Extracorporeal Shock Wave Therapy for the Treatment of Equine Lameness Conditions

Extracorporeal (externally, outside the body) shock wave lithotripsy has been used extensively to treat renal calculi (kidney stones) in man. Over the last several years, extracorporeal shock wave therapy (ESWT) has been used to treat numerous orthopedic conditions in both humans and animal. In humans, it has been used successfully to treat such conditions as heel spurs, "tennis elbow" and calcified shoulder. In horses, it has been used to treat bucked shins, chronic proximal and distal suspensory desmitis, calcification of tendons and ligaments, fractures, splints, navicular disease, bone spavin, ring bone, and back pain.

Shock waves are pressure waves characterized by high and rapid peak pressure of a short pulse duration followed by rapid decompression. There are 2 types of devices currently used for ESWT. One is a high-energy focused shock wave device and the other is a low-energy radial shock wave device. Both have been used successfully to treat a number of equine lameness conditions in both Europe and North America. The Swiss DolorClast®Vet (EMS Corp, USA, Dallas, TX) is a radial shock wave device that uses pneumatic energy to create the shock waves. The energy is transmitted through the skin and superficial soft tissues and deposited within bone and deeper soft tissue.

The exact mechanism of action of how shock waves cause clinical improvement is unclear. However, it appears that when the shock wave's energy is delivered, there is a transient period of pain relief followed by an increased rate of bone and tissue remodeling. Healing appears to be related to the growth of blood vessels into the affected area.

Standard treatment recommendations for horses is 2 to 3 treatments spaced 14 days apart. During each treatment session, the horse is sedated and the affected area clipped and cleaned. Two thousand radial shock waves are transmitted along a hand piece to the treatment area to stimulate the healing process. Each session lasts approximately 10-20 minutes. Following treatment, some horses experience mild swelling and sensitivity at the treatment site, which subsides within 48 hours. The majority of horses show no signs of discomfort or swelling following treatment. Since the technique is non-invasive and involves minimal restraint and sedation, there is little risk of injury to the animal. The cost of a session depends on the area being treated and amount of sedation required to complete the procedure. If you have a horse with a chronic lameness issue that has not responded favorably to conventional medical therapy, consult with your veterinarian to determine if your horse would be a candidate for ESWT. If you would like additional information regarding ESWT, please feel free to contact our clinic.

Joanne Tetens, DVM, MS, PhD, Diplomate of the American College of Veterinary Surgeons
Chief Equine Surgeon Aeolus Animal Hospital & Equine Center

145 Harmony Lane
Manchester Center, VT 05255