A Comprehensive Review of Extracorporeal Shockwave Therapy in the Management of Musculoskeletal Disorders: Efficacy, Mechanisms, and Clinical Applications

Abstract

Extracorporeal Shockwave Therapy (ESWT) has gained prominence as a non-invasive treatment option for various musculoskeletal disorders. This review examines the efficacy, underlying mechanisms, and clinical applications of ESWT, synthesizing current evidence from clinical studies, systematic reviews, and mechanistic research. The clinical efficacy of ESWT for common musculoskeletal conditions such as plantar fasciitis, tendinitis, and shoulder impingement syndrome. It synthesizes findings from randomized controlled trials and meta-analyses to compare ESWT with other treatment modalities, including physical therapy, corticosteroid injections, and surgical interventions. Evidence indicates that ESWT can significantly reduce pain and improve functional outcomes in many cases, although results can vary depending on the condition and treatment protocol. Mechanistic insights into ESWT are explored to understand how it exerts its therapeutic effects. The review highlights how ESWT influences cellular and molecular processes, including pain modulation, collagen synthesis, and angiogenesis. By promoting these biological responses, ESWT enhances tissue repair and alleviates symptoms associated with musculoskeletal injuries and chronic conditions. Clinical applications of ESWT are discussed, focusing on treatment protocols and parameters such as energy flux density, frequency, and duration of sessions. The review provides practical guidance on optimizing treatment regimens based on the specific musculoskeletal disorder being treated. It also addresses patient selection criteria and potential contraindications to ensure safe and effective use of ESWT. Safety considerations are reviewed, including common side effects and rare complications. The overall safety profile of ESWT is evaluated, with a discussion on the long-term implications of treatment. The existing research gaps and suggests directions for future research, including advancements in ESWT technology and the need for further studies to refine treatment protocols and enhance therapeutic outcomes. This comprehensive overview aims to inform clinicians and researchers about the current state of ESWT, offering insights into its effectiveness, mechanisms, and practical applications in managing musculoskeletal disorders.

Keywords: Extracorporeal Shockwave Therapy, Frozen shoulder, Trigger Finger, Plantar Fasciitis, Osteoarthritis, Achilles tendinitis.