Pulse Wave™

Focused Shockwave Therapy

 

 

Focused Shockwave Therapy works by producing acoustic energy waves which are focused to a precise point within the damaged tissue.  These waves activate your body's own healing mechanisms accelerating healing and decreasing pain.

What Conditions Does It Treat?

Tennis Elbow     Golfer's Elbow     Tendonitis     Patello-Femoral Syndrome

Plantar Fasciitis     Carpal Tunnel     Labrum Injuries     Back Pain

Rotator Cuff Injury     Frozen Shoulder     Neuropathy     Neck Pain

 

Success Rate and Effectiveness

Focused Shockwave Therapy has been shown to have a 95% success rate at healing soft tissue injuries. There have been more than 300 articles published on Shockwave Therapy, including 10 double-blinded, randomized, controlled trials. The evidence for the use of Shockwave Therapy is overwhelming.

Will I Need to Continue Treatments?

Most common musculoskeletal conditions once resolved will not require ongoing treatments.  Other chronic conditions may require additional or supportive care treatments over time.

 

Contraindications:

 

• Coagulation disorders
• Use of anticoagulants (esp. Marcumar)
• Thrombosis
• Tumor diseases, carcinoma patients
• Pregnancy
• Polyneuropathy (in the case of DM)
• Children in growth
• Cortisone therapy up to six weeks before first treatment in the target area
• Pacemakers
• Over metal implants

 

Please do not take anti-inflammatories or administer topical anti-inflammatories prior to the Shockwave treatment.
If you have had a cortisone injection you will need to wait 4-6 weeks post injection prior to commencing Shockwave Therapy.

 

How Safe is Focused Shockwave?

Very Safe! Focused Shockwave Therapy has no long-term side effects or damages. Some short-term discomfort is felt during the treatment and some patients may experience temporary soreness, tenderness or swelling for a few days following the procedure. Others may experience mild bruising, tingling or numbness over the area of treatment. Upon completion of your treatment, you can return to most regular activities almost immediately, however for certain conditions we may advise you to avoid heavy strenuous activities for a day or two. Occasionally, pain or discomfort may persist for a few days following treatment, but no serious complications or side effects have been reported.

 

 

The advent of new technologies over the past several years has opened a vast range of possibilities for therapeutic, non-invasive, and non-pharmacological methods to help patients manage pain and heal damaged tissues.

Bend Spinal Care is pleased to offer this groundbreaking new technology to our patients to treat a variety of conditions, including joint and muscle disorders, bone fractures, athletic injuries, and chronic pain conditions.

F-ESWT and Chronic Inflammation

F-ESWT can be used to reverse chronic inflammation that occurs when the inflammatory response is not completely halted. Chronic inflammation can damage healthy areas of the body, causing chronic pain. F-ESWT stimulates mast cells to release pro-inflammatory compounds like cytokines and chemokines. This stimulates the regeneration of healthy cells and helps restore normal healing.

F-ESWT and Tendon Healing

F-ESWT can help the body to produce more collagen. Collagen is a protein found throughout the body that gives tendons and ligaments their structure. The collagen fibers produced by the body after shock wave therapy are forced into longitudinal structures that make tendons stiffer and denser, stopping and reversing tendon degeneration.

What Does the Research Say?

Effectiveness of Focused Shockwave Therapy versus Radial Shockwave Therapy for Non-calcific Rotator Cuff Tendinopathies: A Randomized Clinical Trial

Chengxin Li ¹, Zhizhuo Li ¹, Lijun Shi ², Peixu Wang ², Fuqiang Gao ³, Wei Sun ^3,✉

• Author information
• Article notes
• Copyright and License information

PMCID: PMC7811429  PMID: 33506031

Conclusions

Both F-SWT and R-SWT are effective in patients with non-calcific rotator cuff tendinopathy. F-SWT proved to be significantly superior to R-SWT at long-term follow-up (more than 24 weeks).

 

Focused extracorporeal shockwave therapy for the treatment of low back pain: a systematic review

Dilyan Ferdinandov ^1,2,3,*

• Author information
• Article notes
• Copyright and License information

PMCID: PMC11390445  PMID: 39267973

Conclusion:   Focused ESWT is a modern physiotherapeutic method that can potentially treat a broad spectrum of conditions responsible for low back pain. Despite the small number of low-evidence studies, there is sufficient data on the effectiveness and safety of this therapeutic modality.

