Shockwave therapy has emerged as a valuable non-invasive modality, with an absence of surgical risks.
Shockwave Technology in orthopedics
In the complex world of orthopedic care, while surgical interventions remain a mainstay, the potential of adjuvant therapies such as Shockwave Therapy is recognized as complementary tool that enhances the continuum of care. Shockwave, as an adjunctive modality, is grounded in research, works in tandem with primary treatments to optimize healing, pain management, and rehabilitation, enriching the holistic approach of orthopedic practice.
While fracture healing remains a documented benefit of Shockwave Therapy, a considerable volume of orthopedic research has pivoted towards its application in managing tendinopathies, fasciopathies, and other soft tissue ailments of both the upper and lower extremities. Shockwave therapy’s benefits have been observed in numerous orthopedic conditions. Over 256 studies have shown the benefits of Shockwave Therapy in Orthopedic Practice.
Central to its healing mechanism is its capacity to:
Encourage neovascularization at the tendon-bone junction.
Stimulate tenocyte proliferation and osteoprogenitor differentiation.
Intensify leukocyte infiltration.
Enhance growth factor and protein synthesis, thereby driving collagen production and tissue remodeling.
The Following Effects have been Investigated and Confirmed:
Angiogenesis Promotion: Shockwave Therapy has been demonstrated to influence angiogenesis by modulating various factors, including:
Von Willebrand factor (vWF)
Vascular endothelial growth factor (VEGF)
Endothelial nitric oxide synthase (eNOS)
Proliferating cell nuclear antigen (PCNA)
Anti-inflammatory Effects: The treatment showcases powerful anti-inflammatory properties, modulating molecules like:
Soluble intercellular adhesion molecule 1 (sICAM)
Soluble vascular cell adhesion molecule 1 (sVCAM)
Wound Healing: Shockwave Therapy accelerates wound healing, influenced by factors such as Wnt3, Wnt5a, and β-catenin,
Bone Healing and bone recovery 2 (Moya) through factors like:
Bone morphogenetic protein (BMP)
Stimulation of tenocyte proliferation and osteoprogenitor differentiation
Dickkopf-related protein 1 (DKK-1)
Insulin-like growth factor (IGF)
Regenerative Properties: Apart from promoting functional proteins that foster a chondroprotective effect, shockwave therapy aids in:
Tissue and nerve regeneration 1(Wang)
1Dr. C.J. Wang FS Shockwave Therapy induces neovascularization at the tendon bone junction. A study on Rabbits Journal of Orthopedic Research 2003 Nov; 21 (6): 984-9
Immunomodulation: A unique feature of shockwave therapy is its ability to induce a shift in the macrophage phenotype from M1 to M2 and augment T-cell proliferation, enhancing the body’s immunomodulatory capabilities.
Inflammation Modulation and Muscle Treatment: The therapy activates the TLR3 signaling pathway, adjusting the expression of interleukins like IL-6, leading to improved treatment outcomes for ischemic muscles.
In vitro studies show that Hyaluronic Acid (HA), Platelet-Rich Plasm (PRP) and shockwave promote regeneration and attenuate human chondrocyte degeneration of osteoarthritic cells explanted by patients subjected to total hip replacement. In addition, we show for the first time that ESWT-mediated increase of CD44 expression enhances their susceptibility to HA treatment. Shockwave, HA and PRP can help manage restrictions affecting cartilage repair capacity, confirming a possible relationship in the pathways involved in the dedifferentiation and senescence of human chondrocytes.
Ready to Add a Shockwave Therapy Device to Your Practice
See the evidence from studies conducted with shockwave technology.
Improved for Plantar Fasciitis
Improvement for Calcific Tendonitis of the shoulder
Improvement for Tennis Elbow (Lateral Epicondylitis)
Improvement for Achilles