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Extracorporeal shockwave therapy

January 01, 1970

"shock wave therapy" redirects here. For the use of electrical shocks in therapy, see Electroconvulsive therapy.

Extracorporeal shockwave therapy (ESWT) is a treatment using powerful acoustic pulses which is mostly used to treat kidney stones and in physical therapy and orthopedics.[1][2]

Extracorporeal shockwave therapy
ESWT device (EMS Swiss DolorClast)
ICD-10-PCS6A93
ICD-9-CM98.5
[edit on Wikidata]
ESWT device

Medical uses edit

 
Some of the passed fragments of a 1-cm calcium oxalate stone that was smashed using lithotripsy

The most common use of extracorporeal shockwave therapy (ESWT) is for lithotripsy to treat kidney stones[3] (urinary calculosis) and biliary calculi (stones in the gallbladder or in the liver) using an acoustic pulse. It is also reported to be used for salivary stones[4] and pancreatic stones.[5]

In the UK, the National Institute for Health and Care Excellence (NICE) found that the evidence for ESWT in the majority of indications is conflicting, and therefore ESWT should only be used where there are special arrangements for clinical governance and audit.[6] Two 2017 reviews had similar findings, with moderate level evidence at best.[7][8]

Extracorporeal shockwave therapy is used as a second line measure to treat tennis elbow,[9][10] shoulder rotator cuff pain,[11][12] achilles tendinitis,[13][14] plantar fasciitis,[15][16] and greater trochanteric pain syndrome.[17]

ESWT is also used to promote bone healing and treat bone necrosis.[18] It is an effective alternative to surgical treatment of non-healing fractures.[19]

ESWT is used for wound healing and has shown positive results in short-term and long-term outcomes in diabetic patients with foot ulcers.[20] Randomised controlled trials into the use of ESWT for healing venous leg ulcers are needed as there is a lack of evidence in this area.[21]

Procedure edit

The lithotripter attempts to break up the stone with minimal collateral damage by using an externally applied, focused, high-intensity acoustic pulse. The patient is usually sedated or anesthetized for the procedure in order to help them remain still and reduce possible discomfort.[22] Sedation is not required in its application for soft tissue injuries.

History edit

Beginning in 1969 and funded by the German Ministry of Defense, Dornier began a study of the effects of shock waves on tissue. In 1972, on the basis of preliminary studies performed by Dornier Medical Systems, an agreement was reached with Egbert Schmiedt, director of the urologic clinic at the University of Munich. The development of the Dornier lithotripter progressed through several prototypes, ultimately culminating in February 1980 with the first treatment of a human by SWL. The production and distribution of the Dornier HM3 lithotripter began in late 1983, and SWL was approved by the U.S. Food and Drug Administration in 1984.[23]

In the 1980s people using ESWT for kidney stones noticed that it appeared to increase bone density in nearby bones, leading them to explore it for orthopedic purposes.[24]

Research edit

In response to concerns raised by NICE, in 2012 a study called the Assessment of the Effectiveness of ESWT for Soft Tissue Injuries was launched (ASSERT).[6]

As of 2018 use of ESWT had been studied as a potential treatment for chronic prostatitis/chronic pelvic pain syndrome in three small studies; there were short term improvements in symptoms and few adverse effects, but the medium term results are unknown, and the results are difficult to generalize due to low quality of the studies.[25]

Veterinary use edit

ESWT is commonly used for treating orthopedic problems in horses, including tendon and ligament injuries, kissing spine, navicular syndrome, and arthritis. The evidence for these uses is weak.[24]

Physiotherapy use edit

ESWT is used in physical therapy for pain reduction, increase in metabolism at the cellular level, revascularisation, and recovering normal muscle tone following various disorders.[26] The use of ESWT was demonstrated in patients with frozen shoulders compared to therapeutic ultrasound with exercises.[27]

Research suggests that ESWT can accelerate the blood flow, facilitating the healing of the inflamed Achilles tendon.[citation needed] In one study involving 23 patients with chronic achilles tendinopathy, 20 reported improvement in their condition and pain scores after ESWT; three saw no change, and none reported any worsening.[28]