 

Efficacy of Extracorporeal Shock Wave Therapy for Lateral Epicondylitis: A Systematic Review and Meta-Analysis

Gaowen Yao ¹, Jing Chen ², Yanji Duan ¹, Xiao Chen ^1,✉

• Author information
• Article notes
• Copyright and License information

PMCID: PMC7106907  PMID: 32309425

Conclusion:   Based on the existing clinical evidence, extracorporeal shock wave therapy can effectively relieve the pain and functional impairment (loss of grip strength) caused by tennis elbow, with better overall safety than several other methods. However, owing to the limited quality and quantity of the included studies, more high-quality RCTs are needed to support the trend towards better functional outcomes with ESWT.

 

Effectiveness of shockwave therapy in the treatment of plantar fasciitis

Renan Gonçalves Leão ¹, Marina Mayumi Azuma ¹, Gustavo Henrique Carillo Ambrosio ¹, Flavio Faloppa ¹, Eduardo Shoiti Takimoto ¹, Marcel Jun Sugawara Tamaoki ¹

• Author information
• Article notes
• Copyright and License information

PMCID: PMC7006537  PMID: 32095104

Conclusion:   Shock wave therapy was effective for plantar fasciitis treatment according to the proposed protocol considering pain, function and quality of life. Level of Evidence Ic, Case-series Study.

 

Long Term Effectiveness of ESWT in Plantar Fasciitis in Amateur Runners

Joanna Kapusta ^1,*, Marcin Domżalski ²

Editor: Umile Giuseppe Longo

• Author information
• Article notes
• Copyright and License information

PMCID: PMC9737564  PMID: 36498501

Conclusions: Extracorporeal shock wave therapy is an effective form of therapy for amateur runners. It reduces pain associated with plantar fasciitis that amateur runners may experience at rest, while walking, and during daily and recreational activity.

 

Comparative Effectiveness of Focused Extracorporeal versus Radial Extracorporeal Shockwave Therapy for Knee Osteoarthritis—Randomized Controlled Study

Nai-Yu Ko ¹, Chih-Ning Chang ¹, Chu-Han Cheng ¹, Hui-Kung Yu ², Gwo-Chi Hu ^1,3,*

Editor: Paul B Tchounwou

• Author information
• Article notes
• Copyright and License information

PMCID: PMC9332723  PMID: 35897371

Both groups showed significant improvement in secondary outcomes; however, the f-ESWT group yielded greater improvement in the VAS score, WOMAC score, and 6-minute walk test. Our results showed that f-ESWT was more effective than r-ESWT in improving pain and physical function in patients with knee osteoarthritis.

 

Effectiveness and Safety of Shockwave Therapy in Tendinopathies

Vasileios Dedes ¹, Apostolos Stergioulas ², Georgios Kipreos ², Ariadni Maria Dede ³, Athanasios Mitseas ⁴, Georgios I Panoutsopoulos ¹

• Author information
• Article notes
• Copyright and License information

PMCID: PMC6029898  PMID: 30061805

The results of the present study clearly indicate that shockwave therapy achieved a significant reduction in pain as well as a significant improvement in both the functionality and quality of life after the completion of the therapeutic intervention and the 4-week follow-up in patients suffering from plantar fasciitis, elbow tendinopathy, Achilles tendinopathy and rotator cuff tendinopathy. Significant pain reduction and improvement in functionality and quality of life were also observed in the control groups of each tendinopathy, but these findings were less pronounced than those in the group treated with shock waves.

 

Extracorporeal shock wave therapy mechanisms in musculoskeletal regenerative medicine

Claudio Lopes Simplicio ^a, Joseph Purita ^b, William Murrell ^c, Gabriel Silva Santos ^d,∗, Rafael Gonzales dos Santos ^d, José Fábio Santos Duarte Lana ^d

• Author information
• Article notes
• Copyright and License information

PMCID: PMC7275282  PMID: 32523286

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.

