The Benefits of Shockwave Therapy for Muscle Pain: What You Need to Know

"The Benefits of Shockwave Therapy for Muscle Pain: What You Need to Know"

The Benefits of Shockwave Therapy for Muscle Pain: What You Need to Know

There are 2 types of shockwave therapy, radial and focused

Radial shockwave therapy is the MOST COMMON for treating muscle pain and dysfunction

FOCUSED shockwave is for more acute cases ( under 12 weeks of pain ) that require more precision.

Radial shockwave is like a softer version and is good for treating larger areas

Focused shockwave, a harder version, penetrates deeper into tissues, this is good for muscles close to the bone, calcifications and non-unions

How many treatments will you need?

A good rule of thumb is around 5 sessions, with treatments being done every 5- 10 days

Research has found a weekly regime can work whereas doing it monthly did not produce great results

The session usually lasts around 15 minutes to 20 minutes depending on the area of the body.

How does a shockwave cause positive changes in your muscles?

• increased collagen synthesis-

• Cellular proliferation and wound healing - helps with Il6 and IL8 (tendon remodelling)

• Pain reduction- modifies substance P release

• Decrease in soft tissue calcification

• Decrease in inflammation

How shockwave affects different parts of the body

Pathology	Mechanism of action
Tendons	Decreased edema and inflammatory cell infiltration within tendons Tissue regeneration via conversion of mechanical stimulation to biochemical signal Stimulate tenocyte and collagen proliferation (important in healing) Scleraxis upregulation (promotes tendon growth and development) Proliferation of anti‐inflammatory cytokines Increased proliferation and migration of tendon‐derived tenocytes Decreased metalloproteinase expression (enzymes that can degrade collagen) Reduction of inflammatory interleukins
Bones	Protein upregulation may enhance angiogenesis and neovascularization of the bone Osteogenesis and bone remodelling by release of growth factors Bone morphogenic protein 2 Vascular endothelial growth factor Promotion of periosteal bone formation Decreased osteoclast activity Increased osteoblast activity
Joints (knee)	Decreased inflammation Decreased edema Improvements in subchondral bone architecture Increased chondrocyte activity (cartilaginous repair)
Spasticity	Decreased spasticity at the level of the muscle and neuromuscular junction Reduced rigidity of connective tissues (muscle level) Stimulate synthesis of nitric oxide Neuromuscular junction formation Neovascularization

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Reference

Extracorporeal Shockwave Therapy

Extracorporeal shockwave therapy, most notably used in the treatment of kidney stones, is a unique adjunct that continues to show promise in treatment of refractory plantar fasciitis patients.

From: Essentials of Physical Medicine and Rehabilitation (Fourth Edition), 2020

PM R. 2022 May; 14(5): 611–619.

Published online 2022 Apr 14. doi: 10.1002/pmrj.12790

PMCID: PMC9321712

PMID: 35187851

Best practices for extracorporeal shockwave therapy in musculoskeletal medicine: Clinical application and training consideration

Adam S. Tenforde, MD, 1 Haylee E. Borgstrom, MD, MS, 1 Stephanie DeLuca, MD, 1Molly McCormack, BA, 1 Mani Singh, MD, 2 Jennifer Soo Hoo, MD, 3 and Phillip H. Yun, MD4