Extra-Corporeal Shockwave Therapy (ESWT)

Dr. Revenaugh, along with Dr. Furlong, were amongst the first practitioners in the United States to utilize shockwave therapy for treatment in horses. Since then, a growing number of veterinarians are utilizing Shockwave therapy to dramatically enhance the rate of soft tissue and bone healing in horses as it has been shown to do in humans. The shockwave machine is very similar to a machine used in human medicine to pulverize kidney stones. The "shock waves" are not electrical waves. Instead they are powerful "positive pressure" acoustic waves. These waves transmit energy to deeper structures in the body. The energy of the shockwave has a very unique characteristic and it is extremely fine-tuned in order to achieve the desired physiologic response. Conceptually, shockwave therapy is a "controlled re-injury" to a specific structure. In fact shock waves are actually focused to various depths and energy levels depending upon the injury being treated.

Which first injuries respond to shockwave treatment? Shockwave therapy appears to enhance the rate of bone healing. It is currently being used to treat certain specific arthritis problems, (for example arthritic hocks), ligamentous insertion injuries ("high suspensory"), and old injuries as well as slow to heel bone injuries.

Shockwave therapy also appears to enhance the rate of tendon and ligament healing. Specific examples include treatment of bowed tendons and suspensory ligament injuries. In addition to speeding up healing time, shockwave therapy also appears to cause the injured area to heal stronger than if the horse was simply rested for a prolonged period. One of the most frequently treated injuries is a "high suspensory ". Following shockwave therapy, the likelihood of returning to full function appears to be dramatically improved.

Shockwave therapy is also being used to treat back and pelvic problems. Depending upon the specific problem, dramatic responses have been seen, particularly when treating "kissing spine" disease of the back.

For more information on ‘Kissing Spines” see the following article: Feeling The Pinch of Kissing Spines, "Reprinted by permission of The Chronicle of the Horse. Visit www.chronofhorse.com to subscribe".

Shockwave therapy is usually done on an outpatient basis. The horse is brought to the clinic where he/she is sedated before treatment. Many horses also require application of a twitch. Treatment lasts approximately 10 to 15 minutes. When the sedation has worn off, the horse can ship home.

Treatment protocols vary depending upon the specific injury. Anywhere from one to four treatment sessions are conducted. If more than one treatment is conducted the treatments are ideally spaced and at least 14 days apart. Price varies depending upon how many shocks are administered. One can expect to pay approximately $400 per treatment.

Horse owners should note that shockwave therapy does not "fix" everything. Furthermore a small number of cases that "should," respond don't respond. Hopefully, as we learn more, we will be more able to determine which cases do and do not respond.

Shockwave therapy remains in its infancy for treatment of orthopedic injuries in horses. Because of the cost, shockwave therapy is usually used after traditional therapies have failed. We are finding favorable results following shockwave therapy, even on many otherwise frustrating cases. After treating thousands of horses over the past 6 years and watching the responses, it appears that we are only beginning to realize the full potential of shockwave therapy.

For more information:

SHOCKWAVE Therapy , Treating Orthopedic Injuries in Horses from the January 2002 Issue of Flying Changes Magazine

Extracorporeal Shock Wave Therapy for Treatment of Osteoarthritis in the Horse: Clinical Applications by Mark S. Revenaugh as published in the December 2005 issue of Veterinary Clinics of North America Equine Practice . ( A copy of this article can be requested by email - click here and request the article by title.)