 

Extracorporeal shockwave therapy for degenerative meniscal tears results in a decreased T2 relaxation time and pain relief: An exploratory randomized clinical trial

Shogo Hashimoto ¹, Takashi Ohsawa ¹, Hiroaki Omae ², Atsufumi Oshima ³, Ryota Takase ¹, Hirotaka Chikuda ¹

Conclusion: ESWT decreased the T2 relaxation time in the meniscus at 12 months post-treatment. ESWT also provided pain relief, but no differences were observed in clinical outcomes.

 

EXTRACORPOREAL SHOCKWAVE THERAPY IN SHOULDER INJURIES: PROSPECTIVE STUDY

Victor Otavio Moraes DE Oliveira ¹, Juliana Munhoz Vergara ¹, Vicente Furquim DE Oliveira ¹, Paulo Henrique Schmidt Lara ¹, Luiz Carlos Nogueira ¹, Gustavo Gonçalves Arliani ¹

Conclusion: Extracorporeal shockwave therapy proved to be efficient and safe in the treatment of shoulder pathologies, improving pain, range of motion and functional scores in all groups of patients evaluated in the study. Level of Evidence IV, Case series.

 

Extracorporeal shockwave therapy as a novel and potential treatment for degenerative cartilage and bone disease: Osteoarthritis. A qualitative analysis of the literature

Qiaodan Ji ¹, Pu Wang ¹, Chengqi He ²

 

The effect of extracorporeal shock wave therapy on the treatment of moderate to severe knee osteoarthritis and cartilage lesion

Yongming Xu ¹, Kun Wu ², Yu Liu ², Huan Geng ², Haochong Zhang ², Shuitao Liu ³, Hongying Qu ⁴, Gengyan Xing ²

Conclusions: The ESWT has potential in reducing pain and improving knee function, and the therapeutic effects may peak at 8 weeks after the completion of treatment.

 

What does the research say about focused shockwave and delayed-union and non-union fractures?

Research supports the use of focused shockwave for treating both delayed and non-union fractures, reporting it to be a reliable and safe modality (Mittermayr et al., 2021) with a success rate as high as 85% (Schleusser et al., 2020).

The Efficacy of Focused Extracorporeal Shock Wave Therapy and Ultrasound Therapy in the Treatment of Calcar Calcanei: A Randomized Study

Ivana Topalović ¹, Dejan Nešić ², Sindi Mitrović ³, Vera Miler Jerković ⁴, Ljubica Konstantinović ³

 

Patients treated with standard ultrasound therapy did not have a statistically significant reduction in the calcification size. In contrast, the patients in the experimental group treated with f-ESWT showed a substantial decrease in the calcification size.

 

Extracorporeal Shockwave Therapy as an Adjunctive Therapy for Frozen Shoulder: A Systematic Review and Meta-analysis

Ruihan Zhang ^*, Zhenyu Wang ^*,†, Ruishu Liu ^‡, Nan Zhang ^*, Jiaxun Guo ^*, Yunxia Huang ^*

Conclusion:  ESWT seems to be beneficial to patients with frozen shoulder by alleviating pain and improving function.

 

Efficacy of Extracorporeal Shockwave Therapy in Frozen Shoulder

Babak Vahdatpour ¹, Parisa Taheri ¹, Abolghasem Zare Zade ^1,✉, Saeed Moradian ¹

Conclusions:  The use of ESWT seems to have positive effects on treatment, quicker return to daily activities, and quality-of-life improvement on frozen shoulder.

 

The Role of Extracorporeal Shock Wave Therapy in the Treatment of Muscle Injuries: A Systematic Review

Yuriy Mazin ^1,✉, Carolina Lemos ², Carolina Paiva ³, Luís Amaral Oliveira ¹, Andre Borges ⁴, Tiago Lopes ¹

 

ESWT was associated with less pain on VAS, better function, reduction of size of lesion on ultrasound evaluation, faster RTP and/or lower re-injury rate in patients with indirect and direct muscle injuries and muscular hematomas, a frequent secondary complication of muscle injuries. The evidence regarding the use of ESWT for these types of injuries is therefore promising.

 

Clinical evaluation of the efficacy of focused extracorporeal shock-wave therapy in patients with cervical spondylosis: A randomized control trial

Shuangyue Li ¹, Jie Liu ², Yan Wang ³, Chan Zhu ¹, Yahong Tang ¹, Minghong Gu ¹

Conclusion: The fESWT has shown promising therapeutic effects in the treatment of cervical spondylosis. It effectively reduces patient pain, improves cervical function, and enhances the quality of life, making it worthy of clinical promotion and applicationSh.

 

The Effect of Extracorporeal Shock Wave Therapy on Pain Intensity and Neck Disability for Patients With Myofascial Pain Syndrome in the Neck and Shoulder: A Meta-Analysis of Randomized Controlled Trials

Ji Hyun Jun ¹, Geun-Young Park, Choong Sik Chae, Dong-Churl Suh

Conclusions: Extracorporeal shock wave therapy is superior to other treatments in terms of alleviating the pain intensity and pressure pain threshold of patients with myofascial pain syndrome in the neck and shoulder at postintervention. In particular, focused extracorporeal shock wave therapy shows significant improvement in pain relief. However, radical extracorporeal shock wave therapy for myofascial pain syndrome treatment still remains unclear.

 

Focused extracorporeal shockwave therapy for youth sports-related apophyseal injuries: case series

• Tarek Shafshak &
• Marwa Abdullah Amer

Journal of Orthopaedic Surgery and Research volume 18, Article number: 616 (2023)

Conclusion:  ESWT is a potentially safe and effective treatment for apophyseal injuries. It may facilitate an early return to sport activities.

 

Efficacy and safety of extracorporeal shock wave therapy for orthopedic conditions: a systematic review on studies listed in the PEDro database

Christoph Schmitz ^†,*, Nikolaus B M Császár ^†, Stefan Milz ^†, Matthias Schieker ^‡, Nicola Maffulli ^§,¶, Jan-Dirk Rompe ^||, John P Furia ^††

 

ESWT has been proven as an effective and safe non-invasive treatment option for tendon and other pathologies of the musculoskeletal system in a multitude of high-quality RCTs. For plantar fasciopathy, non-calcific tendinopathy of the supraspinatus tendon and calcifying tendonitis of the shoulder RCTs on ESWT are the predominant type of RCT in PEDro and obtained the highest PEDro scores among all investigated treatment modalities for these conditions. The latter criterion was also achieved for Achilles tendinopathy and lateral epicondylitis, albeit in a smaller number of RCTs. Therefore, ESWT should be considered by medical doctors, therapists, patients and payers when discussing treatment options for certain musculoskeletal pathologies.

 

Extracorporeal shock wave therapy mechanisms in musculoskeletal regenerative medicine

Claudio Lopes Simplicio ^a, Joseph Purita ^b, William Murrell ^c, Gabriel Silva Santos ^d,∗, Rafael Gonzales dos Santos ^d, José Fábio Santos Duarte Lana ^d

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.

Effectiveness and Safety of Shockwave Therapy in Tendinopathies

Vasileios Dedes ¹, Apostolos Stergioulas ², Georgios Kipreos ², Ariadni Maria Dede ³, Athanasios Mitseas ⁴, Georgios I Panoutsopoulos ¹

Conclusions:  Shockwave therapy significantly reduced the pain that accompanies tendinopathies and improves functionality and quality of life. It might be first choice because of its effectiveness and safety.

 

Efficacy of high energy, focused ESWT in treatment of lumbar facet joint pain - a randomized sham-controlled trial

Tomas Nedelka ^1 2 3, Jakub Katolicky ^2 4, Jiri Nedelka ², Paul Hobrough ⁵, Karsten Knobloch ⁶

Conclusions: High-energy focused ESWT is a safe and effective non-invasive therapy for chronic lumbar facet joint pain, showing sustained improvements in pain, function, and neuropathic symptoms. MRI findings support its biological effect on joint-related bone marrow edema. ESWT represents a promising alternative to interventional pain procedures.

 

EFFICACY OF FOCUSED SHOCKWAVE THERAPY IN PATIENTS WITH MODERATE-TO-SEVERE CARPAL TUNNEL SYNDROME: A PRELIMINARY STUDY

Pimpisa VONGVACHVASIN ¹, Thitiporn PHAKDEPIBOON ², Waree CHIRA-ADISAI ², Punpetch SIRIRATNA ²

Conclusion:   Focused extracorporeal shockwave therapy plus conservative treatment effectively provided short-term improvement in symptoms, hand function, and nerve conduction in patients with moderate-to-severe carpal tunnel syndrome compared with conservative treatment alone.

