shock wave therapy

Shock wave therapy is a non-invasive therapy that is used by many disciplines (i.e. chiropractic, physiotherapy, orthopaedics, sports medicine etc.) to accelerate healing in various acute and/or chronic pain conditions. The main benefit of shock wave therapy is its ability to reduce pain rapidly and promote healing.

How does it work?

Shock wave therapy or Extracorporeal Shock Wave Therapy (ESWT) utilises a device that generates shock waves (acoustic pressure pulses) generated by an air compressor. A projectile in the handpiece is accelerated at high speed by means of precisely controlled bursts of compressed air. When the projectile strikes the applicator inside the handpiece, its kinetic energy is converted into mechanical energy. The energy that is produced is then transmitted through soft tissues of the body resulting in physiological changes to the treated area. Following a thorough assessment and diagnosis by a trained professional the handpiece is strategically placed on the body of a recipient and treatment commences.

Medical Effects

Acoustic waves used in shock wave therapy interact with tissues causing biochemical and physiological effects including accelerated tissue repair, tissue remodelling, cell growth, analgesia and mobility restoration.

New Blood Vessel Formation (Angiogenesis)

Blood contains nutrients which are necessary for repair and remodelling of damaged soft tissues. The application of shock waves creates micro-ruptures of tiny blood vessels (capillaries) in soft tissues. Due to micro-ruptures, the expression of growth factors is significantly increased, which leads to the formation of new blood vessels.

The new blood vessels improve blood supply to the treated area, which in turn improves the body’s ability to heal and eliminate waste products.  

Reversal of Chronic Inflammation

The human body normally has a certain amount of inflammation even in the healthiest of individuals. Inflammation is a necessary response for healing. When a tissue is damaged, the tissues release chemicals that trigger a localised inflammatory response, which in turn attract the repairmen (leukocytes) of the body to the site. Once the repairmen have completed their work (laid down new tissues and removed the old damaged tissues), the inflammation in the area should return to normal levels. However, for some individuals the body will maintain a high inflammation level in the area of injury, and the repair job is never completed, this is what is termed ‘chronic inflammation’. With chronic inflammation the injured area remains swollen and painful for an extended period of time. This results in  damage to healthy tissue and chronic pain due to central sensitisation. Mast cells (leukocytes) are a key component in the reduction of the inflammatory process. Their activity may be increased with shock wave therapy.

Stimulation of Collagen Production

The production of a sufficient amount of collagen in the body is necessary for the repair and remodelling processes of damaged soft tissues. Shock wave therapy accelerates procollagen synthesis. The treatment forces the newly created collagen fibres into alignment, which makes the newly formed tendon fibres denser and stiffer, thus creating a more resilient tissue.   

Breaks Down Calcium Build-up in Tissues

Calcium build-up is often due to micro-tears or other such trauma to a tendon. Shock waves can break up existing calcifications within soft tissues of the body. Shock wave therapy triggers a biochemical process in calcified tissues that leads to the breakdown of calcium and restoration of normal function and elasticity of the treated tissue. The granular particles of calcium are then removed by the lymphatic system and excreted by the body.

Dispersion of Pain Mediator “Substance P”

Substance P is a neuropeptide that mediates pain information through pain sensitive nerves (C-fibres). Substance P is generally associated with intense, persistent and chronic pain. It relays pain messages to the central nervous system. Lowering the concentration of Substance P reduces the stimulation of C-fibres and hence reduces pain. Decreasing Substance P, histamines and other nociceptive metabolites also helps reduce inflammatory oedema (swelling). Shock wave therapy helps to lower Substance P concentration in the treatment area and results in a local analgesic effect which provides pain relief.

Release of Trigger Points

Trigger points are a main cause of musculoskeletal pain in the back, neck, and limbs. Trigger points are palpable nodules in taut bands of muscle fibres (feels like a marble under the skin). The dysfunctional muscle fibre (sarcomeres) contract so tightly that they begin to cut off their own blood supply. This causes local waste products to build up. Waste product build-up irritates the sensory nerve endings which then causes further contraction. This vicious cycle is referred to as “metabolic crisis”. The theory is that the delivered energy unblocks the calcium pump and thus reverses the metabolic crisis in the muscle fibre and releases the trigger points.

For more information regarding shock wave therapy including indications and contraindications please refer to our FAQ section of the website.