Shockwavetherapy – Fight the pain with mechanical energy
A projectile accelerated in the handpiece generates a mechanical pressure wave, which is transferred to the human body by an applicator head and which radiates out in the tissue. The mechanical energy is absorbed by the tissue and decreases as the distance from the application site increases. The mechanical stress triggers reactions in the tissue that have a positive influence on a wide range of orthopedic and neurological conditions:
- Insertion tendinopathy
- Tendon problems
- Chronic inflammation
- Hypertonic muscle systems
- Myofascial syndromes
- Hemotoma treatments
Successful treatment has been conducted and documented in all these areas. This is an impressive confirmation of the efficacy of this easy-to-use therapeutic procedure and shows that a wide range of additional indications can also be treated.
Shockwavetherapy – Medical effects
The causes of the observed medical effects are still largely hypothetical or not fully evaluated. Current scientific investigations are in progress to try and develop a better understanding of the causes and effects of the radial shockwave.
There are two probable primary effects:
- Normalisation of the muscle tone through stimulation of the muscle spindle and the Golgi apparatus of the muscle tendon
- Pain overlay based on the gate-control principle (Melzack and Wall) with parallel endorphin release by the stimulation of the skin’s pressure and touch receptors
- Stimulation of cellular activity and changes in cell-membrane permeability caused by direct mechanical stress in the cell wall
- Internal cellular building processes for reinforcement of the mechanical structure as a consequence of the mechanical stress at the limit of stress capacityt
Indirect effects being discussed include:
- Increased cellular metabolism due to changes in the membrane permeability, e.g. by opening the glutamate channels
- Release of substance P, a neurotransmitter and pain mediator, into the tissue with subsequent nerve habituation and with that reduction of the pain threshold
- Release of AGF and VGF (growth hormones) with corresponding cell reaction
- Increased cellular activity via gene expression
Similar to the transverse friction technique developed by J. Cyriax which is used by many therapists, the application of radial shockwave therapy results in various, directly observable effects during or immediately after treatment:
- Initially uncomfortable to painful, it generally results in prompt habituation with good tolerance of the applied shockwave
- There is generally a significant reduction in pain immediately after the treatment
- The range of motion is increased
- The muscle tone is normalised
- Previously palpable myogeloses have become relaxed
