Advanced Musculoskeletal Treatment Incorporating Piezoelectric Shockwave Therapy

Beginning of Focused Shockwaves

In 1988 the first shock wave treatment of non-union in human was successfully performed in Bochum/Germany.

At the same time Valchanow et. al. reported about shock wave therapy on non-unions and delayed unions. His success rate was 85% but the requirements of his clinical study were not exactly specified

In the next years different clinical studies reported about success rates between 60% and 90%. At the beginning of the 90’ies the first reports about shock wave therapy on tendinitis calcarea were published. Further investigations lead to successful treatment of epicondylitis and heel spur with reported success rates between 70% and 80%.

What Are Therapeutic Shockwaves?

● A shock wave is defined by an abrupt, nearly discontinuous change in pressure and by having a velocity that is higher than the speed of sound in the medium it propagates  

● A typical pressure profile of a focused shockwave used for therapeutic purposes is shown in fig. 1. 

● Generally, a shock wave can be described as a single pulse with a wide frequency range (from approx. 150 kHz up to 100 MHz), high pressure amplitude (up to 150 MPa), low tensile wave (up to -25 MPa), small pulse width and a short rise time of up to a few hundred nanoseconds.

Parameters for Focused Shockwaves and Radial Pressure Waves

Fundamental Differences in Technology

Piezoelectric Technology

● Piezo-ceramic elements arrayed on a concave surface are briefly and simultaneously expanded by a few micrometers by the application of a high-voltage pulse to create a pressure pulse.

● The piezo elements are precisely aligned with the therapy focus. By precisely focusing the pulse, a shockwave is created in the

● In contrast to the other technologies the piezoelectric system is self-focusing by the geometric shape of the sphere and no focusing lenses or reflectors are needed. This technology allows a compact therapy source design and creates a precise, well-defined focal zone.

Piezoelectric Shockwave Penetration

This study demonstrates that f-ESW'T can effectively penetrate both soft and bone tissues, with depth of penetration varying according to tissue composition and wave intensity. The findings highlight the critical role of an appropriate coupling medium, such as gel, in ensuring effective wave propagation in piezoelectric shock wave devices. