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Shockwave therapy
The Shockwave therapy was originally used as a non-invasive method to remove kidney stones in humans. An increase in bone density of the human pelvis at the treated site, was discovered as an side effect during clinical trials. Since then Shockwave therapy has been used to treat orthopaedic problems in human and veterinary medicine. It turned out that, for example non-healing fractures responded well to shockwave therapy. Nowadays shockwave therapy is an established treatment for equine patients with problems of the musculoskeletal system.
Technology
Shockwaves are sonic pressure waves that disperse wavelike in a medium. Unlike the constant high-frequency sonic wave, the shockwave is characterized by a very fast and high rising pressure. The shockwave is thereby focused and hits the target area bundled on a defined location and depth. Tissue outside focal zone is only slighlty affected.
Another method is the radial transmitted shockwave. In this method the pressure waves are not focused and spread in the tissue undirected. Using this method is cheaper, as the appliance is based on simpler technology and there is less wear and tear on the appliance when used, but it seems that this method is less effective.
Efficacy
There has as yet been no scientific explanation of how exactly shockwaves work to create their therapeutic effect. It is known that after shockwave therapy certain tissue hormones are released, that are responsible for the formation of new blood vessels and the remodelling of bone. The dysfunctional healing of bone tissue is positively influenced and the recovery of lesions in tendon attachments is accelerated.
Shockwaves cause „micro-traumas“ on hard surfaces (bones), therefore increasing blood circulation and improving tissue metabolism. One could imagine it being a “small explosion” at the target site. Due to this “explosion” the intercellular bonds are weakened, leading to a loosening of the inflamed and hardened tissue. This loosening allows the body to initiate the healing process. The healing process and the regeneration of tissue has been initated and will continue during the following weeks.
A temporary reduction of pain at the treated site is a side effect of the shockwave treatment, which can last up to a week. The painfulness will increase again slowly according to the healing progression. Usually there is no total elimination of pain, as can be seen when using nerve block and anaesthetics, but there is a distinct reduction in the perception of pain. The exact procedure of pain reduction is not known, but it is thought it is due to an impairment of nerve endings, which will prevent the impulse transmission in the sensory nerves and allow the reduction of chronic pain. Because of this side effect Shockwave therapy is not allow to be used before a competition. The FEI has prohibited the use of shockwave treatment five days before a competition.
THE BENEFIT
Following injuries and illnesses have shown very positive results after using shockwave therapy:
- bone spavin
- Suspensory desmitis (especially at the origin and/or insertion)
- splints and fractures of splint bones
- stress-fractures
- arthritic changes
- navicular disease
- ligament and tendon problems
- calcification of tissue
- neck and back problems, etc.
Generally the horse will be treated 1-3 times at intervals of 2-4 weeks. The healing progress will be primarily determined by assessing the condition of the horse. Ultrasound and x-ray can be used to further assess the progress.
As mentioned above the shockwave therapy is very focused on an precise area. Therefore a exact diagnosis is vital before commencing treatment. Nowadays top quality Ultrasound-, X-ray, CT and MRI examinations are very helpful for this diagnosis in the veterinary medicine.
Even with some scientific uncertainties the shockwave therapy has proven itself and the effectiveness of the treatment has been undoubtedly proven. The shockwave has firmly established itself has a remedial treatment in human and veterinary medicine.
