Shockwave therapy is a non-invasive physical modality application that creates an acoustic wave with  extreme intensity that creates both penetration to deep tissue and the ability to disrupt the tissue in a manner  to instigate biological influence for various stages of tissue healing. Shockwave is a conservative approach to managing conditions with low adverse reactions. In general, for musculoskeletal disorders, Schmitz et al.  (2015) determined shockwave to be both effective and safe with appropriate selection of parameters and  conditions. 

Controlled clinical studies have found shockwave to be successful in treating many musculoskeletal  disorders and injuries to include muscle and myofascial dysfunction, non-union fractures and necrosis, acute  and chronic tendinopathies, articulation dysfunctions, ischemia and pain.^2-18 

Being an acoustic wave that then creates mechanical impulse to tissues, it may provide enhanced diversity in  typical contraindications to other therapies where limitations occur based on patient presentation such as a  patient with an implanted electromechanical device not being able to receive certain electromagnetic therapies or medications. Being an exogenous therapy with deep penetration, it may also provide a safer  alternative to injections. Eslamian et al. (2016) determined shockwave to be more effective and have higher  patient satisfaction than corticosteroid injections for plantar fasciitis. This has also been a similar result in  other areas of the body where shockwave was equal or more effective than injections in areas such as trigger  points, low back, foot, elbow, shoulder.^18-22 

Lastly, unlike more invasive procedures, shockwave application reduces pain and improves function while not  affecting the other areas such as cognition and allows individuals to remain in limited activity orwork. In  addition, the improvements in a condition are also related to actual improvements in the tissue structure and  function. This can also result in reduced loss of work time, decreases the number therapy sessions, reduced  over the counter medications further reducing comorbidities.^23,24 

If you have any further questions, please do not hesitate to contact our office to discuss how we are improving  the treatment of our patients and your policy holders. 

Delivering and Accelerating Mobility

References 

1. Schmitz C, Császár NB, Milz S, et al. Efficacy and safety of extracorporeal shock wave therapy for  orthopedic conditions: a systematic review on studies listed in the PEDro database. Br Med Bull.  2015;116(1):115-138. doi:10.1093/bmb/ldv047 

2. Buch M, Knorr U, Fleming L, Theodore G, Amendola A, Bachmann C, Zingas C, Siebert WE.  Extracorporeal shockwave therapy in symptomatic heel spurs. An  

overview. Orthopade. 2002;31(7):637–44. doi: 10.1007/s00132-002-0323-z. 

3. Perez M, Weiner R, Gilley JC. Extracorporeal shock wave therapy for plantar fasciitis. Clin Podi Med  Surg. 2003;20(2):323–34. doi: 10.1016/S0891-8422(03)00002-8. 

4. Roehrig GJ, Baumhauer J, DiGiovanni BF, Flemister AS. The role of extracorporeal shock wave on  plantar fasciitis. Foot Ankle Clin. 2005;10(4):699–712. doi: 10.1016/j.fcl.2005.06.002. 

5. Strash WW, Perez RR. Extracorporeal shockwave therapy for chronic proximal plantar fasciitis. Clin  Podi Med Surg. 2002;19(4):467–76. doi: 10.1016/S0891-8422(02)00016-2. 

6. Thomson CE, Crawford F, Murray GD. The effectiveness of extra corporeal shock wave therapy for  plantar heel pain: a systematic review and meta-analysis. BMC Musculoskelet Disord. 2005;6:19. doi:  10.1186/1471-2474-6-19. 

7. Wilner JM, Strash WW. Extracorporeal shockwave therapy for plantar fasciitis and other  musculoskeletal conditions utilizing the Ossatron-an update. Clin Podi Med Surg. 2004;21(3):441–7. doi:  10.1016/j.cpm.2004.03.002. 

8. Buchbinder R, Green SE, Youd JM, Assendelft WJ, Barnsley L, Smidt N. Systematic review of the efficacy  and safety of shock wave therapy for lateral elbow pain. J Rheum. 2006;33(7):1351–63. 9. Rompe JD, Theis C, Maffulli N. Shock wave treatment for tennis elbow. Orthopade. 2005;34(6):567–70.  doi: 10.1007/s00132-005-0805-x. Rompe JD, Maffulli N. Repetitive shock wave therapy for lateral elbow  tendinopathy (tennis elbow): a systematic and qualitative analysis. Br Med Bulletin. 2007;83:355–78.  doi: 10.1093/bmb/ldm019. 

