Extracorporeal Shock Wave Therapy (ESWT) is a non-invasive medical technique that uses high-energy sound waves to stimulate human tissues, promoting local blood circulation and regenerative repair. It is primarily used for chronic conditions of the musculoskeletal and urinary systems, such as non-union fractures, tendinitis, or erectile dysfunction. This therapy can improve tissue microenvironment without surgery and has been widely applied in sports medicine and rehabilitation medicine in recent years.
Based on energy intensity, there are three types: high-energy shock waves used for lithotripsy, and medium- and low-energy shock waves used for tissue repair. The treatment mechanism involves three stages: first, shock wave energy induces cells to release growth factors, stimulating angiogenesis; second, it promotes activation of osteoblasts and fibroblasts, accelerating tissue repair; finally, it modulates local nerve conduction, inhibiting pain signal transmission.
Main indications include non-union fractures, rotator cuff tendinitis (Frozen Shoulder), Achilles tendinitis, iliotibial band syndrome, and other chronic injuries. In recent years, its application has expanded to prostate diseases and diabetic foot ulcers. For patients who respond poorly to long-term medication, this therapy can serve as a second-line option, especially suitable for those who are not candidates for surgery due to age or comorbidities.
During treatment, patients need to expose the affected area. The physician locates the lesion with a probe and delivers shock waves in pulse mode. Each session lasts about 15-30 minutes, with the total number of shock waves adjusted according to symptoms, typically once a week for 3-5 sessions. The energy output should be adjusted based on tissue type; mild burning sensation on the skin may occur but no anesthesia is required.
Compared to traditional surgery, this therapy reduces tissue trauma and hospitalization needs, with patients able to resume daily activities the day after treatment. For chronic pain sufferers, it helps avoid the side effects of long-term steroid or analgesic use.
Common short-term reactions include redness, swelling, or temporary increase in pain at the treatment site, usually resolving within 1-3 days. Very rarely, patients may experience subcutaneous hematoma or temporary nerve paralysis. If severe bruising or tissue necrosis occurs, treatment should be stopped immediately. Patients with bleeding tendencies should be carefully evaluated.
Imaging examinations must be performed before treatment to confirm the lesion location, and anticoagulant medications should be discontinued at least 72 hours prior. Pregnant women and those with suspected unhealed fractures are prohibited from using this therapy.
It can be combined with physical therapy and medication, such as using heat therapy to enhance drug absorption. When using anticoagulants (e.g., warfarin), dosage adjustments or temporary discontinuation may be necessary. The timing with high-frequency electrical therapy or laser therapy should be evaluated by a physician to avoid energy interactions.
In cases of non-union fractures, 60-80% of patients show progress in bone healing within 3-6 months. Patients with Achilles tendinitis experience an average pain reduction of 40-60 after three sessions. Clinical studies indicate that shock wave therapy has a 25% higher long-term improvement rate in tendon disorders compared to traditional physical therapy. Individual responses vary, and imaging follow-up is recommended.
Alternatives include:
When choosing, compare invasiveness, recovery time, and cost. Surgery offers immediate results but has higher complication risks; medication may cause hepatotoxicity or nephrotoxicity.
Before extracorporeal shock wave therapy, doctors usually conduct a detailed medical history review and imaging examinations (such as ultrasound or X-ray) to confirm the indication. Patients should avoid using anticoagulant medications or supplements (like fish oil, vitamin E) at the treatment site to reduce bleeding risk, and wear clothing that exposes the treatment area on the day of treatment.
What should be paid attention to in daily care after treatment?Within 24 hours after treatment, avoid hot packs or baths. The treatment area may experience mild redness or bruising, which can be alleviated with ice packs. Wear comfortable clothing to reduce friction, and follow the physician's instructions to pause high-intensity activities. Usually, strenuous activities can resume after 3-7 days.
How should pain or bruising be handled after treatment?Mild pain or bruising is normal and can be relieved with ice packs for 15 minutes per session (3-4 times daily). If pain persists beyond 48 hours or bruising enlarges, return to the clinic for examination. Avoid massaging the treatment site to prevent worsening tissue damage.
What is the treatment schedule for extracorporeal shock wave therapy?The typical course involves 3-5 treatments, spaced 3-7 days apart, depending on the severity of the condition. Post-treatment, rehabilitation exercises or medication may be recommended. The physician will adjust subsequent treatment plans based on recovery progress. Completing the full course is advised to maximize efficacy.
What activities should be avoided during recovery?Within two weeks after treatment, avoid lifting heavy objects, prolonged standing, or intense exercise, especially for musculoskeletal issues. Gradually resume daily activities following the physician's rehabilitation plan. If engaged in physically demanding work, discuss with the physician when to adjust workload.
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