Shockwave Therapy: A Brief History

The exploration of shock wave applications in medicine, from its initial discovery to the present, spans a relatively short period. During World War II, observations of lung injuries in castaways exposed to waterbomb explosions revealed the impact of shock waves on tissues, marking the first recognition of this phenomenon.

In the 1950s, systematic investigations into shock wave applications commenced. Electrohydraulic-generated shock waves demonstrated their ability to crush ceramic plates in water, leading to the first patent for an electrohydraulic shock wave generator in the United States (Frank Rieber, New York, Patent No. 2.559.277). Concurrently, the physical properties of electromagnetically generated shock waves were elucidated.

In 1966, a serendipitous event at Dornier company sparked interest in shock waves' effects on humans. High-velocity projectile experiments revealed that shock waves, generated from plate impact, could travel through the body. This prompted a program financed by the Department of Defense in Germany (1968-1971) to investigate shock wave interactions with biological tissue in animals. Results indicated long-distance effects, with minimal harm to muscles, fat, connective tissue, and intact bone.

The collaboration between researchers and physicians during these investigations led to the concept of using extracorporeal shock waves to disintegrate kidney stones. The first in-vitro disintegration of a kidney stone without direct contact occurred in 1971, paving the way for subsequent in-vivo and in-vitro experiments. In 1980, the first patient with a kidney stone was treated using a prototype lithotripter (Dornier Lithotripter HM1), and by 1983, the first commercial lithotripter (HM3, Dornier) was installed in Germany.

Extracorporeal shock wave therapy's application expanded to treat gallstones, with the first clinical treatment in 1985. Over the years, advancements in lithotripters eliminated the need for a bathtub and anesthesia, and more than 3 million patients have been treated since.

Beyond urology, shock waves have found success in orthopedics. Research in 1985 explored shock waves' influence on bones, revealing osteogenetic potential and the stimulation of fracture healing. In 1988, successful shock wave treatment of non-union cases in humans was reported, and subsequent studies showed success rates between 60% and 90%.

By the early 1990s, shock wave therapy extended to soft tissue diseases such as tendinitis calcarea, epicondylitis, and heel spur. Specialized devices like OssaTron and ReflecTron were developed, demonstrating high efficiency and low complications in clinical studies.

In summary, shockwave therapy, initially explored for its effects on wartime injuries, has evolved into a versatile medical intervention with applications in urology, orthopedics, and soft tissue diseases. Clinical studies consistently highlight its effectiveness with minimal complications.