What is Extracorporeal Shockwave Therapy?

Graphic illustration of Extracorporeal Shockwave Therapy in action, targeting painful musculoskeletal areas to stimulate accelerated repair, cell growth, pain relief, and restoration of mobility in tissues and bones.

Extracorporeal Shockwave Therapy

Shockwave therapy is an acoustic wave which carries high energy to painful spots and musculoskeletal tissues with subacute, sub-chronic and chronic conditions.

The energy promotes regeneration and reparative processes of the bones, tendons and other soft tissues. Shockwave therapy interacts with tissue causing overall medical effects of accelerated tissue repair and cell growth, analgesia and mobility restoration.

Illustration showing the process of new blood vessel formation induced by acoustic wave therapy, with capillary micro-ruptures leading to growth factor expression and the development of new arterioles, enhancing tissue healing and oxygenation.

New Blood Vessel Formation

Nutrient blood flow is necessary to start and maintain the repair processes of damaged tissue structure. The application of acoustic waves creates capillary micro ruptures in tendon and bone. Due to micro ruptures the expression of growth factors such as eNOS, VEGF, PCNS and BMP is significantly increased.

As a result of these processes arterioles are remodelled, stimulated to grow and new ones are formed. The new blood vessels improve blood supply and oxygenation of the treated area and support faster healing of both the tendon and the bone.

Diagram illustrating the reversal of chronic inflammation through the activation of mast cells by acoustic waves, highlighting the subsequent release of chemokines and cytokines to facilitate healing and regeneration.

Reversal of Chronic Inflammation

Chronic inflammation occurs when the inflammatory response is not completely halted. It can damage healthy tissue and results in chronic pain. Mast cells are one of the key components of the inflammatory process. Their activity may be increased by using pervasive acoustic waves.

Mast cell activation is followed by the production of chemokines and cytokines. These pro-inflammatory compounds first enhance the inflammatory process and in the next step help restore normal healing and regenerative processes. 

Visual representation of Shockwave therapy's effect on damaged myoskeletal and ligamentous structures, showcasing accelerated procollagen synthesis and the formation of denser, more structured tendon fibers for enhanced repair.

Stimulation of Collagen Production

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The production of a sufficient amount of collagen is a necessary precondition for the repair processes of the damaged myoskeletal and ligamentous structures. Shockwave therapy accelerates procollagen synthesis. The therapy forces the newly created collagen fibers into a longitudinal structure which makes the newly formed tendon fibers more dense and stiff and creates a firmer structure.

Graphic representation of the dissolution of calcified fibroblasts through shockwave therapy, showing acoustic waves breaking up calcium deposits in a tendon for removal by the lymphatic system.

Dissolution of Calcified Fibroblasts

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Calcium build-up is most often a result of micro-tears or other trauma to a tendon. Acoustic waves break up the existing calcifications. Shockwave therapy starts the biochemical decalcification of the calcium build-up of a toothpaste-like consistency and treats the tendon. The granular particles of calcium are then removed by the lymphatic system. 

Visual infographic detailing how Shockwave therapy's acoustic waves target and reduce Substance P concentration, leading to diminished pain transmission and relief from chronic pain, with additional benefits like reduced inflammatory oedema.

Dispersion of Pain Mediator 

“Substance P”

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Substance P is a neurotransmitter that mediates pain information through C-fibers. This neuropeptide 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 afferent nociceptive fibers and thus reduces the pain. Decreasing Substance P, histamines and other nociceptive metabolites also helps inhibit development of inflammatory oedema. Acoustic waves generated by Shockwave therapy lower the Substance P concentration and trigger pain relief. ​