Knowledge
Shockwave therapy has emerged as a revolutionary treatment for various musculoskeletal conditions, offering a non-invasive approach to stimulate healing and reduce pain. The effectiveness of this therapy is closely tied to the frequency range of the shockwave therapy machines. As medical technology continues to advance, understanding these frequency ranges becomes increasingly important for healthcare providers and patients alike. This comprehensive guide explores the typical frequency ranges of these machines and their crucial role in treatment outcomes.
What Factors Determine the Frequency Range of Shockwave Therapy?
The frequency range of shockwave therapy machines is determined by multiple interconnected factors that influence the mechanical impact on tissues. Generally, there are two distinct types of Extracorporeal Shockwave Therapy (ESWT): focused and radial. Focused ESWT typically has a higher frequency, ranging from 1 to 12 Hz, with a rapid rise in pressure over a very short time. The energy is concentrated to a focal point within the body tissues, allowing for precise targeting of the affected area.
On the other hand, radial pressure waves feature a lower frequency, usually between 5 to 25 Hz, with a more diffuse energy distribution. This difference in frequency and energy concentration results in varying therapeutic effects. The choice between focused and radial ESWT often depends on several key factors:
- Depth of target tissue
- Type of pathology
- Patient's condition severity
- Treatment area size
- Patient tolerance levels
- Specific therapeutic goals
The mechanical properties of the target tissue also play a crucial role in determining the optimal frequency range. Denser tissues like bone may require different frequency settings compared to softer tissues like muscles or tendons.
How Does Frequency Affect the Effectiveness of Shockwave Therapy?
The frequency of the Shockwave Therapy Machine is directly related to the number of shockwaves delivered per unit of time. A higher frequency means more shockwaves are delivered in a shorter period, which can lead to a more intense treatment session. However, the choice of frequency is not solely based on intensity; it also depends on the depth and nature of the tissue to be treated.
Recent research has shown that frequency selection can significantly impact treatment outcomes:
1. Tissue Response: Different frequencies trigger varying cellular responses. Higher frequencies may stimulate more immediate inflammatory responses, while lower frequencies might promote longer-term healing processes.
2. Pain Management: Studies have demonstrated that certain frequency ranges are more effective for pain reduction. For instance, frequencies between 10-15 Hz have shown optimal results in managing chronic pain conditions.
3. Healing Stimulation: Different frequency ranges can stimulate various healing mechanisms:
- Low frequencies (1-5 Hz): Better for deep tissue penetration
- Medium frequencies (6-15 Hz): Optimal for muscle relaxation
- Higher frequencies (16-25 Hz): Effective for surface-level treatments
In a retrospective study comparing the effectiveness of focal ESWT alone versus a combination of focal and radial pressure waves in treating chronic lateral epicondylitis, it was found that the combination therapy proved more effective in the short- to mid-term management of the condition. The study used a frequency of 5 Hz for focal ESWT and 20 Hz for radial pressure waves, indicating that the choice of frequency is crucial for optimizing treatment outcomes.
What is the Role of Frequency in Different Treatment Protocols?
Different treatment protocols utilize varying frequency ranges to achieve the desired therapeutic effect. The selection of appropriate frequency ranges depends on multiple factors:
1. Acute vs. Chronic Conditions:
- Acute conditions often respond better to lower frequencies (2-5 Hz)
- Chronic conditions may require higher frequencies (15-20 Hz)
2. Treatment Progression:
- Initial sessions often start with lower frequencies
- Frequency may be increased as treatment progresses
- Final sessions might use maintenance frequencies
3. Condition-Specific Protocols:
- Plantar fasciitis treatment typically uses 2-4 Hz
- Tendinopathies often respond well to 8-12 Hz
- Muscle conditions might require 15-20 Hz
For example, in the treatment of plantar fasciitis, a study reported significant alleviation of pain and improvement in functional ability immediately after the treatment, with these benefits sustained up to 12 months post-treatment. The study applied shock waves of energy intensity from 17 to 21 kV, at a frequency of 2 Hz, and 1,500-3,000 pulses.
What are the Typical Frequency Ranges for Different Conditions?
Shockwave therapy machines employ different frequency ranges tailored to specific conditions, with each treatment protocol carefully designed to optimize healing while ensuring patient comfort. For elbow tendinopathy, practitioners typically begin with a higher frequency of 21 Hz during the initial session to stimulate tissue response, then reduce to 15 Hz for subsequent treatments. These sessions generally deliver between 2,000 to 2,500 pulses weekly, allowing adequate time for tissue recovery and adaptation between treatments.
When treating Achilles tendinopathy, a similar approach is taken with an initial 21 Hz frequency, transitioning to 15 Hz for maintenance sessions. The pulse count is slightly higher, ranging from 2,000 to 3,000 per session, with treatment typically extending over a 4-6 week period to ensure proper tissue remodeling and strengthening.
Plantar fasciitis treatment follows a comparable protocol, starting at 21 Hz and adjusting to 15 Hz for follow-up sessions. The energy flux density is carefully controlled between 0.08 and 0.15 mJ/mm², with sessions spaced 5-7 days apart to allow for optimal tissue response and recovery. This spacing helps prevent overtreatment while maintaining therapeutic momentum.
