Shockwave Therapy Clinical Evidence: Orthopedics

Clinical Data:
Acoustic Pressure Waves in Medicine

These articles offer insight into the uses and benefits of non-surgical approaches to include radial pressure wave (EPAT®) and focused shockwave (ESWT) in the field of orthopedics.

Please note: Some of the information contained in the articles listed may pertain to products, indications for use of products and/or treatments/ procedures that are only available outside the United States and have not been approved or cleared for marketing by the United States Food & Drug Administration.

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Foot and Ankle

Extracorporeal shockwave therapy in patients with Morton’s Neuroma.

Hyun Seok , MD, PhD, Sang-Hyun Kim , MD, PhD, Seung Yeol Lee , MD, Sung Won Park , MD Journal of the American Podiatric Medical Association (2016)

Clinically relevant effectiveness of focused extracorporeal shock wave therapy in the treatment of chronic plantar fasciitis: a randomized, controlled multicenter study

Gollwitzer, H; Saxena, A; DiDomenico, LA; Galli, L; Bouché, RT; Caminear, DS; Fullem, B; Vester, JC; Horn, C; Banke, IJ; Burgkart, R; Gerdesmeyer, L. The Journal of Bone and Joint Surgery (2015)

Two emerging technologies for achilles tendinopathy and plantar fasciopathy. Langer PR.

Clinics in Podiatric Medicine and Surgery (2015)

Ultrasonographic evaluation of low energy extracorporeal pulse activated therapy (EPAT) for chronic plantar fasciitis.

Gordon R, Wong C, Crawford EJ. Foot & Ankle International (2012)

Comparison between extracorporeal shockwave therapy, placebo ESWT and endoscopic plantar fasciotomy for the treatment of chronic plantar heel pain in the athlete.

Saxena A, Fournier M, Gerdesmeyer L, Gollwitzer H. Muscles, Ligaments and Tendons Journal (2012)

Successful treatment of chronic plantar fasciitis with two sessions of radial extracorporeal shock wave therapy.

Ibrahim Ibrahim M, Donatelli R, Schmitz C, Hellman M, Buxbaum F. Foot & Ankle International (2010)

Comparison of radial versus focused extracorporeal shock waves in plantar fasciitis using functional measures.

Lohrer H, Nauck T, Dorn-Lange NV, Schöll J, Vester JC. Foot Ankle International (2010)

Radial extracorporeal shock wave therapy is safe and effective in the treatment of chronic recalcitrant plantar fasciitis: results of a confirmatory randomized placebo-controlled multicenter study.

Gerdesmeyer L, Frey C, Vester J, Maier M, Weil L Jr, Weil L Sr, Russlies M, Stienstra J, Scurran B, Fedder K, Diehl P, Lohrer H, Henne M, Gollwitzer H. American Journal of Sports Medicine (2008)

Extracorporeal shock wave therapy for chronic painful heel syndrome: a prospective, double blind, randomized trial assessing the efficacy of a new electromagnetic shock wave device.

Gollwitzer H, Diehl P, von Korff A, Rahlfs VW, Gerdesmeyer L. Journal of Foot Ankle Surgery (2007)

Extracorporeal Shock Wave Therapy for the Treatment of Plantar Fasciitis.

Theodore GH, Buch M, Amendola A, Bachmann C, Fleming LL, Zingas C. Foot & Ankle International (2004)

Effect of shock-wave therapy on patellar tendinopathy in a rabbit model.

Hsu RW, Hsu WH, Tai CL, Lee KF. Journal of Orthopedic Research (2004)

Ultrasonographic evaluation at 6-month follow-up of plantar fasciitis after extracorporeal shock wave therapy.

Hammer DS, Adam F, Kreutz A, Rupp S, Kohn D, Seil R. Archives of Orthopaedic and Trauma Surgery (2003)

Shock wave therapy induces neovascularization at the tendon-bone junction: a study in rabbits.

Wang CJ, Wang FS, Yang KD, Weng LH, Hsu CC, Huang CS, Yang LC. Journal of Orthopedic Research (2003)

Preliminary Results on the Safety and Efficacy of ESWT for Treatment of Plantar Fasciitis.

