HOW DOES SHOCKWAVE HELP TISSUE?
Low to medium energy waves, that can be created via different mechanisms, create a phenomenon referred to as mechanotransduction. In simple terms, it is the process of imparting brief, physical deformation to cells that lead to biochemical changes. These changes have the potential to positively impact pain and tissue repair. 5
“Mechanotransduction” is a biological pathway to which many cell types (including Stem Cells) sense and process the mechanical information from the extracellular environment. These biomechanical forces are converted in biochemical responses, thus influencing some fundamental cell functions such as migration, proliferation, differentiation, and apoptosis. 6
ARE ALL SOUNDWAVES THE SAME?
Some clinicians falsely assume that shockwave equipment is similar to
therapeutic ultrasound (US) since they both utilize soundwaves. It should be noted that therapeutic ultrasound uses a lower intensity sound wave (20 to 1000 mW/cm 2 ) that is delivered at a higher frequency (0.7 to 3.3 MHz.). 8 Therapeutic US waves look like this:
Image obtained from reference 7 in the bibliography.
Continuous US creates thermal effects in tissue by alternating compression and rarefaction of sound waves within tissue. Maximum energy absorption in soft tissue occurs from 2 to 5 cm and intensity decreases as the waves penetrate deeper. 8
Hopefully this review will provide some clarity for readers that are looking to better understand how ESWT can help various conditions.
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