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The application of shock waves in orthopedic and rheumatologic diseases
Modern Rheumatology, 06/19/09

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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