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Shockwave Therapy for Musculoskeletal Disorders: How it Works?

Three main techniques through which shockwaves can be generated are electrohydraulic, electromagnetic and piezoelectric principles, and each one represents a different technique of generative shockwaves.

Electrohydraulic principle is the base generation of the first orthopedic shockwave machine, these are shockwaves with high-energy acoustic waves generated by the underwater explosion with high-voltage electrode spark discharge. The acoustic waves are focused with an elliptical reflector and targeted at the diseased area to produce therapeutic effect which is characterized by large axial diameters of the focal volume and high total energy within that volume.

Shockwave generation through the electromagnetic technique involves the electric current passing through a coil to produce a strong magnetic field. A lens is used to focus the waves, with the focal therapeutic point being defined by the length of the focus lens. The amplitude of the focused waves increases by non-linearity when the acoustic wave propagates toward the focal point Shockwave of piezoelectric technique involves a large number (usually > 1,000) of piezo crystals mounted in a sphere and receives a rapid electrical discharge that induces a pressure pulse in the surrounding water steepening to a shockwave. 

Compared to different shockwave devices, the important parameters include:

  • Pressure distribution;
  • Energy density;
  • Total energy at the second focal point in addition to the principle of shockwave generation of each device.

The whole mechanism of shockwave therapy is not fully understood, it seems that the most physical parameters of shockwave therapy for the treatment of orthopedic related disorders include:

  • Pressure distribution;
  • Energy flux density;
  • Total acoustic energy.

Orthopedic shockwaves do not aim to disintegrate any tissues, but they microscopically cause interstitial and extracellular responses leading to tissue regeneration.

Source: josr-online

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