Extracorporeal shock wave therapy (ECSWT, or shockwave) is a rehabilitation modality which has increased in popularity over the last two decades. Used in many species (humans included!) for healing and pain relief, shock wave is used most commonly in our equine patients to treat soft tissue injuries.
What is Shock Wave Therapy, and How Does it Work?
Though the name may elicit thoughts of an electrical current, a shock wave is actually an acoustic pressure wave with both positive and negative pressure oscillations. Shock waves are high pressure, short energy impulses that travel in microseconds. The initial use of shock waves were to break up urinary stones in humans, but it was quickly discovered that the waves increased the density of the pelvis of those patients.
The shock wave treatment is provided using a machine with a probe. The shockwave generator sends the sound waves directly to the treatment area through the probe. There are various probes with different focal depths, allowing the veterinarian the ability to treat different tissue sites, from superficial injuries close to the surface of the skin to deep injuries of soft tissues and joints.
How Does it Help the Horse?
The primary mechanism of action of shock wave therapy is increasing blood flow, facilitating ingrowth of new blood vessels, providing pain relief, stimulating osteoblast (bone growth) activity, and promoting a healing environment in the treated area through release of a variety of growth factors. Common indications for shock wave therapy in horses include soft tissue injuries, navicular syndrome, and back pain.
Patient Preparation
Shock wave therapy is a non-invasive therapeutic modality that is generally well-tolerated by most horses. Safe application may sometimes be facilitated with administration of light sedation, appropriate patient restraint, and sometimes ear plugs due to the loud noise generated by the machine. Preparation of the site(s) of treatment sometimes include clipping the hair, washing the skin, and application of acoustic coupling gel.
Who Can Perform Shock Wave Therapy?
Due to the high-energy treatments and pain relief offered by shock wave therapy, only licensed veterinarians should prescribe treatment. Horse owners researching shock wave therapy should be wary of anyone claiming to offer shock wave treatment who is not a veterinarian.
In addition, many equestrian governing bodies across multiple disciplines have guidelines in place about when shockwave treatments may be performed. Since shockwave therapy often provides significant pain-relief for up to 72 hours, some organizations and competitions have rules in place to prevent injury in the days immediately following treatment. If you are competing with your horse, be sure to check with your governing body to ensure compliance with their guidelines regarding treatment before and during competition.
