Better Understanding Shock Wave Therapy

Dr. Caity Cosentino

You have probably heard of it, but you may not truly understand the use of extracorporeal shock wave therapy. This modality of therapy helps to treat your horse for several different ailments including proximal suspensory ligament injuries, navicular syndrome, bucked shins, back pain, tendon injuries, arthritis, and stress fractures. This is a non-invasive form of treatment that sends high intensity pressure (sound) waves through the tissue to a site of injury. Electrical energy initiates the wave from the machine and to the head of the probe. There, the waves travel through the membrane of the probe, through coupling gel, and into the soft tissues and fluids of the area being treated. The waves have the best interactions with tissues at soft tissue/bone interfaces. The depth the waves travel to depends on the type of probe head being used. The intensity can be changed, and the amount of pulses set on the machine, depending on the area and injury being treated. Smaller areas and soft tissues require less pulses and less intensity than areas that are deeper or larger.

When deciding whether or not this therapy is appropriate, the horse will be examined by a veterinarian to determine what protocol is best for the individual injury the horse has sustained. If shock wave therapy is appropriate, the horse will then be sedated and the area clipped to ensure good contact with the skin. Light sedation is necessary to keep the horse still during the treatment as the probe emits a loud popping sound and the pressure waves cause mild discomfort as the treatment is initiated. The therapy is suspected to work by stimulating the growth of new blood vessels, increasing cell permeability, stimulating new bone growth and also stimulating fibroblast formation and cell activity. There is an immediate analgesic affect in the area as well. Studies have shown that shock wave therapy can successfully decrease the size of lesions in soft tissues, decrease the amount of swelling and improve the alignment of fibers. Most treatment protocols will call for multiple sessions approximately one week apart. The exact protocol will vary from case to case and is best determined by your veterinarian.

Due to the analgesic effect that occurs, care must be taken to make sure the horse is not overworked immediately following the treatment. The analgesic effects can last for several days to a week, making the horse feel better and potentially pain free due to the numbed nerves in the area treated. Care must be taken to protect the injured site as it heals and to not allow a horse to overdue its exercise, even in a turnout situation. Science and medicine is always advancing. Shock wave therapy is just one more therapeutic modality being used to rehab horse’s injuries and hopefully get them back on track. New uses for this therapy are still being discovered and the spectrum of cases it may be useful in treating will likely grow.