How ESWT and RSWT® work

What are shock waves ?

A shock wave is a single acoustic pulse characterized by a rapid rise to a high peak pressure followed by a rapid drop to below ambient pressure.
“A shock wave (also called shock front or simply "shock") is a type of propagating disturbance. Like an ordinary wave, it carries energy and can propagate through a medium (solid, liquid or gas) [...]. Shock waves are characterized by an abrupt, nearly discontinuous change in the characteristics of the medium. Across a shock there is always an extremely rapid rise in pressure, temperature and density of the flow. [...]” (quotation from Wikipedia).

Generation of shock waves

The 2 principles involved in the generation of shock waves are:
Focused propagation of 3 differently generated shock waves (electro-hydraulic, piezo-electric and electro-magnetic) and
Radial propagation of pneumatically generated shock waves.

How do shock waves act on the musculoskeletal system ?

Shock waves are acoustic waves (single acoustic pulses).

Acoustic waves travel through a medium until the speed of sound changes. At this border the acoustic waves deliver energy or are reflected.

At the musculoskeletal system the speed of sound particularly changes at the border between soft tissue and bone, as well as at the surface of calcifications within the soft tissue (such as within tendons).

Radial shock wave therapy with the Swiss DolorClast® preferably addresses superficial indications, and focused shock wave therapy with the Swiss PiezoClast® preferably deep indications.

PHYSICAL MECHANISMS OF ACTION

Wave propagation
Cavitation

MOLECULAR AND CELLULAR MECHANISMS OF ACTION UNDERSTOOD

Reduction in sensation of chronic pain (mediated by non-myelinated C nerve fibers), immediate pain relief by depletion of substance P
Blockade of neurogenic inflammation (playing an important role in the pathogenesis of insertion tendinopathies such as tennis elbow, plantar fasciopathy, etc.)
Activation of mesenchymal stem cells (such as osteoblasts), thereby induction of healing
Release of growth factors
Improved blood circulation in the treated tissue