Extracorporeal Shock Wave Treatment (ESWT)

The Virginia-Maryland College of Veterinary Medicine provides shock wave therapy to equine patients in our hospital and on the farm through our Equine Field Service. If you have questions about our dental services, please contact us at 540-231-4621 for in-hospital or on-farm treatment.

What is shock wave therapy?

Extracorporeal shock waves are high-pressure sound waves used for therapeutic purposes. Originally developed to treat kidney stones in humans, shock wave therapy was adopted by the veterinary community to treat orthopedic conditions.

Equine Field Services uses a High Medical Technologies (HMT) – Versatron that generates electrohydraulic shock waves (waves with a large focal volume). Some research directed at explaining the exact mechanism of shock wave has shown it to be pain-relieving; other studies have shown that changes occur at a microscopic level, such as neovascularization and changes in cytokines. Although the exact mechanism has not been proven, a volume of anecdotal evidence suggests that shock wave is an alternative therapy that can be considered for a variety of musculoskeletal problems.

What conditions respond to shock wave therapy?

Shockwave can be used for the following conditions:

• Tendonitis (suspensories, flexor tendons)
• Joint disease (ringbone, meniscal tears)
• Navicular disease
• Sacro-illiac/sore backs

Before any treatment, the horse should first have a full lameness exam/workup, which can be accomplished by scheduling a farm call with the Equine Field Service. A veterinarian visits the farm and conducts a thorough physical exam and observes the horse move, which is best accomplished in a flat area with consistent footing. Next, nerve blocks or intra-articular blocks would most likely be applied to help localize the area causing the unsoundness. Finally, radiology, ultrasound, or a bone scan can be used to arrive at a diagnosis. The Equine Field Service travels with a digital radiology unit and a portable ultrasound for onsite imaging. For a bone scan, however, the horse would have to be brought to the Veterinary Teaching Hospital.

What is the procedure?

If shock wave therapy is pursued, a treatment schedule would be planned, and a portable unit would be brought to the farm.

• Because the shock wave delivers a mildly uncomfortable stimulus, the horse is usually sedated.
• The site of the injury is cleaned, and contact gel is applied.
• A probe that treats at the appropriate depth is chosen, and then 800 to 2,000 shocks are applied.
• Treatment is generally repeated at two- to three-week intervals for three to five sessions.

The horse should be rested for the first week after treatment, then gradually returned to work, depending on the underlying injury. If unsoundness persists or the injury requires longer recovery time, the horse should be rested the entire time between treatments.