Alvarez R. Foot & Ankle International (2002)

Efficacy of Different Energy Levels Used in Focused and Radial Extracorporeal Shockwave Therapy in the Treatment of Plantar Fasciitis: A Meta-Analysis of Randomized Placebo-Controlled Trials

Ying-Chun Wang,Shu-Jung Chen, Peng-Ju Huang, Hsuan-Ti Huang, Yuh-Min Cheng, and Chia-Lung Shih Journal of Clinical Medicine (2019)

Study: Radial ESWT Superior To Corticosteroids For Plantar Fasciitis

Brian McCurdy Podiatry Today (2017)

Extra Corporeal Shock Wave Therapy Versus Local Corticosteroid Injection in the Treatment of Chronic Plantar Fasciitis, a Single Blinded Randomized Clinical Trial

Eslamian F, Shakouri SK, Jahanjoo F, Hajialiloo M, Notghi F Pain Medicine (2016)

Achilles

Extracorporeal shock wave therapy improves the walking ability of patients with peripheral artery disease and intermittent claudication.

Serizawa F, Ito K, Kawamura K, Tsuchida K, Hamada Y, Zukeran T, Shimizu T, Akamatsu D, Hashimoto M, Goto H, Watanabe T, Sato A, Shimokawa H, Satomi S. Japanese Circulation Journal (2012)

Extra-corporeal pulsed-activated therapy (“EPAT” sound wave) for Achilles tendinopathy: a prospective study.

Saxena A, Ramdath S Jr, O’Halloran P, Gerdesmeyer L, Gollwitzer H. The Journal of Foot & Ankle Surgery (2011)

Eccentric loading versus eccentric loading plus shock-wave treatment for midportion Achilles tendinopathy: a randomized controlled trial.

Rompe JD, Furia J, Maffulli N. American Journal of Sports Medicine (2009)

Eccentric loading compared with shock wave treatment for chronic insertional achilles tendinopathy: a randomized, controlled trial.

Rompe JD, Furia J, Maffulli N. The Journal of Bone and Joint Surgery (2008)

Eccentric loading, shock-wave treatment, or a wait-and-see policy for tendinopathy of the main body of tendon Achillis: a randomized controlled trial.

http://www.ncbi.nlm.nih.gov/pubmed/17244902

High-energy extracorporeal shock wave therapy as a treatment for insertional Achilles tendinopathy.

Furia JP. The American Journal of Sports Medicine (2006)

Shock wave therapy for chronic Achilles tendon pain: a randomized placebo-controlled trial.

Costa ML, Shepstone L, Donell ST, Thomas TL. Clinical Orthopedics and Related Research (2005)

Current Evidence Of Extracorporeal Shock Wave Therapy In Chronic Achilles Tendinopathy

Gerdesmeyer L. Mittermayr R, Fuerst M, AI Muderis M, Theiel R, Saxena A International Journal of Surgery (2015)

Elbow

Repetitive shock wave therapy for lateral elbow tendinopathy (tennis elbow): a systematic and qualitative analysis.

Rompe JD, Maffulli N. British Medical Bulletin (2007)

Extracorporeal shock wave therapy without local anesthesia for chronic lateral epicondylitis.

Pettrone FA, McCall BR. Journal of Bone and Joint Surgery (2005)

Safety and Efficacy of Extracorporeal Shock Wave Therapy for Chronic Lateral Epicondylitis.

Furia, JP. The American Journal of Orthopedics (2005)

Repetitive low-energy shock wave treatment for chronic lateral epicondylitis in tennis players.

Rompe JD, Decking J, Schoellner C, Theis C. American Journal of Sports Medicine (2004)

Shockwave therapy for patients with lateral epicondylitis of the elbow – A one to two year follow-up study.

Wang CJ. American Journal of Sports Medicine (2002)

Effectiveness Of Extracorporeal Shock Wave Therapy in Patients With Tennis Elbow: A Meta-Analysis of Randomized Controlled Trials

Chenxiao Zheng, Dongjie Zeng, Jiayi Chen, Sijing Liu, Jianyi Li, Zhaohai Ruan, Wusheng Liang Medicine (2020)

Lower Extremity

The effectiveness of extracorporeal shock wave therapy in lower limb tendinopathy: a systematic review.

Mani-Babu S, Morrissey D, Waugh C, Screen H, Barton C. American Journal of Sports Medicine (2014)

Vibration and pressure wave therapy for calf strains: a proposed treatment.

Saxena A, St Louis M, Fournier M. Muscles, Ligaments and Tendons Journal (2013)

Ultrasonographic evaluation of low energy extracorporeal pulse activated therapy (EPAT) for chronic plantar fasciitis.

Gordon R, Wong C, Crawford EJ. (Foot Ankle Int. Mar 2012)

High-energy focused extracorporeal shockwave therapy reduces pain in plantar fibromatosis (Ledderhose’s disease).

