapy.…”

PNF technique combined with extracorporeal shock wave in the treatment of hemiplegia caused by upper cervical perimedullary arteriovenous fistula embolization:clinical experience and review of literature

“…This may be because the extracorporeal shock wave is applied to the human body through high-frequency mechanical stress to improve the microcirculation of body tissues, separate high-density tissues, reduce muscle tension, and release adhesive tissues. [19][20] Meanwhile, studies have found that extracorporeal shock waves can stimulate the synthesis of NO and promote the normal conduction function of the nervous system. 21 Ernesto 22 applied extracorporeal shock wave to 12 children with lower extremity muscle spasms, modi ed Ashworth scale, passive range of motion (PROM), and plantar pressure measurement were performed on these children.…”