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Extracorporeal Shockwave Therapy, or ESWT, is a term applied to all non
-
invasive
shockwaves/pressure pulses used for a variety of medical treatments from breaking
kidney stones to healing wounds and treating a calcified shoulder. The word
“
lithotripter
”
is mostly reserved for the kidney stone machines. Machines that break
kidney stones are very powerful and focused at about 140 mm into the kidney.
Machines used for wound healing and pain resolution are less powerful and the depth
of penetration can be more adjusted.
The term
“
shockwave machine
”
is being applied to smaller hand
-
held machines used
for wound healing and pain resolution, and there are different technologies:
FOCUSED SHOCKWAVES
Electrohydraulic
–
High energy pressure is generated by discharging a spark in
water, creating acoustic (sound) waves. There is a rapid rise in pressure which is
then focused by an elliptical reflector and targeted to the diseased area to produce a
therapeutic effect.
Electromagnetic
–
This involves an electric current passing through a coil to
produce a strong magnetic field. A lens is used to focus the waves; the therapeutic
point is defined by the length of the focus lens.
Piezoelectric
–
Piezoelectricity is the creation of voltage across the sides of a
crystal when you subject the crystal to mechanical stress. In ultrasound equipment,
a piezoelectric transducer converts electrical energy into extremely rapid
mechanical vibrations. These ultrasound vibrations can be used for scanning,
cleaning, and all kinds of other things. In therapeutic applications, this involves a
large number of piezoelectric crystals in water. The arrangement of the crystals
defines the focus.
UNFOCUSED SHOCKWAVES
Radial pressure wave –
This is usually not considered true extracorporeal
shockwave therapy, but more of a pressure wave therapy.
A
“
shockwave
”
is
defined as being a generated energy wave that moves faster than the speed of
sound (1500 meters per second). Radial pressure waves travel at speeds of
approximately 10 meters per second; hence, no actual shockwave is produced.
Radial pressure waves are slower, less intense, elongated, and more sinusoidal in
appearance. The waves cannot be focused.
Of the four, the
electrohydraulic
method appears to be the most effective
therapeutically, likely due to the rapid rise time of the pressure pulse. Also, results are
obtained with a smaller number of sessions.
CellSonic VIPP uses the
electrohydraulic
method. These high energy focused
shockwaves rise 1000 times faster and have a peak pressure 10 to 100 times greater
than radial (unfocused) shockwaves.
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