Knobloch K, Vogt PM. BioMed Central Research Notes (2012)

Shockwave treatment for medial tibial stress syndrome in athletes; a prospective controlled study.

Moen MH, Rayer S, Schipper M, Schmikli S, Weir A, Tol JL, Backx FJ. British Journal of Sports Medicine (2011)

Shockwave therapy for the treatment of chronic proximal hamstring tendinopathy in professional athletes.

Cacchio A, Rompe JD, Furia JP, Susi P, Santilli V, De Paulis F. The American Journal of Sports Medicine (2010)

Low-energy extracorporeal shock wave therapy as a treatment for medial tibial stress syndrome.

Rompe JD, Cacchio A, Furia JP, Maffulli N. American Journal of Sports Medicine (2009)

Extracorporeal shockwave for chronic patellar tendinopathy.

Wang CJ, Ko JY, Chan YS, Weng LH, Hsu SL. The American Journal of Sports Medicine (2007)

Extracorporeal shock wave therapy in the treatment of chronic tendinopathies.

Sems A, Dimeff R, Iannotti JP. Journal of the American Academy of Orthopaedic Surgeons (2006)

Effects of shock waves on the microcirculation in critical limb ischemia (CLI) (8-week study).

De Sanctis MT1, Belcaro G, Nicolaides AN, Cesarone MR, Incandela L, Marlinghaus E, Griffin M, Capodanno S, Ciccarelli R. Angiology (2000)

Extracorporeal Shockwave Therapy Improves Outcome after Primary Anterior Cruciate Ligament Reconstruction with Hamstring Tendons

Weninger, P; Thallinger, C; Chytilek, M; Hanel, Y; Stefel, C; Karimi, R; Feichtinger, X. Journal of Clinical Medicine (2023)

Efficacy of Extracorporeal Pulse-Activated Therapy in the Management of Lower-Extremity Running-Related Injuries: Findings From a Large Case Cohort

Matthew Mitchkash, MD, David Robinson, MD, Adam Tenforde, MD The Journal of Foot & Ankle Surgery (2020)

Effects of Shockwave Treatment for Management of Upper and Lower Extremity Musculoskeletal Conditions: A Narrative Review

Julia M. Reilly, MD, Eric Bluman, MD, PhD, Adam S. Tenforde, MD. PM& R Journal (2018)

Pelvis and Hip

Home training, local corticosteroid injection, or radial shock wave therapy for greater trochanter pain syndrome.

Rompe JD, Segal NA, Cacchio A, Furia JP, Morral A, Maffulli N. American Journal of Sports Medicine (2009)

Low-energy extracorporeal shock wave therapy as a treatment for greater trochanteric pain syndrome.

Furia JP, Rompe JD, Maffulli N. American Journal of Sports Medicine (2009)

Focused Shockwave Treatment for Greater Trochanteric Pain Syndrome: A Multicenter, Randomized, Controlled Clinical Trial

Silvia Ramon, Sergio Russo, Flavia Santoboni, Giacomo Lucenteforte, Carla Di Luise, Rocio de Unzurrunzaga, Mario Vetrano, Mariantonia Albano, Rosella Baldini, PhD, Ramon Cugat, Giulia Stella, Giovanni Balato, Roberto Seijas, Sveva-Maria Nusca, Valeria Servodidio, and Maria-Chiara Vulpiani The Journal Of Bone and Joint Surgery (2020)

Hand Wrist

Extracorporeal shock wave therapy in pillar pain after carpal tunnel release: a preliminary study.

Romeo P, d’Agostino MC, Lazzerini A, Sansone VC. Ultrasound in Medicine and Biology (2011)

Extracorporeal shockwaves versus surgery in the treatment of pseudoarthrosis of the carpal scaphoid.

Notarnicola A, Moretti L, Tafuri S, Gigliotti S, Russo S, Musci L, Moretti B. Ultrasound in Medicine and Biology (2010)

Upper Extremity

RADIAL EXTRACORPOREAL PRESSURE PULSE THERAPY FOR THE PRIMARY LONG BICIPITAL TENOSYNOVITIS.

Liu S1, Zhai L, Shi Z, Jing R, Zhao B, Xing G. Ultrasound in Medicine and Biology (2012)

xtracorporeal shock wave therapy in the treatment of chronic tendinopathies.