See also edit

References edit

  1. ^ Wang, Ching-Jen (2012). "Extracorporeal shockwave therapy in musculoskeletal disorders". Journal of Orthopaedic Surgery and Research. 7 (1): 11. doi:10.1186/1749-799X-7-11. PMC 3342893. PMID 22433113.
  2. ^ Chung, Bryan; Wiley, J. Preston (2002). "Extracorporeal Shockwave Therapy". Sports Medicine. 32 (13): 851–865. doi:10.2165/00007256-200232130-00004. PMID 12392445. S2CID 30387795.
  3. ^ Setthawong V, Srisubat A, Potisat S, Lojanapiwat B, Pattanittum P (August 2023). "Extracorporeal shock wave lithotripsy (ESWL) versus percutaneous nephrolithotomy (PCNL) or retrograde intrarenal surgery (RIRS) for kidney stones". The Cochrane Database of Systematic Reviews. 2023 (8): CD007044. doi:10.1002/14651858.CD007044.pub4. PMC 10392035. PMID 37526261.
  4. ^ "Salivary duct stones". MedlinePlus Medical Encyclopedia. U.S. National Library of Medicine.
  5. ^ Hayes JM, Ding SL (September 2012). "Pancreatic stone and treatment using ERCP and ESWL procedures: a case study and review". The New Zealand Medical Journal. 125 (1361): 89–97. PMID 22960720.
  6. ^ a b Maffulli G, Hemmings S, Maffulli N (September 2014). "Assessment of the Effectiveness of Extracorporeal Shock Wave Therapy (ESWT) For Soft Tissue Injuries (ASSERT): An Online Database Protocol". Translational Medicine @ UniSa. 10: 46–51. PMC 4140430. PMID 25147767.
  7. ^ Korakakis V, Whiteley R, Tzavara A, Malliaropoulos N (March 2018). "The effectiveness of extracorporeal shockwave therapy in common lower limb conditions: a systematic review including quantification of patient-rated pain reduction". British Journal of Sports Medicine. 52 (6): 387–407. doi:10.1136/bjsports-2016-097347. PMID 28954794.
  8. ^ Steuri R, Sattelmayer M, Elsig S, Kolly C, Tal A, Taeymans J, Hilfiker R (September 2017). "Effectiveness of conservative interventions including exercise, manual therapy and medical management in adults with shoulder impingement: a systematic review and meta-analysis of RCTs". British Journal of Sports Medicine. 51 (18): 1340–1347. doi:10.1136/bjsports-2016-096515. PMC 5574390. PMID 28630217.
  9. ^ "Extracorporeal shockwave therapy for refractory tennis elbow". Interventional procedures guidance. National Institute for Health and Clinical Excellence. August 2009. IPG313.
  10. ^ Thiele S, Thiele R, Gerdesmeyer L (December 2015). "Lateral epicondylitis: This is still a main indication for extracorporeal shockwave therapy". International Journal of Surgery. 24 (Pt B): 165–170. doi:10.1016/j.ijsu.2015.09.034. PMID 26455532.
  11. ^ "Extracorporeal shockwave lithotripsy for calcific tendonitis (tendinopathy) of the shoulder". Interventional procedures guidance. National Institute for Health and Clinical Excellence. November 2003. IPG21.
  12. ^ Louwerens JK, Sierevelt IN, van Noort A, van den Bekerom MP (August 2014). "Evidence for minimally invasive therapies in the management of chronic calcific tendinopathy of the rotator cuff: a systematic review and meta-analysis". Journal of Shoulder and Elbow Surgery. 23 (8): 1240–1249. doi:10.1016/j.jse.2014.02.002. PMID 24774621.
  13. ^ "Extracorporeal shockwave therapy for refractory Achilles tendinopathy". Interventional procedures guidance. National Institute for Health and Clinical Excellence. August 2009. IPG312.[needs update]
  14. ^ Wiegerinck JI, Kerkhoffs GM, van Sterkenburg MN, Sierevelt IN, van Dijk CN (June 2013). "Treatment for insertional Achilles tendinopathy: a systematic review". Knee Surgery, Sports Traumatology, Arthroscopy. 21 (6): 1345–1355. doi:10.1007/s00167-012-2219-8. PMID 23052113. S2CID 2214735.