 

Effectiveness of focused extracorporeal shock wave therapy in the treatment of carpal tunnel syndrome

A randomized, placebo-controlled pilot study

Christina Gesslbauer ¹, Michael Mickel ¹, Othmar Schuhfried ¹, Dominikus Huber ¹, Mohammad Keilani ¹, Richard Crevenna ¹

Conclusion:   Focused extracorporeal shock wave therapy is an effective and noninvasive treatment method for mild to moderate carpal tunnel syndrome.

 

Extracorporeal Shock Wave Therapy in Dupuytren’s Disease

Serkan Aykut ^1,✉, Canan Aydın ², Kahraman Öztürk ¹, Fatih Arslanoğlu ³, Cem Yalın Kılınç ⁴

Conclusion:   We can suggest that ESWT in the early term can be preferred over costly injections and surgical intervention options as it increases the quality of life and delays the recurrence of contractures.

 

The Effect of Shock Wave Therapy on Improving the Symptoms and Function of Patients with Dupuytren's Contracture

Parisa Taheri ¹, Najmeh Salek ¹, Maryam Mousavi ¹, Razieh Maghroori ¹

Conclusion:   It can be concluded that shock wave therapy can be effective in improving the symptoms and function of patients with Dupuytren's Contracture.

 

Comparison Between Extracorporeal Shock Wave Therapy and Intra-articular Hyaluronic Acid Injections in the Treatment of First Carpometacarpal Joint Osteoarthritis

Francesco Ioppolo ¹, Fabiana Saracino ¹, Rosaria Sabrina Rizzo ¹, Giampaolo Monacelli ², Danilo Lanni ¹, Luca Di Sante ¹, Angelo Cacchio ³, Valter Santilli ¹, Teresa Venditto ¹

Conclusion:   The use of ESWT in patients with first CMC joint osteoarthritis leads to a reduction in pain, an improvement in pinch test performance that persists for at least 6 months, and a decrease in hand disability up to the 6-month follow-up visit.

 

Application of extracorporeal shock wave therapy in nervous system diseases: A review

Juan Guo ¹, Hong Hai ¹, Yuewen Ma ¹

ESWT is a form of mechanotherapy with a peak pressure of about 1,000 times more than ultrasound therapy (27). ESWT can be classified into focused ESWT (fESWT) and radial ESWT (rESWT) based on the wave patterns used (28). In general, a focused extracorporeal shock wave (fESW) is generated electrohydraulically, electromagnetically, or piezoelectrically, followed by converging it into a focal tissue zone (29). As an acoustic wave, fESW is characterized by its high pressure of more than 1,000 bar (100 MPa), an extremely short rise time (<10 ns), a short duration (<10 ms), and a broad frequency spectrum (16–20 MHz) (30–32). Unlike fESW, radial extracorporeal shock wave (rESW) does not possess the shock wave characteristics of a short rise time, a high peak pressure, and non-linearity. Some scholars even call “rESW” “radial pressure waves” because rESW uses the energy generated from compressed gas to drive the bullet body to the treated tissue area in a pulsed manner

 

Chapter Three - The Use of Shock Waves in Peripheral Nerve Regeneration: New Perspectives?

Author links open overlay panelThomas Hausner * ^† ‡, Antal Nógrádi * ^§

ESWT appears to have differential effects on peripheral nerves and has been proved to promote axonal regeneration after axotomy.

 

Effect of extracorporeal shock wave therapy on nerve conduction: a systematic review and meta-analysis

Liuxin Yang ¹, Xuan Li ¹, Shuhan Li ¹, Jiao Yang ¹, Dianhuai Meng ¹

Conclusion:      ESWT had some excitatory effect on peripheral nerves, especially on sensory nerve studies. Although the efficacy of this treatment was superior to that of the control group, and the combined treatment with PT was more effective than PT alone.

 

Long-term effect of shock wave therapy on upper limb hypertonia in patients affected by stroke

P Manganotti ¹, E Amelio

Conclusions: ESWT reduces hypertonia of the wrist and finger muscles for > or =12 weeks after treatment.