The application of shock waves in orthopedic and rheumatologic diseases
Buch M et al. – Article gives a mini review of the application of shock waves in orthopedics. - Shock wave therapy (SWT) is used for the 4 main indications:
- Non-union of fractures
- Calcareous tendinitis
- Lateral epicondylitis and
- Plantar faciitis
- SWT is used in non-unions since the early 1990s; rate of success varies between 56 and 90% of bony union
- In pts with calcifications of the rotator cuff, shock wave therapy is used as a last step before operating
- Microfracturing of the deposit and a rupture of the pseudomembrane surrounding the calcification explain this effect
- Disintegration of the deposit can be seen in 73% in 6 wks
- Positive effects in chronic cases of enthesopathies (plantar fasciitis, epicondylitis) are explained by:
- Improvement in blood supply
- Alterations in the neuronal cell membrane and
- Gate control theory
- In chronic cases, when other conservative therapy modalities have failed and pts are sent to surgery, positive results can be achieved in 81% (heel spur) and 69% (epicondylitis)
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