  15. ^ "Extracorporeal shockwave therapy for refractory plantar fasciitis". Interventional procedures guidance. National Institute for Health and Clinical Excellence. August 2009. IPG311.
  16. ^ Yin MC, Ye J, Yao M, Cui XJ, Xia Y, Shen QX, et al. (August 2014). "Is extracorporeal shock wave therapy clinical efficacy for relief of chronic, recalcitrant plantar fasciitis? A systematic review and meta-analysis of randomized placebo or active-treatment controlled trials". Archives of Physical Medicine and Rehabilitation. 95 (8): 1585–1593. doi:10.1016/j.apmr.2014.01.033. PMID 24662810.
  17. ^ "Extracorporeal shockwave therapy for refractory greater trochanteric pain syndrome". Interventional procedures guidance. National Institute for Health and Clinical Excellence. January 2011. IPG376.
  18. ^ Cheng JH, Wang CJ (December 2015). "Biological mechanism of shockwave in bone". International Journal of Surgery. 24 (Pt B): 143–146. doi:10.1016/j.ijsu.2015.06.059. PMID 26118613.
  19. ^ Kong FR, Liang YJ, Qin SG, Li JJ, Li XL (January 2010). "[Clinical application of extracorporeal shock wave to repair and reconstruct osseous tissue framework in the treatment of avascular necrosis of the femoral head (ANFH)]". Zhongguo Gu Shang = China Journal of Orthopaedics and Traumatology (in Chinese). 23 (1): 12–15. PMID 20191955.
  20. ^ Wang CJ, Cheng JH, Kuo YR, Schaden W, Mittermayr R (December 2015). "Extracorporeal shockwave therapy in diabetic foot ulcers". International Journal of Surgery. 24 (Pt B): 207–209. doi:10.1016/j.ijsu.2015.06.024. PMID 26079500.
  21. ^ Cooper B, Bachoo P (June 2018). "Extracorporeal shock wave therapy for the healing and management of venous leg ulcers". The Cochrane Database of Systematic Reviews. 2018 (6): CD011842. doi:10.1002/14651858.CD011842.pub2. PMC 6513251. PMID 29889978.
  22. ^ "Lithotrypsy" National Kidney Foundation, Accessed February 6, 2017
  23. ^ "Gastroenterology and Urology Devices; Reclassification of the Extracorporeal Shock Wave Lithotripter AGENCY: Food and Drug Administration, HHS ACTION: Proposed rule". Federal Register (US Government). February 8, 1999. Retrieved February 6, 2017.
  24. ^ a b Chamberlain GA, Colborne GR (2016). "A review of the cellular and molecular effects of extracorporeal shockwave therapy". Veterinary and Comparative Orthopaedics and Traumatology. 29 (2): 99–107. doi:10.3415/VCOT-15-04-0057. PMID 26846274. S2CID 19280257.  
  25. ^ Franco JV, Turk T, Jung JH, Xiao YT, Iakhno S, Garrote V, Vietto V (May 2018). "Non-pharmacological interventions for treating chronic prostatitis/chronic pelvic pain syndrome". The Cochrane Database of Systematic Reviews. 2018 (5): CD012551. doi:10.1002/14651858.CD012551.pub3. PMC 6494451. PMID 29757454.
  26. ^ Gündüz R, Malas FÜ, Borman P, Kocaoğlu S, Özçakar L (May 2012). "Physical therapy, corticosteroid injection, and extracorporeal shock wave treatment in lateral epicondylitis. Clinical and ultrasonographical comparison". Clinical Rheumatology. 31 (5): 807–812. doi:10.1007/s10067-012-1939-y. PMID 22278162. S2CID 13109216.
  27. ^ Muthukrishnan R, Rashid AA, Al-Alkharji F (July 2019). "The effectiveness of extracorporeal shockwave therapy for frozen shoulder in patients with diabetes: randomized control trial". Journal of Physical Therapy Science. 31 (7): 493–497. doi:10.1589/jpts.31.493. PMC 6642889. PMID 31417208.
  28. ^ Fridman R, Cain JD, Weil L, Weil L (November–December 2008). "Extracorporeal shockwave therapy for the treatment of Achilles tendinopathies: a prospective study". Journal of the American Podiatric Medical Association. 98 (6): 466–468. doi:10.7547/0980466. PMID 19017855.

