J Korean Orthop Assoc.  2018 Oct;53(5):400-406. 10.4055/jkoa.2018.53.5.400.

Extracorporeal Shock Wave Therapy in Musculoskeletal Disorders

• Yum JK
• Ahn SJ

• KMID: 2424098
• DOI: http://doi.org/10.4055/jkoa.2018.53.5.400

Abstract

The sources of shockwave generation include electrohydraulic, electromagnetic and piezoelectric principles, and extracorporeal shock wave therapy (ESWT) appears to have mechanical and biological effects on tissue healing. The application of ESWT to musculoskeletal disorders has been around for more than a decade and is used primarily in the treatment of calcific or non-calcific tendinitis of the shoulder, lateral and medial epicondylitis of the elbow, patellar tendinopathy, Achilles tendinitis or proximal plantar fasciitis of the heel, myofascial pain syndrome, etc. ESWT is also used in the treatment of delayed union or non-union of long bone fractures, avascular necrosis of the femoral head, and chronic diabetic ulcers. The vast majority of papers have reported positive and beneficial effects with few complications. The clinical application of ESWT has increased steadily. This article reviews the current status of ESWT in musculoskeletal disorders.

Keyword

extracorporeal shockwave therapy; musculoskeletal disease

MeSH Terms

Elbow
Fasciitis, Plantar
Fractures, Bone
Head
Heel
Magnets
Musculoskeletal Diseases
Myofascial Pain Syndromes
Necrosis
Shock*
Shoulder
Tendinopathy
Ulcer

Figure

• 

  Figure 1 Schematic illustration of a radial shock wave. Cited from the article of Moya et al. (J Bone Joint Surg Am. 2018;100:251-63).19)

• 

  Figure 2 Three main techniques through which shock waves are generated. (A) Electrohydraulic. (B) Electromagnetic. (C) Piezoelectric. Cited from the article of Moya et al. (J Bone Joint Surg Am. 2018;100:251-63).19)

• 

  Figure 3 The mechanism of shock wave therapy appears to involve a cascade of interactions between the physical shock wave energy and biological responses. eNOS, endothelial nitric oxide synthase; VEGF, vessel endothelial growth factor; PCNA, proliferative cell nuclear antigen. Cited from the article of Wang (Chang Gung Med J. 2003;26:220-32).1)

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