Shock Wave TherapyIntroductionShock wave therapy (SWT) or therapeutic ultrasound therapy or acoustic energy transference therapy is reviewed briefly here.DisclaimersThis discussion is for educational purposes only. Please have all care administered by a well trained physician excited about doing a team approach with you the patient and them.Humble opinion is kept to a minimum, I promise. Some ranting and raving.DiscussionSWT has been around as a physical therapy modality for 20 years. Probably its most established indication is plantar fasciitis. Professional athletes in respected organizations like the NBA plagued by such have received SWT for such indications with great success for many many years.More and more uses have been found for it, and new uses are discovered every day. Anything with soft tissue damage may benefit from it. Clinicians try it, it works, and they continue doing so privately. Formal research funding for prospective research has been limited for two reasons. One, it’s completely safe. So there’s no danger to research in turns of lack of safety. Two, there is a lack of funding for research trials, largely coming from big Pharma, because big Pharma has no interest in it. There’s nothing they can patent, so they don’t invest a single dollar. Not only does it not help them, it is likely to hurt their markets if they accidentally prove that it works. So... They stay clear of it. Academic institutions like universities have pursued a great deal of peer reviewed studies that justify its worth fortunately. So we salute sports and health minded pro American institutions like Duke, the Ivy leagues, Texas, California, Virginia... Thanks to them, it’s here to stay.IndicationsPhysical therapy for all soft tissue damageErectile dysfunctionFemale incontinence syndromesFemale sexuality, increases sensitivity, increases pinkness, increases orgasmPlantar fasciitisCelluliteBody sculptingAfter other noninvasive body sculpting lipolysis techniquesAfter surgical liposuctionPost surgery (in general)Aesthetics (in general)Delayed granulomas following surgery, indicated or electiveSome of these indications, only a single 20-30 minute therapy is necessary to fully resolve the problem. In others, 10-20 such therapies may be required.Physiology, pathophysiologyEdema from damage tissue increases lymphatic drainage, driving up blood flow.Repeated use of SWT leads to collagen production and blood vessel production.So, SWT increases the vasculature of the area providing for this increased need.Tissue damage leads to traffic jams. SWT leads to increased roadway production.SWT works by bubble formation. That bubble bombardment stimulates angiogenesis, blood vessel production.So:Most if not all of these clinical indications mentioned above are nicely complemented by concurrent use of PRP, platelet rich plasma, as an adjunct to provide growth factors. Stem cells as an adjunct can augment PRPs ability to help SWT, especially if the patient is low in their supply, i.e., the elderly.ConclusionThese beneficial outcomes are consistent. You combine that with spectacular safety, and you find that SWT is a terrific therapy choice whenever there is some sort of soft tissue damage involved with the medical condition you are trying to treat.

 

Stay well,

David Allingham, MD