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ESWT, adapted from the technology used to break up kidney stones (ESWL), has been used successfully for approximately 20 years. It is the gold standard and first line of treatment for the management of kidney stone disease.

ESWT is the application of high energy acoustic waves that pass easily through the fluid-filled cavities and cells of soft tissue like skin, fat and muscle. However, when these waves encounter the resistance of denser structures such as ligament or bone, the slowing of the wave releases energy which is absorbed by the surrounding tissue. ESWT systems are designed to deliver a tightly focused beam that affects target areas as small as a few millimeters in diameter while avoiding other sensitive tissues such as arteries or nerves.

moa_video_player Shock waves cause a cascade of biological responses in musculoskeletal tissues and produce consistent biological effects in tendon, bone, and tendon bone joint interface in animal models. Shock waves have been shown to increase blood supply to the treated area, manipulate inflammatory processes, stimulate oesteoclasts and fibroblasts to rebuild injured tissues, promote a linear pattern of healing in tendons and ligaments, decrease pain, increase the immune response to acute injuries, and jump-start the immune system to promote healing of chronic injuries.

Specifically, shock wave treatment increased the expressions of angiogenic growth factors including eNOS, VEGF, PCNA and BMP-2 greater than the control without shock wave treatment. It is believed that neovascularization may play a role in anti-inflammation and pain relief, and initiate the repair and regeneration of tendon and bone with improvement in blood supply.

In humans, researchers have reported that approximately 85% of people who have received ESWT for chronic conditions such as heel pain and tennis elbow experienced pain relief and improved function.  SANUWAVE’s OssaTron is the gold standard for electro hydraulic ESWT, and is the only device approved for use by the FDA to treat both heal pain and tennis elbow, respectively. SANUWAVE’s OssaTron and EvoTron have the European Community CE Mark approval for a variety of soft tissue and bone musculoskeletal indications including plantar fasciitis, lateral epicondylitis, calcifying tendonitis, achilles tendonopathies, delayed fracture healing, avascular necrosis (AVN), and osteochondrosis dissecans (OCD).

Veterinary Applications


Based on the results seen in the human population, an increasing number of veterinary specialists offer ESWT. In 2002 VersaTron® was launched in the U.S. and established itself as a valuable tool in the treatment of a number of lameness conditions in horses.

Shock wave treatment with VersaTron® devices is indicated for the non-invasive management of a variety of musculoskeletal disorders causing chronic pain and lameness of the horse or small animal, primarily canines.  Shock wave treatment can be used in combination with or as a substitute for anti-inflammatory drugs, surgical intervention, and physical therapy.

PulseVet® promotes VersaTron® ESWT for equine applications and VersaTron® 4Paws for use on small animal maladies such as degenerative joint disease.

VersaTron® has been designed specifically for non-invasive shock wave applications in veterinary medicine. The rugged build and easy maneuverability make it convenient for usage in the field and the operating room.

The technology is non-invasive. Therapy heads are used to focus the shock waves toward the affected and surrounding areas.  In order to accommodate a large range of indications, VersaTron® can be fitted with four therapy heads, providing a range of penetration depths suitable for equine applications. The VersaTron® 4Paws device has two available therapy head sizes. The number of shocks needed to achieve a desirable response depends on the “volume” of the treatment area – the larger the volume the greater number of shocks required.