From the Guidelines
In a medical context, there are several types of shockwaves used therapeutically, including electrohydraulic, electromagnetic, and piezoelectric shockwaves, which vary in energy intensity, penetration depth, and focal zone characteristics. These different types of shockwaves are used for various conditions, such as musculoskeletal disorders and kidney stones. The therapeutic mechanism of shockwaves involves microtrauma that stimulates healing responses, increases blood flow, releases growth factors, and can disrupt calcifications 1.
Types of Shockwaves
- Electrohydraulic shockwaves: generated through electrical discharge in fluid
- Electromagnetic shockwaves: use magnetic fields to create pressure waves
- Piezoelectric shockwaves: produced when electrical current causes rapid expansion of crystals
- Focused shock waves: concentrate energy at a specific depth in tissue
- Radial shock waves: disperse energy more broadly near the surface
Applications of Shockwaves
- Musculoskeletal conditions: tendinopathies, plantar fasciitis
- Kidney stones: lithotripsy
- The therapeutic mechanism involves microtrauma that stimulates healing responses, increases blood flow, releases growth factors, and can disrupt calcifications 1.
Treatment Protocols
- Multiple sessions spaced days to weeks apart
- Each session delivering several thousand shockwave pulses to the affected area
- Recent studies suggest that pretreatment with shock waves at low energy can significantly reduce tissue effects during SWL, and that a slower shock wave rate can significantly improve stone-free rates 1.
From the Research
Types of Shockwaves
- Extracorporeal Shock Wave Lithotripsy (ESWL) 2, 3: a non-invasive treatment that uses shockwaves to break up kidney stones into small pieces that can then pass out of the body in the urine.
- Focused Extracorporeal Shock Wave Therapy (F-ESWT) 4, 5: a type of shockwave therapy that uses high-energy shockwaves to treat musculoskeletal conditions such as plantar fasciitis and calcific tendinitis.
- Radial Pulse Therapy (RPT) 4, 5: a type of shockwave therapy that uses low-energy shockwaves to treat musculoskeletal conditions such as plantar fasciitis.
Characteristics of Shockwaves
- Energy level: shockwaves can be classified as high-energy or low-energy, with high-energy shockwaves being more effective for treating certain conditions 4, 5.
- Frequency: the frequency of shockwaves can vary, with some studies suggesting that higher frequencies may be more effective for certain conditions 5.
- Duration: the duration of shockwave treatment can vary, with some studies suggesting that longer treatment sessions may be more effective for certain conditions 5.
Medical Applications of Shockwaves
- Treatment of kidney stones: ESWL is a common treatment for kidney stones, with studies showing that it can be an effective and safe option for patients with certain types of stones 2, 3.
- Treatment of musculoskeletal conditions: F-ESWT and RPT are commonly used to treat musculoskeletal conditions such as plantar fasciitis, calcific tendinitis, and lateral epicondylitis, with studies showing that they can be effective in reducing pain and improving function 4, 5, 6.