10. Stasinopoulos D, Johnson MI. Effectiveness of extracorporeal shock wave therapy for tennis elbow  (lateral epicondylitis) Br J Sports Med. 2005;39(3):132–6. doi: 10.1136/bjsm.2004.015545. 11. Mouzopoulos G, Stamatakos M, Mouzopoulos D, Tzurbakis M. Extracorporeal shock wave treatment for  shoulder calcific tendonitis: a systematic review. Skeletal Radiol. 2007;36(9):803–11. doi:  10.1007/s00256-007-0297-3. 

12. Spindler A, Berman A, Lucero E, Braier M. Extracorporeal shock wave treatment for chronic calcific  tendinitis of the shoulder. J Rheum. 1998;25(6):1161–3. 

13. Cacchio A, Giordano L, Colafarina O, Rompe JD, Tavernese E, Ioppolo F, Flamini S, Spacca G, Santilli V.  Extracorporeal shock-wave therapy compared with surgery for hypertrophic long-bone nonunions. J  Bone Joint Surg -Am. 2009;91(11):2589–97. doi: 10.2106/JBJS.H.00841. [Erratum appears in J Bone Joint  Surg Am. 2010 May;92(5):1241]  

14. Elster EA, Stojadinovic A, Forsberg J, Shawen S, Andersen RC, Schaden W. Extracorporeal shock wave  therapy for nonunion of the tibia. J Orthop Trauma. 2010;24(3):133–41. doi:  

10.1097/BOT.0b013e3181b26470. 

15. Xu ZH, Jiang Q, Chen DY, Xiong J, Shi DQ, Yuan T, Zhu XL. Extracorporeal shock wave treatment in  nonunions of long bone fractures. Int Orthop. 2009;33(3):789–93. doi: 10.1007/s00264-008-0553-8. 16. van Leeuwen MT, Zwerver J, van den Akker-Scheek I. Extracorporeal shockwave therapy for patellar  tendinopathy: a review of the literature. Br J Sports Med. 2009;43(3):163–8.

17. Vahdatpour B, Kiyani A, Dehghan F. Effect of extracorporeal shock wave therapy on the treatment of  patients with carpal tunnel syndrome. Adv Biomed Res. 2016;5:120. Published 2016 Jul 29.  doi:10.4103/2277-9175.186983 

18. Eslamian F, Shakouri SK, Jahanjoo F, Hajialiloo M, Notghi F. Extra Corporeal Shock Wave Therapy  Versus Local Corticosteroid Injection in the Treatment of Chronic Plantar Fasciitis, a Single Blinded  Randomized Clinical Trial. Pain Med. 2016;17(9):1722-1731. doi:10.1093/pm/pnw113 

19. Hong JO, Park JS, Jeon DG, Yoon WH, Park JH. Extracorporeal Shock Wave Therapy Versus Trigger Point  Injection in the Treatment of Myofascial Pain Syndrome in the Quadratus Lumborum. Ann Rehabil Med.  2017;41(4):582-588. DOI: https://doi.org/10.5535/arm.2017.41.4.582 

20. Nedelka T1, Nedelka J2, Schlenker J3, Hankins C4, Mazanec R1. Mechano-transduction effect of  shockwaves in the treatment of lumbar facet joint pain: comparative effectiveness evaluation of  shockwave therapy, steroid injections and radiofrequency medial branch neurotomy.Neuro Endocrinol  Lett. 2014;35(5):393-7. 

21. Beyazal MS, Devrimsel G. Comparison of the effectiveness of local corticosteroid injection and  extracorporeal shock wave therapy in patients with lateral epicondylitis. J Phys Ther Sci.  2015;27(12):3755-3758. doi:10.1589/jpts.27.3755 

22. Li W, Zhang SX, Yang Q, Li BL, Meng QG, Guo ZG. Effect of extracorporeal shock-wave therapy for  treating patients with chronic rotator cuff tendonitis. Medicine (Baltimore). 2017;96(35):e7940.  doi:10.1097/MD.0000000000007940 

23. Lee S, Lee D, Park J. Effects of extracorporeal shockwave therapy on patients with chronic low back  pain and their dynamic balance ability. J Phys Ther Sci. 2014;26(1):7-10. doi:10.1589/jpts.26.7 24. Muthukrishnan R, Rashid AA, Al-Alkharji F. The effectiveness of extracorporeal shockwave therapy for  frozen shoulder in patients with diabetes: randomized control trial. J Phys Ther Sci. 2019;31(7):493-497.  doi:10.1589/jpts.31.493