How Does Shockwave Therapy Affect Bone and Cartilage?

Shockwave therapy

Shockwave Therapy

Extracorporeal Shockwave Therapy (ESWT), has been used more and more for musculoskeletal conditions ranging from tendon tears to fractures, arthritis and swollen bones. The use of ESWT over the past 10 years has skyrocketed in both Europe and North America. As a result, there is a wide range of studies that have been compiled to examine the effects of shockwave on various tissues. One extensive systematic review published in 2022 (1) summarized the results from many different publications on how ESWT affects the cells directly, including bone and cartilage .

In total, 100 studies within the systematic review addressed shock wave effects on cartilage and bones. Fifty-one percent of these studies were published within the last ten years and the vast majority, 85% of studies, looked at focused shock waves specifically.

The findings of these studies included numerous benefits to the treated bones and cartilage including:

  • Increased mineral apposition rates, trabecular bone volume, number, and thickness.
  • Increased bone/tissue volumes.
  • Increased bone strength, bone mineral density, trabecular thickness, and bone /tissue volumes.
  • Increased osteoblastic activity and improved pain score.
  • Increased number of proliferative chondrocytes (cartilage producing cells) of growth plate’s cartilage
  • Increased cell viability; decreased number of pro-inflammatory, cartilage degradation markers
  • Reduced synovitis and cartilage damage
  • Increased contents of sulfated glycosaminoglycans and hyaluronic acid
  • Reduced arthritic area of injury joint, enhanced bone mineral density and bone strength, improved subchondral plate thickness with reduced cartilage damage
  • More mature bone formation, better healing, higher density of the cartilage

What is the Clinical Significance of Shockwave Therapy?

Osteoarthritis can involve degenerative changes to the bone and cartilage as well as inflammation or synovitis. The studies summarized in this review paper show that shockwave therapy can improve the bones, cartilage, and inflammation at a cellular level and appear to stimulate the regenerative capabilities of these tissues. Therefore using shockwave by itself or in combination with other treatments may be a good option for patients with pain involving degenerative joints and bones. 

Patients should always be evaluated thoroughly before and should be made aware of all options before embarking on a treatment plan. If you have any questions or wish to set up a consultation, please do not hesitate to contact us.

References

  1. Wuerfel, T., Schmitz, C., & Jokinen, L. L. (2022). The effects of the exposure of musculoskeletal tissue to extracorporeal shock waves. Biomedicines, 10(5), 1084. https://doi.org/10.3390/biomedicines10051084 
About The Author
Ignatios Papas, DO

Ignatios Papas, DO

Ignatios Papas, DO, is a non-surgical orthopedic physician specializing in Physical Medicine and Rehabilitation at Regenexx® at New Regeneration Orthopedics.
Ignatios Papas, DO

Ignatios Papas, DO

Ignatios Papas, DO, is a non-surgical orthopedic physician specializing in Physical Medicine and Rehabilitation at Regenexx® at New Regeneration Orthopedics.

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