Extracorporeal Shockwave Therapy
Extracorporeal shock wave therapy (ESWT) was originally used in medicine to break up kidney stones in people. German physicians first used ESWT to treat tennis elbow, and plantar fasciitis (heel spurs). Because of the positive results seen in treating these conditions, ESWT was adopted for use in treating assorted orthopedic conditions in the horse. Veterinarians have embraced ESWT as a treatment for tendon and ligament injuries, bone spavin, navicular syndrome, insertional desmopathy, back soreness, stimulation of bone remodeling, delayed wound healing, stress fractures and treatment of non-unions.
Research has demonstrated that focused shock wave therapy causes increased bone formation in horses at the treatment site. In the suspensory ligament both radial and focused shock wave therapy have been shown to increase formation of collagen fibrils and growth factors. Tendon injuries treated with shock wave therapy showed more mature and parallel collagen fibers and increased new blood supply when compared to untreated controls. Recent studies of wound healing have indicated that shock wave therapy promotes healing of wounds in horses by increasing growth factors, reducing inflammation and promoting tissue proliferation. Shock wave therapy has also been shown to decrease inflammation associated with arthritis in horses. Interestingly, this effect may last for up to 3 months. While the exact mechanisms of shock wave therapy seem to differ among the various tissues being treated, the effect of shock wave therapy appears to be dose-dependent.
There are two types of shock wave therapy devices: radial and focused shock wave modalities. Radial shock wave devices (also called radial pressure wave systems) seem to be most helpful for treatment of soft tissue injuries, while focused shock wave modalities are most appropriate for treatment of orthopedic conditions. Focused shock wave machines are capable of generating a unique wave form with more power than do radial machines. Both forms of extracorporeal shock wave therapy have been shown to produce a localized analgesic effect at the treatment site for approximately 3 days following treatment. Both radial and focused shock wave therapy is available at the New Jersey Equine Clinic.