Sems A, Dimeff R, Iannotti JP. Journal of the American Academy of Orthopedic Surgeons (2006)

Shoulder

High-Energy Extracorporeal Shock-Wave Therapy for Treating Chronic Calcific Tendinitis of the Shoulder: A Systematic Review

Raveendhara R. Bannuru, MD; Nina E. Flavin, MD; Elizaveta Vaysbrot, MD, MS; William Harvey, MD, MSc; and Timothy McAlindon, MD, MPH. Annals of Internal Medicine (2014)

Calcific tendinitis of the shoulder

Diehl P, Gerdesmeyer L, Gollwitzer H, Sauer W, Tischer T. Orthopade – German (2011)

Effectiveness of radial shock-wave therapy for calcific tendinitis of the shoulder: single-blind, randomized clinical study.

Cacchio A, Paoloni M, Barile A, Don R, de Paulis F, Calvisi V, Ranavolo A, Frascarelli M, Santilli V, Spacca G. Physical Therapy (2006)

Extracorporeal shock wave therapy for the treatment of chronic calcifying tendonitis of the rotator cuff: a randomized controlled trial.

Gerdesmeyer L, Wagenpfeil S, Haake M, et al. The Journal of the American Medical Association (2003)

Radial shock wave therapy in calcifying tendinitis of the rotator cuff – a prospective study.

Z Orthop Ihre Grenzgeb (2003)

Exact focusing of the extracorporeal shock wave therapy for calcifying tendinopathy.

Haake M, Deike B, Thon A, Schmitt. Journal of Clinical Orthopaedics and Trauma (2002)

Extracorporeal Shockwave Therapy as an Adjunctive Therapy for Frozen Shoulder: A Systematic Review and Meta-analysis

Zhang, R; Wang, Z; Liu, R; Zhang, N; Guo, J; Huang, Y. Orthopedic Journal of Sports Medicine (2022)

Focused, radial and combined shock wave therapy in treatment of calcific shoulder tendinopathy

Al-Khair, M; Khouly, R; Khodair, S; Elsergany, M; Hussein, M; Mowafy, M. Phys Sportsmed (2021) Level One Study

Spine and Back

Shock Wave Treatment Protects From Neuronal Degeneration via a Toll-Like Receptor 3 Dependent Mechanism: Implications of a First-Ever Causal Treatment for Ischemic Spinal Cord Injury.

Lobenwein D1, Tepeköylü C, Kozaryn R, Pechriggl EJ, Bitsche M, Graber M, Fritsch H, Semsroth S, Stefanova N, Paulus P, Czerny M, Grimm M, Holfeld J. Journal of the American Heart Association (2015)

Mechano-transduction effect of shockwaves in the treatment of lumbar facet joint pain: Comparative effectiveness evaluation of shockwave therapy, steroid injections and radiofrequency medial branch neurotomy.

Nedelka T, Nedelka J, Schlenker J, Hankins C, Mazanec R. (Neoro Enocrinology Letters 2014)

Efficacy and safety of extracorporeal shockwave therapy in chronic low back pain: a systematic review and meta-analysis of 632 patients

Liu, K; Zhang, Q; Chen, L; Zhang, ; Xu, X; Yuan, Z; Dong, J. Journal of Orthopedic Surgery Res. (2023)

Comparison of Different Treatment Regimens of Extracorporeal Shockwave Therapy in Chronic Low-back Pain: A Randomized Controlled Trial

Sun, H; Chen, H; Mu, G; Fu, H; Yue, L. Pain Physician (2022)

Extracorporeal Shockwave Therapy for Treating Chronic Low Back Pain: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Yue, L; Sun, M; Chen, H; Mu, G; Sun, H. Biomed Res Int. (2021)

Enhanced Spinal Therapy: Extracorporeal Shock Wave Therapy for the Spine

Fiani, B; Davati, C; Griepp, D; Lee, J; Pennington, E; Moawad, C. Cureus (2020)

The Effectiveness Of Radial Extracorporeal Shock Wave Therapy In Patients With Chronic Low Back Pain: A Prospective, Randomized, Single-Blinded Pilot Study

Walewicz, K; Taradaj, J; Rajfur, K; Ptaszkowski, K; Kuszewski, M; Sopel, M; Dymarek, R. Clin Interventional Aging (2019)

Bone

Biological mechanism of shockwave in bone.

Cheng JH, Wang CJ. International Journal of Surgery (2015)

Low-energy extracorporeal shock wave therapy as a treatment for medial tibial stress syndrome.

Rompe JD, Cacchio A, Furia JP, Maffulli N. American Journal of Sports Medicine (2010)

Extracorporeal shock-wave therapy compared with surgery for hypertrophic long-bone nonunions.

