Extracorporeal Shock Wave Therapy (ESWT) is a non-invasive treatment that has been gaining popularity in the veterinary field over the past three decades, particularly for treating equine orthopedic conditions. This therapy uses high-energy sound waves, or shock waves, to stimulate healing processes in various tissues. It’s used for a variety of conditions such as osteoarthritis, navicular syndrome, tendon injuries, and back pain. This blog post will help horse owners understand how ESWT works, its benefits, and what conditions it can treat.
What is ESWT and How Does It Work?
ESWT involves the use of high-energy pressure waves that interact with the tissues in the horse’s body to promote healing. When shock waves are applied to an area, they create mechanical stress that stimulates biological responses in the cells. This helps to control inflammation, promote the formation of new blood vessels (angiogenesis), and stimulate the production of healing-promoting proteins called cytokines.
Research has shown that shock waves increase the production of beneficial cytokines like transforming growth factor-beta (TGF-β1) and vascular endothelial growth factor (VEGF), both of which are associated with improved healing. Studies in horses have demonstrated that ESWT can increase the expression of these proteins, particularly in conditions involving tendons and ligaments.
How is ESWT Used in Horses?
ESWT is utilised for several conditions in horses, primarily those affecting bones, soft tissues like tendons and ligaments, and wounds.
- Bone Healing: ESWT was initially used to stimulate bone healing in human medicine, and this application has extended to horses. Studies show that ESWT can promote bone remodelling and reduce lameness. For instance, treating horses with shock wave pulses has been found to increase bone cell activity and improve healing without damaging the bone or surrounding tissues.
- Soft Tissue Healing: ESWT is also effective in treating tendon and ligament injuries. Studies have shown that shock waves increase blood flow to the affected area and promote faster and better-quality healing. For example, when applied to tendon injuries, ESWT has been found to promote a more organized arrangement of collagen fibers, which is crucial for tissue strength.
- Wound Healing: Research on the use of ESWT for wound healing has shown promising results. ESWT has been found to reduce inflammation and promote faster healing in both skin and deeper tissues. In horses, studies have indicated that wounds treated with ESWT heal faster and have less scar tissue compared to untreated wounds.
What are the benefits of ESWT for Horses?
- Non-Invasive: ESWT is applied directly to the skin.
- Pain Relief: ESWT has been shown to reduce pain in conditions like navicular disease and osteoarthritis, which can improve a horse’s quality of life and ability to perform.
- Stimulates Natural Healing: By enhancing blood flow and promoting cellular activity, ESWT supports the body’s natural healing processes.
- Minimal Side Effects: When performed correctly, ESWT has minimal side effects. Horses may experience mild discomfort during the procedure, but this is generally short-lived.
Conditions Treated with ESWT
- Proximal Suspensory Desmopathy (High Suspensory): This condition, which affects the ligament in the horse’s forelimbs or hindlimbs, is one of the most common uses of ESWT. Clinical trials have shown that horses treated with ESWT returned to work faster than those treated with other methods.
- Navicular Disease: ESWT is increasingly used to manage navicular disease, a common source of lameness in performance horses. Studies have demonstrated that ESWT can significantly reduce lameness and improve function by targeting pain and inflammation in the navicular bone and surrounding tissues.
- Osteoarthritis: ESWT has been shown to reduce lameness caused by osteoarthritis and improve joint function, particularly but not limited to the distal tarsal joints (hock joints). Although the exact mechanism isn’t fully understood, it’s believed that ESWT may help by reducing pain and inflammation or by promoting bone remodeling.
- Thoracolumbar Pain (Back Pain) and Sacroiliac Pain: ESWT has been used successfully to manage pain associated with back and sacroiliac problems, such as spinous process impingement or dorsal articular process osteoarthritis and sacroiliac disease. Studies indicate improvements in pain levels, muscle function, and overall mobility.
- Wound Healing: While more research is needed, initial studies suggest that ESWT can help heal wounds more quickly and with less scarring, which is particularly valuable for horses recovering from surgery or trauma.
Practical Considerations for Horse Owners
While ESWT offers numerous benefits, it’s important to discuss the specifics with your veterinarian, who will evaluate if it’s appropriate for your horse’s condition. Here are some practical points to keep in mind:
- Treatment Frequency and Duration: ESWT is usually performed in multiple sessions, depending on the severity of the condition and the response to treatment. Each session is typically spaced a few weeks apart.
- Recovery and Rest: After treatment, a period of rest or restricted activity is often recommended to maximize the benefits of the therapy.
Future of ESWT in Equine Medicine
As research continues, new applications for ESWT are emerging. For instance, the therapy is being explored for managing respiratory issues like exercise-induced pulmonary haemorrhage and for enhancing the effectiveness of regenerative therapies like stem cell treatments. These developments suggest that the future of ESWT in equine medicine is promising, with potential benefits expanding beyond current uses.
Conclusion
ESWT represents a valuable tool in the treatment of various equine conditions, offering a non-invasive way to manage pain and promote healing. From bone and tendon injuries to complex joint diseases, ESWT can improve a horse’s quality of life and return to performance more quickly. However, every horse is unique, so if you want to discuss further about this treatment modality, schedule an appointment with our expert team today! Book Now or give us a call at (08) 9479 1800. We’re here to help you every step of the way.
Best Regards,
Dr. Augie
Equine Veterinarian at Perth Equine Hospital
(08) 9479 1800 | augie@perthequinehospital.com.au
https://www.perthequinehospital.com.au/
References:
Johnson, S. A., Richards, R. B., Frisbie, D. D., Esselman, A. M., & McClure, S. R. (2022). Equine shock wave therapy – where are we now?. First published: 09 October 2022.
