Shockwave treatment for refractory soft-tissue pain

Extracorporal shock-wave application (ESWA) has been used in the treatment of stones located in the kidneys, bile, pancreas and the glandula parotis. In the last 2 years several studies have shown the benefit of ESWA in the treatment of soft-tissue disorders and tendinosis calcarea. To date, the exact mechanism is unknown. Local hyperemia following damage or afferent inhibition is discussed. The possibilities and indications of ESWA with respect to several syndroms are presented. The results show the benefit of ESWA in the treatment of chronic soft-tissue disorders without severe side effects. Some patients showed small subcutaneous hematomas and erosion of the skin when energies about 20 mJ were used. Forty seven of 84 of the patients obtained complete relief; 24 patients showed a marked reduction in their complaints. In only 13 of 84 cases was the treatment unsuccessful.