January 01, 1970
extracorporeal, shockwave, therapy, shock, wave, therapy, redirects, here, electrical, shocks, therapy, electroconvulsive, therapy, eswt, treatment, using, powerful, acoustic, pulses, which, mostly, used, treat, kidney, stones, physical, therapy, orthopedics, . shock wave therapy redirects here For the use of electrical shocks in therapy see Electroconvulsive therapy Extracorporeal shockwave therapy ESWT is a treatment using powerful acoustic pulses which is mostly used to treat kidney stones and in physical therapy and orthopedics 1 2 Extracorporeal shockwave therapyESWT device EMS Swiss DolorClast ICD 10 PCS6A93ICD 9 CM98 5 edit on Wikidata ESWT device Contents 1 Medical uses 2 Procedure 3 History 4 Research 5 Veterinary use 6 Physiotherapy use 7 See also 8 ReferencesMedical uses edit nbsp Some of the passed fragments of a 1 cm calcium oxalate stone that was smashed using lithotripsy The most common use of extracorporeal shockwave therapy ESWT is for lithotripsy to treat kidney stones 3 urinary calculosis and biliary calculi stones in the gallbladder or in the liver using an acoustic pulse It is also reported to be used for salivary stones 4 and pancreatic stones 5 In the UK the National Institute for Health and Care Excellence NICE found that the evidence for ESWT in the majority of indications is conflicting and therefore ESWT should only be used where there are special arrangements for clinical governance and audit 6 Two 2017 reviews had similar findings with moderate level evidence at best 7 8 Extracorporeal shockwave therapy is used as a second line measure to treat tennis elbow 9 10 shoulder rotator cuff pain 11 12 achilles tendinitis 13 14 plantar fasciitis 15 16 and greater trochanteric pain syndrome 17 ESWT is also used to promote bone healing and treat bone necrosis 18 It is an effective alternative to surgical treatment of non healing fractures 19 ESWT is used for wound healing and has shown positive results in short term and long term outcomes in diabetic patients with foot ulcers 20 Randomised controlled trials into the use of ESWT for healing venous leg ulcers are needed as there is a lack of evidence in this area 21 Procedure editThe lithotripter attempts to break up the stone with minimal collateral damage by using an externally applied focused high intensity acoustic pulse The patient is usually sedated or anesthetized for the procedure in order to help them remain still and reduce possible discomfort 22 Sedation is not required in its application for soft tissue injuries History editBeginning in 1969 and funded by the German Ministry of Defense Dornier began a study of the effects of shock waves on tissue In 1972 on the basis of preliminary studies performed by Dornier Medical Systems an agreement was reached with Egbert Schmiedt director of the urologic clinic at the University of Munich The development of the Dornier lithotripter progressed through several prototypes ultimately culminating in February 1980 with the first treatment of a human by SWL The production and distribution of the Dornier HM3 lithotripter began in late 1983 and SWL was approved by the U S Food and Drug Administration in 1984 23 In the 1980s people using ESWT for kidney stones noticed that it appeared to increase bone density in nearby bones leading them to explore it for orthopedic purposes 24 Research editIn response to concerns raised by NICE in 2012 a study called the Assessment of the Effectiveness of ESWT for Soft Tissue Injuries was launched ASSERT 6 As of 2018 use of ESWT had been studied as a potential treatment for chronic prostatitis chronic pelvic pain syndrome in three small studies there were short term improvements in symptoms and few adverse effects but the medium term results are unknown and the results are difficult to generalize due to low quality of the