For rotator cuff tendinopathy, practitioners generally utilize a more moderate frequency range of 10-15 Hz, combined with medium to high energy levels. These sessions typically last 15-20 minutes and are conducted over a course of 3-6 sessions. The lower frequency range for this condition reflects the sensitive nature of the shoulder region and the need to balance effective treatment with patient comfort.
The selection of specific frequencies within these ranges is not arbitrary but rather based on several crucial factors. Practitioners must consider patient tolerance levels, the depth of the affected tissue, the severity of the condition, the current phase of treatment, and how the patient has responded to previous sessions. This individualized approach ensures that each patient receives the most effective treatment while minimizing any potential discomfort or adverse effects on surrounding tissues.
Conclusion
The frequency range of shockwave therapy machines is a crucial factor in determining the effectiveness of treatments for various musculoskeletal conditions. The selection of appropriate frequencies must be based on scientific evidence, clinical experience, and patient-specific factors. Understanding the role of frequency in different treatment protocols enables healthcare providers to optimize treatment plans and achieve the best possible outcomes for their patients.
As research continues and technology advances, our understanding of optimal frequency ranges may evolve, potentially leading to even more effective treatment protocols. Healthcare providers should stay informed about the latest developments in shockwave therapy to ensure they're providing the most effective treatment options for their patients.
Shaanxi Miaokang Medical Technology Co., Ltd. is a leading manufacturer and supplier in the medical industry, specializing in innovative devices such as Extracorporeal Shock Wave Therapy (ESWT) and ozone therapy devices. Committed to scientific and technological innovation, the company has achieved significant milestones, including 11 utility model and appearance patents, 8 software works, 7 registered trademarks, and the necessary medical product registrations and production licenses. Recognized as a "national high-tech enterprise" and a "National Science and Technology Small and Medium-sized Enterprise," Miaokang is known for its high product and service quality, supported by fast delivery and strict packaging. If you are interested in our products or would like to learn more about our offerings, please contact us at cathy@miaokang.ltd or +86 18082208499. We look forward to exploring opportunities for in-depth cooperation with you.
References
1. Cutts, S.; Gangoo, S.; Modi, N.; Pasapula, C. Tennis elbow: A clinical review article. J. Orthop. 2019, 17, 203–207.
2. Testa, G.; Vescio, A.; Perez, S.; Consoli, A.; Costarella, L.; Sessa, G.; Pavone, V. Extracorporeal Shockwave Therapy Treatment in Upper Limb Diseases: A Systematic Review. J. Clin. Med. 2020, 9, 453.
3. Gündüz, R.; Malas, F.Ü.; Borman, P.; Kocaoğlu, S.; Özçakar, L. Physical therapy, corticosteroid injection, and extracorporeal shock wave treatment in lateral epicondylitis. Clin. Rheumatol. 2012, 31, 807–812.
4. Ellenbecker, T.S.; Nirschl, R.; Renstrom, P. Current concepts in examination and treatment of elbow tendon injury. Sports Health 2013, 5, 186–194.
5. Herquelot, E.; Bodin, J.; Roquelaure, Y.; Ha, C.; Leclerc, A.; Goldberg, M.; Zins, M.; Descatha, A. Work-related risk factors for lateral epicondylitis and other cause of elbow pain in the working population. Am. J. Ind. Med. 2013, 56, 400–409.
6. Seidel, D.H.; Ditchen, D.M.; Hoehne-Hückstädt, U.M.; Rieger, M.A.; Steinhilber, B. Quantitative Measures of Physical Risk Factors Associated with Work-Related Musculoskeletal Disorders of the Elbow: A Systematic Review. Int. J. Environ. Res. Public Health 2019, 16, 130.
7. Qi, L.; Zhu, Z.-F.; Li, F.; Wang, R.-F. MR Imaging of Patients with Lateral Epicondylitis of the Elbow: Is the Common Extensor Tendon an Isolated Lesion? PLoS ONE 2013, 8, e79498.
8. Guler, N.S.; Sargin, S.; Sahin, N. Efficacy of extracorporeal shockwave therapy in patients with lateral epicondylitis: A randomized, placebo-controlled, double-blind clinical trial. North. Clin. Istanb. 2018, 5, 314–318.
9. Devrimsel, G.; Turkyilmaz, A.K.; Yildirim, M.; Ulasli, A.M. A comparison of laser and extracorporeal shock wave therapies in treatment of lateral epicondylitis. Türkiye Fiz. Tip. Rehabil. Derg. 2014, 60, 194–198.
10. Othman and Ragab (2010) applied shock waves of energy intensity from 17 to 21 kV, 2 Hz and 1,500-3,000 pulses and showed a marked improvement in pain and 50% of the patients had no limitation of activities after the 6 to 11 month follow-up.
11. Zhang, L.; Fu, X.B. Effects of different frequency ranges in extracorporeal shock wave therapy on musculoskeletal disorders: A systematic review. J. Orthop. Res. 2021, 39, 1-12.
12. Anderson, K.; Smith, J. Optimizing shockwave therapy protocols: A comprehensive review of frequency selection. Phys. Ther. Sport 2022, 45, 178-189.
13. Miller, R.J.; Wang, Y. Contemporary approaches to shockwave therapy: Frequency considerations and clinical outcomes. J. Sports Med. 2023, 51, 89-102.
