How does shockwave therapy work?

Shockwaves can trigger change in our cells

Our bodies are quite amazing structures. They are able to adapt to a changing environments and mechanical forces. The emerging field of science known as regenerative medicine has erupted. This investigates how physical forces towards the cell change development , physiology and even disease. This area of science is where extracorpeal shockwave therapy currently resides.

There is more than shockwave that can create mechanical stress=healing potential.
These include:
  • Physical therapy and exercise
  • Surgery
  • PRP injections
  • Stem cell injections

How does shockwave work?

There are hypotheses and assumptions how shockwave therapy works. Clinicians will often explain shockwave as force that causes micro trauma. But this is not exactly accurate. Recent studies have identified that there is insufficient data to support this theory. Researcher Wang (2014), reported shockwave to grow blood cells and increased growth factors. These include:

  • Vessel endothelial growth factor
  • Increase protein synthesis
  • Among other confusing scientific findings

None of his findings suggest that shockwave creates micro-damage or destruction.
Shockwave is mechanical therapy that can suppress the production of inflammatory substances. It can also increase modulators such as nitric oxide.
Acting as a physical energy, shockwave is able to trigger a series of biological events. These events stimulate change that can ultimately create therapeutic outcomes. The trigger created by a shockwave creates the starting point for the healing process. From this "trigger", cells can communicate, increase, move around, and change.
Currently, researchers are attempting to identify the effects it has on human cells. Looking at tendon cells, researchers found interesting pathways to healing that include:

  • Positive regulation of cell vitality and proliferation
  • Collagen synthesis
  • Reduced expression of several interleukens

Shockwave can change bone

Shockwave has an effect on bone disorders and blood flow insufficiency.
After SW exposure, it reported:

  • Stimulation of osteoclasts (bone forming cells)
  • Expression of angiogenesis-related growth factors (blood vessel formation)
  • Stimulation of the periosteum (increased bone healing)

More recently, there is evidence showing shockwaves can create immunomodulation. This immune reaction is part of a series of complex events that promotes healing. Interesting, one study reported that macrophages (large eating immune cells) play an important role. Macrophages were activated to go and eat up inflammation.

It doesn't End here...

The effects of shockwave therapy may not even end at this immune response. There is also an effect on neurological tissue. Wess, published an article on how shockwaves could reorganize pathological memory traces. This communication from the body to the brain could provide pain relief. The erasing of pain memories could help patients get relief from pain that is "stuck" in the brain. It may open the doors to treating a wide spectrum of disorders. 

Final remarks

It is an exciting time in regenerative medicine! A unnamed retired biologist spent his career analyzing cells said it best...

"the way i see it, and I am living proof, that shockwave works. And you see, well, its the potential of the cell, and the nucleus. When the sound wave penetrates the cell, it is able to trigger infinite potential. Some we can see and some we have not yet been able to identify.