Dr. Karin Freitag has participated in this International Conference of Physical Medicine and Rehabilitation held in Porto from 19 to 20 October with a presentation on “Shockwaves, mechanisms of action. Current indications and future applications”.
In her lecture Dr. Freitag pointed out that shockwaves are waves with mechanical and biological effects to treat degenerative tendinopathies of elbow, shoulder, knee, trochanter and foot. Shock waves are also applied in delays of consolidation of a fracture and osteonecrosis. These applications are joined by many others in the future for the rehabilitation of certain pathologies.
Shockwaves are a non-invasive treatment that can be quickly applied and associated with other treatments, which can also be repeated in other sessions, with irrelevant side effects and low cost. It is a treatment that produces biological response, causing the release of growth factors with great angiogenic potential and without damaging or destroying the injured tissues.
In addition, the effects of shockwaves are quickly visible, since within one or two weeks, pain is clearly reduced, together with a reduction in inflammation and free radicals, increasing cell multiplication, vascularisation and the bactericidal effect. Also, within about 12 weeks there is a dissolution of calcifications and regeneration of bone tissue.
In order to perform this type of treatment, it is necessary to first perform a clinical examination, have radiological images and, exceptionally, complementary tests such as magnetic resonance, neurological, etc. In addition, only nationally or internationally certified doctors can conduct this type of treatment.
The treatments in which the benefits of the application of Shockwaves have been demonstrated are calcifying shoulder tendinopathies, lateral elbow epicondylitis (tennis elbow), major trochanter syndrome, patellar tendinopathy, Achilles tendinopathy, plantar fasciitis, with or without calcaneal spur, delayed healing of fractures, pseudoarthrosis or bad union of fractured bones, stress fractures, bone necrosis, Osteochondritis Dissecans (OCD), delayed healing of wounds, decubitus, arterial and venous ulcers and burns.
On the other hand, empirical clinical uses are tendinopathy without calcification of rotator maguitus, elbow epitrocleopathy, adductor tendinopathy syndrome, Pes-Anserinus tendinopathy peroneal tendinopathy syndrome, ankle and foot tendinopathy, bone edema, Osgood Schlatter disease, tibial stress syndrome, myofascial syndrome, partial muscle tear and cellulitis.
Exceptionally, it can be applied in cases of osteoarthritis, Dupuytren’s disease, plantar fibromatosis, De Quervain’s disease, trigger finger, spasticity, polyneuropatias, carpal tunnel syndrome, chronic pelvic pain syndrome, erectile dysfunction, Peyronie’s disease and lymphedema.
In terms of experimental applications, the beneficial effects on cardiac ischemia, peripheral nerve injuries, pathologies of the spine and brain, calcinosis of the skin, periodontal disease, pathologies of the mandibular bone, sympathicoreflex dystrophy and osteoporosis are being investigated.
However, the use of shock waves is contraindicated in the case of malignant tumors in the treated area or that the area to be treated is close to the fetus in case of pregnancy.