Extracorporeal shock wave therapy (ESWT) is a noninvasive treatment that allows for the stimulation of healing in horses with soft tissue or bony injuries. Shockwave is a term used to describe a high energy soundwave that increases pressures as it moves through tissue. The shockwave is created within a fluid filled probe as a controlled ‘spark.’ There are several types of shockwave machines available and they are not all created equal. Focused shockwave machines generate the highest peak pressure and improved penetration depth. Radial pressure shockwaves produce a pressure wave via mechanical contact and have much shallower penetration and a lower peak pressure with a greatly reduced efficacy.
Focused ESWT produces a local tissue response when a site is treated leading to the release of inflammatory cytokines and growth factors. In effect, this helps stimulate the healing process. There is a recognized pain reduction seen in patients post treatment that varies in duration depending on severity and region treated.
ESWT has numerous applications including the treatment of wounds, sore backs, tendon and ligament injuries, osteoarthritis, and navicular syndrome. Of these applications, it is most often used to alleviate back pain, reduce discomfort, and improve the healing process in soft tissue injuries. Treatments are not recommended in acute injuries, and therefore a 10-14 day waiting period is advised to determine the full extent of an injury. Joints with osteoarthritis can be directly treated with ESWT and aid in maintaining comfort in these patients. Protocols will vary depending on the areas being treated. As an example, typical tendon/ligament injuries are treated every 2 weeks for 3 sessions shortly after initial onset of signs in addition to rest and a traditional rehabilitation program.
ESWT can be an important treatment option in horses that are unable to receive steroid injections into a joint. A diagnosis of Equine Metabolic Syndrome or Equine Cushing’s disease might be a reason to avoid steroids in a particular horse. ESWT is a great alternative that can provide pain relief without using a medication.
The ESWT machine itself creates a noise, so most horses do have an adjustment period getting comfortable with the sound. Patients are often sedated lightly for the first several sessions, however many patients become accustomed to the noise and no longer require sedation. An additional benefit of ESWT is that it can be transported to treat patients out in the field.
If you feel you have a horse that might benefit from shockwave therapy please don’t hesitate to contact us to discuss your horses’ particular case. Each patient has unique requirements and we can adapt protocols for a given patient and problem.