Extracorporeal shock wave therapy mechanisms in musculoskeletal regenerative medicine

Abstract

Extracorporeal shockwave therapy (ESWT) is a popular non-invasive therapeutic modality in the medical field for the treatment of numerous musculoskeletal disorders. This technique first emerged around the 1980s as extracorporeal shockwave lithotripsy and has been studied since then for its application towards orthopedics and traumatology. ESWT works by the emission of acoustic waves (shockwaves) that carry energy and can propagate through tissues. Shockwaves can generate interstitial and extracellular responses, producing many beneficial effects such as: pain relief, vascularization, protein biosynthesis, cell proliferation, neuro and chondroprotection, and destruction of calcium deposits in musculoskeletal structures. The combination of these effects can lead to tissue regeneration and significant alleviation of pain, improving functional outcomes in injured tissue. Considering these facts, ESWT shows great potential as a useful regenerative medicine technique for the treatment of numerous musculoskeletal injuries.

Keywords: Inflammation; Musculoskeletal disorders; Regeneration; Shockwave.

Conflict of interest statement

The authors declare that they have no conflict of interest.

© 2020 Delhi Orthopedic Association. All rights reserved.

Figures

Fig. 1

The fundamental differences between focused and radial ESWT.

Fig. 2

The cell signaling pathways activated by ESWT application.