Cacchio A, Giordano L, Colafarina O, Rompe JD, Tavernese E, Ioppolo F, Flamini S, Spacca G, Santilli V. Journal of Bone and Joint Surgery (2009)

Shock waves in the treatment of stress fractures.

Moretti B, Notarnicola A, Garofalo R, Moretti L, Patella S, Marlinghaus E, Patella V. Ultrasound in Medicine and Biology (2009)

The effects of extracorporeal shock wave in acute high-energy long bone fractures of the lower extremity.

Wang, CJ et al. Archives of Orthopaedic and Trauma Surgery (2006)

Treatment for osteonecrosis for the femoral head: comparison of extracorporeal shock waves with core decompression and bone-grafting.

Wang, CJ et al. The Journal of Bone and Joint Surgery (2005)

Effect of shock wave therapy on acute fractures of the tibia: a study in a dog model.

Wang CJ, Huang HY, Chen HH, Pai CH, Yang KD. Clinical Orthopaedics and Related Research (2001)

Treatment of nonunions of long bone fractures with shock waves.

C. Wang, MD. Clinical Orthopaedics and Related Research (2001)

The use of extracorporeal shock wave therapy for the treatment of bone marrow oedema - a systematic review and meta-analysis

Hausser, J; Wieber, J; Catala-Lehnen, P. Journal of Orthopedic Surgery Res. (2021)

Extracorporeal shockwave treatment in knee osteoarthritis: therapeutic effects and possible mechanism

An, S; Li, J; Zie, W; Yin, W; Li, Y; Hu, Y. Bioscience Rep. (2020)

Myofascial Trigger Points

Trigger points – Diagnosis and treatment concepts with special reference to extracorporeal shockwaves (German).

Gleitz M, Hornig K. Orthopade (2012)

Shock wave therapy of trigger points in the masticatory muscles.

Gleitz M, Hornig K. Orthopade (Feb 2012)

Instrumented assisted soft tissue mobilization vs extracorporeal shock wave therapy in treatment of myofascial pain syndrome

Shamseldeen, N; Hegazy, M; Fayaz, N; Mahmoud, N. World Journal of Orthopedics (2023)

Combined Effects of Extracorporeal Shockwave Therapy and Integrated Neuromuscular Inhibition on Myofascial Trigger Points of Upper Trapezius: A Randomized Controlled Trial

Mohamed, D; Kamal, R; Gaber, M; Aneis, Y. Ann Rehabilitation Medicine (2021)

The effects of shock wave and dry needling on active trigger points of upper trapezius muscle in patients with non-specific neck pain: A randomized clinical trial

Manafnezhad, J; Salahzadeh, Z; Salimi, M; Ghaderi, F; Ghojazadeh, M. Journal for Back Musculoskeletal Rehabilitation (2019)

Non PubMed Listed Publications Papers

Influence of medical shockwaves on healthy muscle tissue.

Vincent KC, d’Agostino C, Schaden W, Karalus P, Grant L. European Congress of Sports Medicine (2016)

The Effectiveness of Extracorporeal Shock Wave Therapy (ESWT) in the Management of Trigger Finger

LUK MLM, CHO JSY, NG DMT, POON MC, LAU PMY. Physiotherapy Department, Queen Elizabeth Hospital. Hospital Authority Convention (2014)

Extracorporeal Pulse Activation Technology in Acute and Chronic Musculoskeletal Pain of the Lower Extremity: A case series.

Iorio A, Rode K., Hart B. NYCPM (2009)

A neural model for chronic pain and pain relief by extracorporeal shock wave treatment.

Wess, OJ. Urol Res (2008)

Assorted Abstracts.

Markus Gleitz. (2003-2008)

TMJ

Effects of radial extracorporeal shock wave therapy in reducing pain in patients with temporomandibular disorders: A pilot randomized controlled trial

Marotta, N., Ferrillo, M., Demeco, A., Drago Ferrante, V., Inzitari, M.T., Pellegrino, R., Pino, I., Russo, I., de Sire, A., & Ammendolia, A. (2022). Applied Sciences, 12(8), p.3821.

Initial results using extracorporeal low energy shockwave therapy ESWT in muscle reflex-induced lock jaw (German)

Schenk I, Vesper M, Nam VC. Mund Kiefer Gesichtschir (2002)

Low energy extracorporeal shockwave therapy (ESWT) for treatment of myogelosis of the masseter muscle (German)

Kraus M, Reinhart E, Krause H, Reuther J. Mund Kiefer Gesichtschir (1999)
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