Page 600 - The Veterinary Care of the Horse

different tissues the resistance to the flow of the shock waves is altered and the result is that

mechanical energy is released.
VetBooks.ir How does it work?

How this release of energy affects healing is not fully understood. It is thought to stimulate

the body’s own healing. The proposed mechanisms include:
• increased activity of osteoblasts (bone forming cells)

• stimulation of new blood vessel growth

• stimulation of nerve endings (nociceptors) which release neurotransmitters and block

pain signals from reaching the brain (gate theory)
• induction of cytokines, e.g. TGF-β1 which play a role in healing.

Radial and focused shock waves

There are two different types of shock wave therapy. Radial shock waves do not penetrate so

far into the tissues and expose the site being treated and the surrounding tissues to similar
pressures. Focused shock waves can be accurately delivered to the site of injury with less
pressure exerted on the neighbouring tissues. Both types have a number of probes so the

depth of penetration can be altered.

With both systems the energy is transferred between the shock wave probe and the body
with the aid of a coupling gel.

What conditions is it used for?

Shock wave therapy is commonly used in equine veterinary medicine. It has been used for
the following conditions with some success.

• Tendonitis.
• Ligament injuries.

• Fractures, e.g:

– stress fractures, e.g. of the tibia

– splint bone fractures

– proximal sesamoid fractures

– non-union fractures (i.e. fractures that are not healing properly).
• Periostitis (inflammation of the periosteum of a bone), e.g. ‘bucked shins’.

• Navicular syndrome.