Peer Reviewed
Rheumatology clinic

New therapy for musculoskeletal conditions? Extracorporeal shockwave treatment

Les Barnsley, Julia Martin
Abstract
Public interest in the use of extracorporeal shockwave treatment for musculoskeletal problems is increasing. This article will review the empirical evidence for its effectiveness in four specific conditions.
Key Points
    What is extracorporeal shockwave therapy?

    Extracorporeal shockwave treatment (ESWT) or ‘orthotripsy’ is a new therapy for musculoskeletal conditions that is receiving significant media attention. The use of shock waves (high intensity sound waves) in medicine is not new and, in the setting of calcific tendonitis of the shoulder, ESWT is analogous to classic lithotripsy (the calcium deposit being the target). In other conditions (such as enthesopathy) the mechanism of action is uncertain, although there may be a direct effect on local nerves causing ‘hyperstimulation anaesthesia’, and physical effects on cell permeability and induction of diffusible radicals.

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