Mechanism of Shockwave Therapy

Shockwave therapy's exact mechanism isn't fully understood, but its key physical parameters include pressure distribution, energy flux density, and total acoustic energy. Unlike lithotripsy, which disintegrates renal stones, orthopedic shockwaves are used to stimulate tissue responses for regeneration, not tissue disintegration.

Microtrauma and Stress Response:

The shockwaves cause microtrauma to the tissue, stimulating a healing response. This includes the release of growth factors and the formation of new blood vessels (angiogenesis) and connective tissue (collagen synthesis).

Mechanical Effects:

The rapid pressure changes produced by shockwaves stimulate cell activity and enhance cell membrane permeability. This can lead to increased blood flow and the release of pain-reducing substances.

Cavitation:

Shockwaves create tiny bubbles in the tissue (cavitation), which collapse after a short time, releasing energy. This phenomenon helps to break down calcifications and stimulate tissue regeneration.

Mechanical Stress

Shockwaves induce a controlled stress response in the tissue, promoting the production of growth factors, collagen, and other substances necessary for tissue repair.

Pain Reduction:

Shockwaves can interfere with the transmission of pain signals, leading to a reduction in pain perception.

Neovascularization:

Shockwave therapy can stimulate the formation of new blood vessels (neovascularization), improving blood supply to the treated area and promoting healing.

Anti-inflammatory Effects:

Shockwaves can help reduce inflammation by increasing the production of anti-inflammatory substances and decreasing the production of pro-inflammatory substances.

Breakdown of Calcifications:

In some cases, shockwave therapy can break down calcifications, such as those found in conditions like calcific tendinitis.

Overall, shockwave therapy is thought to accelerate the healing process and improve tissue regeneration, making it a valuable treatment option for various musculoskeletal conditions.