A new method of treating orthopedic injuries in horses is gaining interest among veterinarians and horse owners. Veterinarians around the world are using extracorporeal shock wave therapy (ESWT) and are encouraged by the results they are seeing with this technology. This article will summarize current research and applications of ESWT in human and veterinary medicine. Additionally, I will share some of my own experiences with equine cases.

Leading members of the veterinary community met in early March in Simpsonville, Ky., to discuss the latest in ESWT treatment findings and to introduce the technology to veterinarians interested in employing the therapy in their own practices. For more information on the Equine Musculoskeletal High-Energy Shockwave Therapy Symposium, see the news item in this month’s NewsFront section.

What Is ESWT?

Extracorporeal shock waves are energy waves that are transmitted through the skin into deeper anatomical structures. The waves are characterized by high positive pressures, and their energy is transmitted through the skin and underlying soft tissues with little to no harmful effect to the superficial tissues. The energy of the waves predominately is deposited within bone and soft tissues (as in high suspensory ligament injuries). Although the exact medical process is not clear, it appears that when the shock waves’ energy is delivered, two things occur: 1) A transient period of pain relief (analgesia), and 2) An eventual increased rate of bone and tissue remodeling (healing). Because of these effects, ESWT has gained considerable attention for the promotion of healing and remodeling musculoskeletal injuries.

Several types of machines are used currently for ESWT. Therefore, results seen with one machine type might not necessarily apply for other machine types. A debate currently exists regarding the importance of using an ESWT machine that focuses the shock waves. “Focused” machines create a fundamentally different wave than a “radial head” emits. While both types of machines create “pressure gradient waves,” the focused units create waves that focus on a specific point. Focused shock wave machines are larger and more expensive than machines that emit a radial shock wave, which spreads out concentrically from the unit