studies 25 Veterinary use editESWT is commonly used for treating orthopedic problems in horses including tendon and ligament injuries kissing spine navicular syndrome and arthritis The evidence for these uses is weak 24 Physiotherapy use editESWT is used in physical therapy for pain reduction increase in metabolism at the cellular level revascularisation and recovering normal muscle tone following various disorders 26 The use of ESWT was demonstrated in patients with frozen shoulders compared to therapeutic ultrasound with exercises 27 Research suggests that ESWT can accelerate the blood flow facilitating the healing of the inflamed Achilles tendon citation needed In one study involving 23 patients with chronic achilles tendinopathy 20 reported improvement in their condition and pain scores after ESWT three saw no change and none reported any worsening 28 See also editLaser lithotripsyReferences edit Wang Ching Jen 2012 Extracorporeal shockwave therapy in musculoskeletal disorders Journal of Orthopaedic Surgery and Research 7 1 11 doi 10 1186 1749 799X 7 11 PMC 3342893 PMID 22433113 Chung Bryan Wiley J Preston 2002 Extracorporeal Shockwave Therapy Sports Medicine 32 13 851 865 doi 10 2165 00007256 200232130 00004 PMID 12392445 S2CID 30387795 Setthawong V Srisubat A Potisat S Lojanapiwat B Pattanittum P August 2023 Extracorporeal shock wave lithotripsy ESWL versus percutaneous nephrolithotomy PCNL or retrograde intrarenal surgery RIRS for kidney stones The Cochrane Database of Systematic Reviews 2023 8 CD007044 doi 10 1002 14651858 CD007044 pub4 PMC 10392035 PMID 37526261 Salivary duct stones MedlinePlus Medical Encyclopedia U S National Library of Medicine Hayes JM Ding SL September 2012 Pancreatic stone and treatment using ERCP and ESWL procedures a case study and review The New Zealand Medical Journal 125 1361 89 97 PMID 22960720 a b Maffulli G Hemmings S Maffulli N September 2014 Assessment of the Effectiveness of Extracorporeal Shock Wave Therapy ESWT For Soft Tissue Injuries ASSERT An Online Database Protocol Translational Medicine UniSa 10 46 51 PMC 4140430 PMID 25147767 Korakakis V Whiteley R Tzavara A Malliaropoulos N March 2018 The effectiveness of extracorporeal shockwave therapy in common lower limb conditions a systematic review including quantification of patient rated pain reduction British Journal of Sports Medicine 52 6 387 407 doi 10 1136 bjsports 2016 097347 PMID 28954794 Steuri R Sattelmayer M Elsig S Kolly C Tal A Taeymans J Hilfiker R September 2017 Effectiveness of conservative interventions including exercise manual therapy and medical management in adults with shoulder impingement a systematic review and meta analysis of RCTs British Journal of Sports Medicine 51 18 1340 1347 doi 10 1136 bjsports 2016 096515 PMC 5574390 PMID 28630217 Extracorporeal shockwave therapy for refractory tennis elbow Interventional procedures guidance National Institute for Health and Clinical Excellence August 2009 IPG313 Thiele S Thiele R Gerdesmeyer L December 2015 Lateral epicondylitis This is still a main indication for extracorporeal shockwave therapy International Journal of Surgery 24 Pt B 165 170 doi 10 1016 j ijsu 2015 09 034 PMID 26455532 Extracorporeal shockwave lithotripsy for calcific tendonitis tendinopathy of the shoulder Interventional procedures guidance National Institute for Health and Clinical Excellence November 2003 IPG21 Louwerens JK Sierevelt IN van Noort A van den Bekerom MP August 2014 Evidence for minimally invasive therapies in the management of chronic calcific tendinopathy of the rotator cuff a systematic review and meta analysis Journal of Shoulder and Elbow Surgery 23 8 1240 1249 doi 10 1016 j jse 2014 02 002 PMID 24774621 Extracorporeal shockwave therapy for refractory Achilles tendinopathy Interventional procedures guidance National Institute for Health