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Equine veterinary journal2022; 55(4); 593-606; doi: 10.1111/evj.13890

Equine shock wave therapy – where are we now?

Abstract: Over the past three decades, electrohydraulic extracorporeal shock wave therapy (ESWT) as a treatment modality for equine orthopaedic disorders has sparked exponential interest among practitioners, but its clinical applications are quickly evolving and a current review highlighting modernised equine clinical use is lacking. The objective of this review is to summarise the most current ESWT technology, evidence for its use, proposed mechanisms of action and clinical applications in horses while also highlighting the areas requiring further investigation. The three ways to generate a shock wave are through electrohydraulic, electromagnetic or piezoelectric mechanisms, but over the last decade, electrohydraulic systems have predominated due to the ability to focus and control a therapeutic waveform. Shock waves' primary physical effect is believed to be via mechanotransduction leading to cellular activation and downstream signalling. Experimentally, ESWT's effects on osseous, connective tissue and wound healing via various mechanisms of action have been reported both in the human and veterinary literature. Clinical trials have investigated ESWT's orthopaedic application including osteoarthritis, thoracolumbar pain, navicular syndrome, tendinopathy and proximal suspensory desmopathy, with its concomitant use with biologics representing an area of active research. Direct ESWT protocol comparisons in terms of long-term efficacy with variables of energy, depth and exposed tissue types are still lacking with evidence-based recommendations being largely anecdotal. Technical advancements to facilitate the safe and judicious use of ESWT include human and equine hearing protection, light sedation and/or patient restraint. Efforts to ensure the safe and judicious use of ESWT and its analgesic effects are ongoing.
© 2022 The Authors. Equine Veterinary Journal published by John Wiley & Sons Ltd on behalf of EVJ Ltd.
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Publication Date: 2022-10-28 PubMed ID: 36210719DOI: 10.1111/evj.13890Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The study provides a comprehensive review of the current applications, mechanisms, and evidence related to Electrohydraulic Extracorporeal Shock Wave Therapy (ESWT) in treating equine orthopedic conditions. It highlights the need for further investigations to establish evidence-based recommendations on the therapy’s protocols.

Current ESWT Technology and Mechanisms of Action

  • Electrohydraulic Extracorporeal Shock Wave Therapy (ESWT) is a treatment technique for horse orthopedic disorders that has gained substantial interest over the past 30 years. The therapy works by generating a shock wave via three primary mechanisms – electrohydraulic, electromagnetic, or piezoelectric.
  • In recent years, the electrohydraulic mechanism has become the preferred method due to its ability to focus and control therapeutic waveforms effectively.
  • The primary physical impact of the shock waves is thought to be mechanotransduction, which initiates cellular activation and subsequent signaling.

Effects and Clinical Applications of ESWT

  • Studies, both in human and veterinary literature, have reported the effects of ESWT on bone healing, connective tissue healing, and wound healing.
  • Clinical trials have explored the application of ESWT for various orthopedic conditions like osteoarthritis, thoracolumbar pain, navicular syndrome, tendinopathy, and proximal suspensory desmopathy.
  • The concurrent use of ESWT with biologics represents a significant field of ongoing research.

Techniques and Safety Measures in ESWT

  • Equine and human hearing protection, light sedation, and patient restraint are some of the technical advancements implemented to ensure the safe and judicious use of ESWT.
  • However, comparisons of ESWT protocols in terms of long-term efficacy, energy utilized, depth, and exposure tissue types are still lacking.
  • Most recommendations are largely anecdotal, highlighting the need for further studies to provide clear, evidence-based guidelines for ESWT’s application.

Future of ESWT

  • ESWT’s analgesic effects are still being investigated, pointing to the therapy’s untapped potential in pain management.
  • Future efforts should focus on ensuring the safe, effective, and evidence-based use of ESWT technology.

Cite This Article

APA
Johnson SA, Richards RB, Frisbie DD, Esselman AM, McClure SR. (2022). Equine shock wave therapy – where are we now? Equine Vet J, 55(4), 593-606. https://doi.org/10.1111/evj.13890

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English
Volume: 55
Issue: 4
Pages: 593-606

Researcher Affiliations

Johnson, Sherry A
  • Department of Clinical Sciences, Orthopaedic Research Center at the Translational Medicine Institute, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA.
Richards, Roderick B
  • PulseVet Shock Wave, Alpharetta, Georgia, USA.
Frisbie, David D
  • Department of Clinical Sciences, Orthopaedic Research Center at the Translational Medicine Institute, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA.
Esselman, Angie M
  • Department of Clinical Sciences, Orthopaedic Research Center at the Translational Medicine Institute, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA.
McClure, Scott R
  • Midwest Equine Surgery and Sports Medicine, Boone, Iowa, USA.

MeSH Terms

  • Humans
  • Horses
  • Animals
  • Extracorporeal Shockwave Therapy / veterinary
  • High-Energy Shock Waves / therapeutic use
  • Mechanotransduction, Cellular
  • Wound Healing
  • Osteoarthritis / veterinary
  • Musculoskeletal Diseases / veterinary
  • Treatment Outcome
  • Horse Diseases / drug therapy

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Citations

This article has been cited 1 times.
  1. Boado A, Pollard D, Dyson S. Retrospective Analysis of Suspensory Ligament Branch Injuries in 70 Dressage Horses. Animals (Basel) 2025 Oct 23;15(21).
    doi: 10.3390/ani15213079pubmed: 41227410google scholar: lookup
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