Second Application of Low-energy Shock Waves Has a Cumulative Effect on Free Nerve Endings

Takahashi, Norimasa; Ohtori, Seiji; Saisu, Takashi; Moriya, Hideshige; Wada, Yuichi

doi:10.1097/01.blo.0000188064.56091.a7

Cited by 77 publications

(67 citation statements)

References 21 publications

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“…Currently, there are no standardized guidelines for the number of rESWT sessions required when treating soft tissue conditions,50 although studies have suggested that multiple applications provide superior long-term results compared with a single application 51. Compared to other tendinopathies treated with rESWT, the finger is a rather painful area to treat.…”

Section: Discussionmentioning

confidence: 99%

Radial extracorporeal shockwave therapy for the treatment of finger tenosynovitis (trigger digit)

Malliaropoulos

Jury

Pyne

et al. 2016

OAJSM

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IntroductionStenosing tenosynovitis that is characterized by the inability to flex the digit smoothly, usually leads to prolonged rehabilitation or surgery.Study designThis case series is a retrospective cohort study.PurposeThe aim of this case series was to evaluate the effectiveness of radial extracorporeal shockwave therapy (rESWT) for the treatment of stenosing tenosynovitis of the digital flexor tendon (trigger digit).MethodsA retrospective analysis of 44 patients (49 fingers) treated with an individually adapted rESWT protocol was conducted. Trigger digit pain and function were evaluated at baseline and 1-, 3-, and 12-months posttreatment. Recurrence and pretreatment symptom duration were analyzed.ResultsSignificant reductions in pain scores and functional improvement were found between baseline and all follow-up assessments (P<0.001). Pretreatment symptom duration was significantly correlated with the number of rESWT sessions required (r=0.776, P<0.001) and 1-year posttreatment pain score (r=0.335, P=0.019).ConclusionThis study provides initial evidence that rESWT is an effective treatment for trigger digit, but randomised controlled trials are required to provide further evidence of this effect.

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Section: Discussionmentioning

confidence: 99%

Radial extracorporeal shockwave therapy for the treatment of finger tenosynovitis (trigger digit)

Malliaropoulos

Jury

Pyne

et al. 2016

OAJSM

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“…The fibers began to regenerate in 14 days. By applying a second session of shock waves at 14 days, the nerve fiber regeneration was delayed to 42 days [175]. There is also evidence tenocytes release growth factors in response to ESWT that may promote tendon healing.…”

Section: Extracorporeal Shock Wave Therapymentioning

confidence: 99%

Treatment of Tendinopathy: What Works, What Does Not, and What is on the Horizon

Andres

Murrell

2008

Clinical Orthopaedics &Amp; Related Research

454

345

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Tendinopathy is a broad term encompassing painful conditions occurring in and around tendons in response to overuse. Recent basic science research suggests little or no inflammation is present in these conditions. Thus, traditional treatment modalities aimed at controlling inflammation such as corticosteroid injections and nonsteroidal antiinflammatory medications (NSAIDS) may not be the most effective options. We performed a systematic review of the literature to determine the best treatment options for tendinopathy. We evaluated the effectiveness of NSAIDS, corticosteroid injections, exercise-based physical therapy, physical therapy modalities, shock wave therapy, sclerotherapy, nitric oxide patches, surgery, growth factors, and stem cell treatment. NSAIDS and corticosteroids appear to provide pain relief in the short term, but their effectiveness in the long term has not been demonstrated. We identified inconsistent results with shock wave therapy and physical therapy modalities such as ultrasound, iontophoresis and low-level laser therapy. Current data support the use of eccentric strengthening protocols, sclerotherapy, and nitric oxide patches, but larger, multicenter trials are needed to confirm the early results with these treatments. Preliminary work with growth factors and stem cells is promising, but further study is required in these fields. Surgery remains the last option due to the morbidity and inconsistent outcomes. The ideal treatment for tendinopathy remains unclear.

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“…Effects on soft tissues have been described as an early response involving activation of the sympathetic nerve endings and opening of the capillary bed (wash-out effect), and a secondary response, ensuing during the following days, leading to angiogenesis and removal of inflammatory mediators. A significant result of shock waves applied on soft tissues is the analgesic effect, which is due to action on nervous conduction (31), increase of free radicals that change nociceptors excitability, degeneration of nerve fibers that originate from small ATF3+ neurons, rapid degeneration of intracutaneous nerve fibers, and release of substance P (32). Several studies demonstrated the effectiveness of shock waves in promoting wound healing through the stimulation of many growth factors, such as EGF, IGF-l, VEGFA, and NO, inducing angiogenesis (33).…”

Section: Discussionmentioning

confidence: 99%

Long-Term Effectiveness of Combined Mechanotransduction Treatment in Jumper's Knee

et al. 2012

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The aim of the study was to show that the addition of extracorporeal shockwave therapy (ESWT) may significantly improve beneficial effects of eccentric training together with high efficiency focused acoustic waves for jumper's knee. We speculate that such an effect may be due to increased mechanotransduction effects on affected tissues. We assessed changes in pain and function in 42 male football players (aged 18-34 years) after a treatment protocol consisting of I session with focused ESWT per week combined with 3 physiotherapy sessions per week, for 3 consecutive weeks. While treatment protocol was administered, ordinary activities, but not playing football were permitted. Their condition was evaluated before treatment, at the end of the rehabilitation period (3 weeks) and at 2 months, 4 months and 6 months after the end of treatment by clinical examination, instrumental analysis and VAS for pain assessment. Functional ability related to symptoms was assessed with VISA score. At the end of 2005,2006,2007,2008 and 2009 we carried out a telephone interview to investigate changes in pain and function and the efficacy of the treatment over time. Follow-up controls showed a reduction of average VAS score; after 6 months, tendons showed a structure closer to normal at ultrasonographic investigation. At the last telephone interview in 2009 many patients reported to consider ESWT as an effective treatment and described a significant improvement in their functional abilities, a significant reduction in drug consumption and 88% ofsubjects continued to play agonistic football. In conclusion, our results showed that, through the addition of ESWT, the effects of the classic vibration and eccentric training combination were improved compared to those found in our experience without ESWT. Although a control group was not included in the study (vibration and eccentric training without ESWT), results show a promising improvement and justify future prospective studies with a control group and more case series.

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Second Application of Low-energy Shock Waves Has a Cumulative Effect on Free Nerve Endings

Cited by 77 publications

References 21 publications

Radial extracorporeal shockwave therapy for the treatment of finger tenosynovitis (trigger digit)

Radial extracorporeal shockwave therapy for the treatment of finger tenosynovitis (trigger digit)

Treatment of Tendinopathy: What Works, What Does Not, and What is on the Horizon

Long-Term Effectiveness of Combined Mechanotransduction Treatment in Jumper's Knee

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