Application of extracorporeal shock wave therapy in nervous system diseases: A review

Frontiers in Neurology, 2022 · DOI: 10.3389/fneur.2022.963849 · Published: August 17, 2022

Simple Explanation

Extracorporeal Shock Wave Therapy (ESWT) is emerging as a potential non-invasive treatment for neurological disorders. It uses acoustic waves to stimulate tissue regeneration and repair. The therapy is simple to operate, relatively cost-effective, and has fewer side effects than traditional methods like surgery or drug therapy. ESWT works through two main physical effects: mechanotransduction and cavitation. Mechanotransduction involves the conversion of mechanical stimuli into biochemical signals, affecting cell functions. Cavitation refers to the formation and collapse of bubbles, which can break down calcified deposits and stimulate nerves. Animal studies and clinical trials have shown promising results using ESWT for conditions such as sciatic nerve injury, carpal tunnel syndrome, postherpetic neuralgia, and limb spasticity. While challenges remain, ESWT holds potential for treating central and peripheral nervous system diseases.

Study Duration

Not specified

Participants

Animal studies (rats) and human clinical studies

Evidence Level

Review

Key Findings

1
ESWT can promote neural tissue regeneration and repairment in both the central and peripheral nervous systems, as demonstrated in animal studies of sciatic nerve injury, cerebral infarction, and spinal cord injury.
2
Clinical studies suggest that ESWT is a promising therapeutic method for peripheral nerve injuries like Carpal Tunnel Syndrome (CTS), improving pain symptoms and reducing sensory latency of the median nerve.
3
ESWT, especially radial ESWT (rESWT), has shown potential in reducing spasticity in various central nervous system diseases like stroke, cerebral palsy, and multiple sclerosis.

Research Summary

This review discusses the principles of ESWT, its cellular and molecular mechanisms, and its application in treating central and peripheral nervous system diseases based on animal and clinical studies. ESWT's therapeutic effects are attributed to mechanotransduction and cavitation, which trigger physiological actions at molecular and tissue levels, leading to tissue regeneration, pain relief, and anti-inflammation. While ESWT shows promise, challenges remain, including the lack of uniform treatment standards and the need for more research on potential adverse effects and optimal energy levels, particularly when treating the human brain and spinal cord.

Practical Implications

Clinical Application Guidelines

Medical associations should develop guidelines for using ESWT to treat different neurological disorders to ensure consistent and effective treatment.

Basic Research

Further research is needed to understand the physical, cellular, and molecular mechanisms of interactions between ESWT and lesion tissues.

Treatment of Spasticity

ESWT, especially rESWT, has the potential to reduce spasticity in various central nervous system diseases, offering a non-invasive treatment option.

Study Limitations

1
ESWT is not considered safe when used to treat bleeding disorders and pregnancy problems.
2
Pain, blistering, and hematomas can occur during and after treatment by ESWT.
3
There is a lack of a uniform standard for selecting the lesion area targeted by ESWT, leading to variability in effectiveness.

Your Feedback

Was this summary helpful?

Back to Neurology