Shock wave is defined from a physical point of view as a pressure wave of short duration, traveling faster than the speed of sound. It is characterized by an explosive, rapid and maximum pressure peak that penetrates the tissue causing a “shock”, after which a series of biological effects responsible for the regeneration of the damaged tissue take place.
Why have shock waves been positioned as an excellent injury recovery device?
In 1980, when treating a urinary lithiasis by lithotripsy, it was accidentally observed that the patient’s iliac bone showed an osteoblastic or bone-forming reaction. From that moment on, it began to be used in the field of orthopedics due to its capacity to regenerate other tissues in addition to bone.
How do they work?
The shock wave sets in motion the mechanisms responsible for tissue regeneration.
Initially, the expression of angiogenic and osteogenic growth factors (blood vessel and bone forming cells) is stimulated. This is followed by neovascularization or the formation of new blood vessels and improved tissue trophism through the stimulation of stem cells, which induces a process of repair of damaged tissues.
How do radial shock waves differ from focal shock waves?
Focal or high-energy shock waves are applied exclusively by specialized physicians (recommendation of the International and Spanish Shock Wave Society), while radial or low-energy shock waves are usually applied by physiotherapists.
The energy applied by focal shock waves is 100 times higher than that applied by radial shock waves. The focal shock wave concentrates its energy in one point and has great penetrating power in the tissue. In contrast, the radial shock wave propagates radially or expansively on the surface.
What does it depend on whether one or the other is used?
It is essential to obtain a medical diagnosis, often supported by musculoskeletal ultrasound. Once the lesion has been labeled, a decision is made as to which type of shock wave is most indicated, taking into account the depth of the pathology and the energy required to be able to treat it with guarantees.
In which pathologies are they indicated?
Focal shock waves are indicated, mainly in the treatment of:
- Calcifications
- Deep and superficial tendinopathies
- Plantar fasciitis
- Epicondylopathy or “tennis elbow”.
- Trochanteritis
- Delayed consolidation or fracture pseudoarthrosis
Radial or low energy shock waves are used in the treatment of superficial tendinosis and muscle disorders.