Extracorporeal shock wave therapy in musculoskeletal disorders

Abstract

Shock waves as high energy acoustic waves are generated from underwater explosion with high voltage condition in shockwave generator. The physical characteristics of shockwave are a high rapid positive peak pressure and a negative pressure that propagates rapidly through the body tissue. Shock wave was primarily used to treat lithotripsy (kidney stone) by outside the body technique (called extracorporeal shockwave lithotripsy: ESWL). The application of shock wave has been utilized in the treatment of musculoskeletal disorders for over 20 years. Especially, it was used to treat chronic inflammation of tissue such as with or without calcific tendinitis of the shoulder, chronic proximal plantar fasciitis and chronic patellar tendinopathy. This narrative literature review was undertaken to provide an overview of principle and physical characteristics, classification, physical parameters, indication, contraindication and the therapeutic effectiveness of shockwave therapy in musculoskeletal disorders. Even though, the possibly therapeutic mechanism of musculoskeletal disorders was not used to disintegrate tissue and the exact mechanism of shock wave therapy was not known. But, the mechanism of therapeutic effects was emphasis in facilitating healing process and tissue regeneration. Previous studies have reported effective in the treatment of plantar fasciitis and calcific tendinitis. Therefore, shock wave therapy is an alternative therapeutic agent and an effective therapy in some chronic musculoskeletal conditions.