Shockwave treatments aid in the healing of your horse’s back and many lower limb lamenesses, especially tendon and ligaments. Covered by most horse insurance, it provides outstanding results.
Shockwave is a great addition to the arsenal of treatments that we can provide for a variety of injures. In the last few years, our ability to diagnose conditions has improved greatly (such as digital x-rays, 3D ultrasound, MRI), but we were still limited in our treatment options (rest, steroids, shoeing–to name a few). Shockwave gives us a great treatment option that is minimally invasive with proven results.
Extracorporeal shock wave therapy (ESWT) is an emerging new technology for treating musculoskeletal problems, soft-tissue and bone injuries in horses. ESWT is non-invasive and used to stimulate healing so horses return to a level of full soundness and useful activity without recurrence of disease. It actually heals tissues, not just suppresses pain and inflammation.
How is the wave produced?
A shockwave is a pressure wave – any action that displaces its surrounding medium is a shockwave. The ripple created when a stone is thrown into a pond is a shockwave. It has nothing to do with “shocking” or electricity. The shockwaves used in equine medicine are generated in a fluid medium inside a transducer head and are then transmitted readily through skin, fat, and muscle. The high energy waves are focused within the transducer head so that the shockwave can be directed to the precise area of the injury. When shockwaves hit an area of higher acoustic impedance, such as bone, the waves slow dramatically and a large amount of energy is released into the surrounding tissue.
From outside the body (extracorporeal), the machine generates high-intensity shock or pressure waves, which pulse to a specific site within the injured tissue. Though its actual mode of action is still in dispute, it stimulates and accelerates the healing process, essentially combining an immediate analgesic effect with a reduction in inflammation, creating new blood vessels in soft tissue and regeneration in bone.
Initially used to treat musculo-skeletal problems and kidney stones in humans, this same shockwave technology has been found to be highly effective in treating many lameness and musculo-skeletal problems in horses. Using hydraulic pressure, soundwaves are generated by the machine that penetrate the horse’s tissue, where they result in the release of beneficial bio-chemicals and stimulate the growth of a new blood supply to injured areas, as well as providing pain relief.
Shockwaves are high-energy sound waves, which are transmitted to the affected body part. There, they trigger the body’s natural repair mechanisms by stimulating immune-competent cells. Thus, a lasting healing response is achieved without any side-effects.
Shockwave therapy is similar to ultrasound because shockwave equipment sends a wave-like pulse into the tissue from a position outside the body. The energy of the acoustic (sound) wave produced by shockwave equipment is approximately 100 times higher than the energy of the acoustic (sound) wave produced by diagnostic ultrasound units used in equine veterinary medicine. While the acoustic (sound) wave produced by diagnostic ultrasound equipment does not distort body tissue as it enters, travels through, and then rebounds back out of the body tissues to be picked up by the ultrasound probe; the higher energy acoustic (sound) wave produced by equine shockwave equipment does distort the denser body tissues upon initial contact and again at rebound. The “shockwave” wave or pulse compresses denser body tissues such as ligaments, tendons, and bone on its initial journey into the body and then as the “shockwave” wave or pulse recedes these denser body tissues rebound and expand at the cellular level. So, while ultrasound waves rebound without tissue distortion and provide the viewer with a computer generated visual image of body tissues, “shockwave” waves do distort the denser body tissues and thereby essentially “massage” the denser body tissues at the cellular level. This micro-manipulation of the denser body tissues such as ligaments, tendons and bone by the shockwave acoustic (sound) wave stimulates neovascularization (growth of new blood vessels in tissue) and the production of fibroblasts and osteons (cells that heal tendon, ligament and bone). The cellular “deep tissue massage” produced by shockwave therapy also provides some degree of analgesia (pain control), improves healing rates in skin wounds, and produces improvement in infected injury sites.
Shockwave therapy has been shown to:
- Recruit stem cells locally so that the healing is most like the original tissue (less scarring)
- Stimulate new bone growth
- Increase cell permeability and stimulate the release of a cascade of healing and growth factors that contribute to the natural healing process
- Stimulate stem cells in the animal’s body to be directed to the treated area
- Cause neovascularization (an ingrowth of new blood vessels)
- Stimulate fibroblasts, the cells that generate new connective tissue
Shockwave therapy constitutes a new modality for dealing with refractory conditions, by stimulating the animals natural repair mechanisms.
ESWT is a non-invasive treatment that can speed the healing of many types of orthopedic and soft tissue injuries and conditions. It has been used in Europe in human medicine to treat tennis elbow, plantar fasciitis (heel pain), rotator cuff injuries, diabetic ulcers, calcifying tendonitis of the shoulder, femoral head necrosis (hip degeneration), non-union fractures, wounds, burns, osteomyelitis (infection of the bone) with draining tracts, and myofascial pain to name a few. New research has shown potential applications in treating periodontal disease, infected wounds, and to help speed fracture healing and reduce the incidence of non-union fractures. It has been approved by the U.S. Food and Drug Administration for use in people to treat plantar fasciitis and tennis elbow that fail to respond to six months of conventional therapy.
Shockwave therapy is very safe for the horse. Unlike surgical or injectable treatment options, it does not require sterility, prolonged recovery time, or bandaging, and does not present any risk from needle puncture. For hock and stifle problems, as well as sesamoiditis, it can be an excellent option for the owner who wants to avoid joint injections, or the horse who does not tolerate needles well. Although the horse is generally lightly sedated to prevent movement during therapy, the treatment is easily done in the standing horse, does not require clipping of the treated area, can be done on the farm, and takes only 10-20 minutes. Most horses improve quickly with responses being seen in 7-10 days.
Shockwave is a great option for treating several common horse injuries and conditions. It is non-invasive and well-tolerated by horses. It speeds healing and improves the quality of repair of tissue. It is affordable and covered by most insurance plans. Be wary of inferior shockwave devices that cannot deliver proven results.