What is shockwave therapy for horses？

Shockwave therapy for horses, also known as Extracorporeal Shock Wave Therapy (ESWT), is a non-invasive medical treatment that uses acoustic waves to stimulate healing and alleviate pain in horses. This therapy is commonly used to treat various musculoskeletal conditions and injuries in equines. The shockwaves are generated outside the horse’s body and then directed to the affected area, promoting increased blood flow, cellular repair, and collagen production. ESWT is considered a valuable tool in equine veterinary medicine for promoting faster recovery and improving the overall well-being of horses.

Indications addressed with shockwave therapy:

Bowed tendons
Suspensory ligament injuries
Stress fractures
Splint bone fractures
Bone spavin
Navicular syndrome
Vertebral spinal pain/kissing spine
Sacro-iliac conditions (Hunter Bumps)
Back pain
Bucked shins

How does ESWT benefit horses?

ESWT has gained widespread usage, with one theory suggesting that shock waves affect cell-to-cell communication by altering the expression of key molecules like growth factors and cytokines, promoting healing. To investigate this, a research group conducted a study on horses, creating wounds on both forelimbs. They treated one forelimb with ESWT and left the other untreated, measuring the levels of wound-healing related genes throughout the study.

A published review article further elucidated that ESWT not only impacts growth factors for healing but also mediators supporting blood vessel growth (angiogenic cytokines). Additionally, it increases the presence of bone-producing cells (osteoblasts) and recruits stem cells to facilitate healing across various tissue types, offering potential pain relief.

Ongoing research aims to comprehensively understand ESWT’s mechanisms, optimizing its benefits for patients.

What to expect during ESWT for horses?

The actual shockwave therapy treatment typically lasts around 10 to 20 minutes, preceded by a few minutes of preparation. The procedure emits a loud sound and can be slightly uncomfortable, depending on the treated area. To ensure the horse’s comfort, mild sedation may be used in certain cases.

The biological response and healing effects occur over a span of 2 to 4 weeks. For most indications, optimal benefits are achieved with 2 to 3 treatments, spaced 2 to 3 weeks apart. Notably, a mild analgesic effect can last up to 4 days post-treatment, making it crucial to avoid overworking the horse during this period.

Equine disciplines have varying regulations regarding the administration of shockwave therapy. Trainers and owners are advised to verify competition rules and inform their veterinarian about upcoming show schedules before administering shockwave therapy sessions.

Important considerations for applying ESWT in horses

Accurate Diagnosis:

An accurate diagnosis is crucial for optimal outcomes with ESWT. Treating an area without a proper diagnosis may not lead to the desired results, such as a return to peak performance. Regular follow-up examinations to adjust the horse’s rehabilitation schedule can significantly improve the overall outcome.

Proper Site Preparation:

Adequate site preparation enhances the penetration of sound waves. For instance, when treating navicular disease, veterinarians recommend trimming the frog and using a wet bandage overnight to soften the tissues, allowing the sound waves to reach the deeper tissues where the navicular bone is located. Similarly, clipping and cleaning the site before applying the handpiece can maximize the benefits of ESWT for horses with tendon, ligament, and muscle pain.

Sedation Requirement:

Many horses may require sedation during ESWT. Additionally, it is essential that only trained professionals apply ESWT, as with other physical therapy and rehabilitation modalities, to ensure safety and effectiveness.

[1] Revenaugh, M. S. (2005). Extracorporeal shock wave therapy for treatment of osteoarthritis in the horse: clinical applications. Veterinary Clinics: Equine Practice, 21(3), 609-625.

[2] Trager, L. R., Funk, R. A., Clapp, K. S., Dahlgren, L. A., Werre, S. R., Hodgson, D. R., & Pleasant, R. S. (2020). Extracorporeal shockwave therapy raises mechanical nociceptive threshold in horses with thoracolumbar pain. Equine veterinary journal, 52(2), 250-257.