Current Trend: Why More and More Physicians Prefer Combined Shock Wave Therapy

Current Trend: Why More and More Physicians Prefer Combined Shock Wave Therapy

Until just a few years ago, either focused shock waves or radial pressure waves (from a physical point of view, they are radial pressure waves, not shock waves) were used for orthopaedic pain management, depending on the indication. Lately, however, there has been a change: In order to achieve even better therapy results, more and more physicians prefer to combine both technologies for many indications.

This trend towards combined shock wave therapy can be observed not only in daily practice but also in case reports and training events. The reasons for this development become clear when we take a closer look at the two therapy options.

»By combining the two technologies, their advantages can be fully exploited.«
Prof. Dr Sergio Russo
Naples, Italy

Both Methods Have Advantages
Radial pressure waves spread throughout the body in a radial way. They can reach regions with a depth of up to 5 cm, although the energy decreases as the depth increases. As a result, radial pressure waves are especially useful for an extensive therapy of superficial zones. The wide range of transmitters permits both localised and generalised treatments. Muscle chains can be treated functionally in the longitudinal direction. Tissue layers are mobilised, which breaks up adhesions and trigger points. In addition, the shifting of the tissue layers causes a myofascial release – an important prerequisite for fascial therapy. On the other hand, the therapeutic efficacy of focused shock waves reaches a depth of up to 12.5 cm. Therefore, they are mainly used for the treatment of deeper regions. Focused technology allows for precise, pinpoint treatment (for example of trigger points or tendon insertion) because the energy is applied exactly where it is needed.

»Often, the overall symptoms can only be treated by combining focused shock waves and radial pressure waves.«
Prof. Dr Karsten Knobloch
Hanover, Germany

Better Patient Care with Combination Therapy
As the short overview shows: Radial pressure waves and focused shock waves have different advantages and offer specific therapy options. In practice, clinical presentations are often complex (for example, myofascial pain syndrome). In order to achieve long-lasting results, it is not enough to use radial pressure waves or focused shock waves alone. If, for example, the treatment regions are located at different depths, only the combination of both technologies allows for the precise treatment of the overall symptoms and leads to better patient care.

»Combined shock wave therapy offers many treatment options. This maximises the benefit for the patient.«
Prof. Dr Heinz Lohrer
Wiesbaden, Germany

Inclusion of Additional Therapies
Combined shock wave therapy points the way to a more complex and overall treatment strategy for musculoskeletal soft tissue disorders. This strategy not only includes focused shock waves and radial pressures waves, but also complementary therapies such as vibration therapy (V-ACTOR®), »Suction Wave Therapy« (VACU-ACTOR®) or (as of late) extracorporeal magnetotransduction therapy (EMTT®). In this context, the term  »Soft Tissue Engineering« – an umbrella term for therapies that focus on tissue regeneration – is frequently discussed at the moment.