Managing Refractory Tendinopathy: Shock Wave Therapy Explained Shock Wave Therapy (SWT) provides “shock waves” via mechanical, low energy sound waves to pathologic tissue to promote healing and reduce pain.
Managing Refractory Tendinopathy: Shock Wave Therapy Explained Shock Wave Therapy (SWT) provides “shock waves” via mechanical, low energy sound waves to pathologic tissue to promote healing and reduce pain. Shockwaves are generated through a combination of electrohydraulic, electromagnetic, and piezoelectric principles. It has been theorized to help modulate pain receptors by increasing blood flow.
The electrophysiological pathways and molecular mechanisms of the proposed anti-nociceptive effect of the treatment are still unknown. SWT is safe, complication rates are low and negligible. Extracorporeal shock wave therapy can be performed following two modalities: repetitive low-energy extracorporeal shock waves, which do not require local anesthesia, or high-energy extracorporeal shock waves, which require local or regional anesthesia.
It is unclear if one modality is superior to the other, however in a study of calcific tendonitis of the rotator cuff, high energy SWT appeared to be superior.SWT appears to help for common upper extremity tendinopathies. Nonetheless, they concluded there was evidence for effectiveness of shock wave treatment for tennis elbow. One randomized, multicenter trial found no difference.
In patients with calcific tendonitis of the rotator cuff, SWT was beneficial for function, pain and size of calcifications compared to placebo [7, 11].SWT also appears to help with several lower extremity tendinopathies. In patients with patellar tendinopathy, SWT was superior to controls up to 3 years following initiation of therapy. In patients with Achilles tendinopathy, SWT produced similar improvements in pain and function when compared to eccentric loading.
Additionally, eccentric exercises combined with SWT was superior to eccentric exercises only. In another study compared to control group managed nonoperatively, SWT improved pain and function. Co.uk)f There is some literature that SWT is not helpful for certain musculoskeletal conditions.
If you are experiencing symptoms that may be related to managing refractory tendinopathy (part 4): extracorporeal shock wave therapy, it is important to see a sports medicine physician. Early evaluation and treatment typically lead to better outcomes. Do not ignore pain or symptoms that are limiting your activity.
*This article is for educational purposes only and does not substitute for professional medical advice. Always consult a qualified healthcare provider.*
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