Extracorporeal shockwave therapy (ESWT), or shockwave for short, is an amazing noninvasive treatment used to treat a variety of injuries and illnesses. Shockwave works by pulsing a focused wave of sound energy through tissues. The effect of these pulses is threefold, increasing blood flow, stimulating tissue repair, and reducing pain. The increase in blood flow allows more efficient delivery of nutrients and oxygen to damaged tissues which are essential for healing. Tissue repair is stimulated by causing microdamage to tissues promoting the increase in production of healing cells essential for the repair of tendons and bone. As a pain reduction modality, ESWT can reduce the ability for pain signals to reach the brain by reducing conduction of sensory nerves in the treatment area.

There are many uses for ESWT in veterinary medicine. Our practice commonly recommends ESWT in conjunction with other therapies in suspensory ligament injuries. The suspensory ligament has poor blood flow and can be a difficult injury to heal. As outlined above ESWT helps improve blood flow to the region and promote healing cells to migrate to the area. Studies have also shown that ESWT helps horses with osteoarthritis pain, while it does not reverse changes associated with osteoarthritis, it can provide noninvasive pain relief. This pain relief has also been used in cases of back pain, especially with impinging dorsal spinous processes (kissing spine). ESWT can also be used to help difficult to heal wounds by providing an anti-inflammatory effect, new blood vessel formation, and pain control.

Treatment protocols are adjusted depending on the region being treated. Veterinarians can adjust the energy levels, frequency of pulses, depth of tissue penetration, and duration of pulses. Most treatment protocols consist of 3 treatments 2-3 weeks apart. This protocol allows tissues to heal from the microdamage ESWT causes. Your veterinarian may clip your horse at the area of treatment to allow for adequate contact between the ESWT probe and the skin.

The use of ESWT in addition to other therapies allows us to speed up the healing process and decrease pain and discomfort. It’s an important and helpful tool veterinarians have. Have a conversation with your veterinarian on if ESWT may be useful for your horse.

(pict above applying shockwave therapy to a lower arthritic/fusing tarsal metatarsal hock joint for pain relief)