and Clinical Excellence August 2009 IPG312 needs update Wiegerinck JI Kerkhoffs GM van Sterkenburg MN Sierevelt IN van Dijk CN June 2013 Treatment for insertional Achilles tendinopathy a systematic review Knee Surgery Sports Traumatology Arthroscopy 21 6 1345 1355 doi 10 1007 s00167 012 2219 8 PMID 23052113 S2CID 2214735 Extracorporeal shockwave therapy for refractory plantar fasciitis Interventional procedures guidance National Institute for Health and Clinical Excellence August 2009 IPG311 Yin MC Ye J Yao M Cui XJ Xia Y Shen QX et al August 2014 Is extracorporeal shock wave therapy clinical efficacy for relief of chronic recalcitrant plantar fasciitis A systematic review and meta analysis of randomized placebo or active treatment controlled trials Archives of Physical Medicine and Rehabilitation 95 8 1585 1593 doi 10 1016 j apmr 2014 01 033 PMID 24662810 Extracorporeal shockwave therapy for refractory greater trochanteric pain syndrome Interventional procedures guidance National Institute for Health and Clinical Excellence January 2011 IPG376 Cheng JH Wang CJ December 2015 Biological mechanism of shockwave in bone International Journal of Surgery 24 Pt B 143 146 doi 10 1016 j ijsu 2015 06 059 PMID 26118613 Kong FR Liang YJ Qin SG Li JJ Li XL January 2010 Clinical application of extracorporeal shock wave to repair and reconstruct osseous tissue framework in the treatment of avascular necrosis of the femoral head ANFH Zhongguo Gu Shang China Journal of Orthopaedics and Traumatology in Chinese 23 1 12 15 PMID 20191955 Wang CJ Cheng JH Kuo YR Schaden W Mittermayr R December 2015 Extracorporeal shockwave therapy in diabetic foot ulcers International Journal of Surgery 24 Pt B 207 209 doi 10 1016 j ijsu 2015 06 024 PMID 26079500 Cooper B Bachoo P June 2018 Extracorporeal shock wave therapy for the healing and management of venous leg ulcers The Cochrane Database of Systematic Reviews 2018 6 CD011842 doi 10 1002 14651858 CD011842 pub2 PMC 6513251 PMID 29889978 Lithotrypsy National Kidney Foundation Accessed February 6 2017 Gastroenterology and Urology Devices Reclassification of the Extracorporeal Shock Wave Lithotripter AGENCY Food and Drug Administration HHS ACTION Proposed rule Federal Register US Government February 8 1999 Retrieved February 6 2017 a b Chamberlain GA Colborne GR 2016 A review of the cellular and molecular effects of extracorporeal shockwave therapy Veterinary and Comparative Orthopaedics and Traumatology 29 2 99 107 doi 10 3415 VCOT 15 04 0057 PMID 26846274 S2CID 19280257 nbsp Franco JV Turk T Jung JH Xiao YT Iakhno S Garrote V Vietto V May 2018 Non pharmacological interventions for treating chronic prostatitis chronic pelvic pain syndrome The Cochrane Database of Systematic Reviews 2018 5 CD012551 doi 10 1002 14651858 CD012551 pub3 PMC 6494451 PMID 29757454 Gunduz R Malas FU Borman P Kocaoglu S Ozcakar L May 2012 Physical therapy corticosteroid injection and extracorporeal shock wave treatment in lateral epicondylitis Clinical and ultrasonographical comparison Clinical Rheumatology 31 5 807 812 doi 10 1007 s10067 012 1939 y PMID 22278162 S2CID 13109216 Muthukrishnan R Rashid AA Al Alkharji F July 2019 The effectiveness of extracorporeal shockwave therapy for frozen shoulder in patients with diabetes randomized control trial Journal of Physical Therapy Science 31 7 493 497 doi 10 1589 jpts 31 493 PMC 6642889 PMID 31417208 Fridman R Cain JD Weil L Weil L November December 2008 Extracorporeal shockwave therapy for the treatment of Achilles tendinopathies a prospective study Journal of the American Podiatric Medical Association 98 6 466 468 doi 10 7547 0980466 PMID 19017855 Retrieved from https en wikipedia org w index php title Extracorporeal shockwave therapy amp oldid 1220190563, wikipedia, wiki, book, books, library,

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