Extracorporeal Shockwave Therapy (ESWT) is used to treat various musculoskeletal conditions and accelerate the healing process. It's physiological effects are discussed below:
- PAIN MEDIATION
ESWT has been shown to lower the concentration of neurotransmitter Substance P. This neurotransmitter is associated with intense, persistent, chronic pain. Pain mediation also occurs through hyperstimulation of sensory pathways - Gate control theory.
ESWT increases the expression of growth factors such as eNOS, VEGF, PCNS and BMP. These factors facilitate the formation of new blood vessels improve blood supply and oxygenation to the affected area.
- REDUCE CHRONIC INFLAMMATION
ESWT activates mast cells which in turn activate pro-inflammatory compounds. This reactivates the natural healing cascade and tissue repair responses in recalcitrant chronic tendinopathies.
- STIMULATES COLLAGEN PRODUCTION
ESWT accelerates procollagen synthesis. Repair can only take place with the production of sufficient amounts of callagen. ESWT, together with an appropriate tissue loading protocol, reorganises the newly formed oollagen strands into functional tissue.
- DISSOLUTION OF CALCIFIED FIBROBLASTS
ESWT has the ability to break up calcifications which may form in soft tissues due to repetitive micro-trauma or other trauma. The shockwaves mechanically break up calcification, and aids recovery of the tendon through the physiological effects already discussed.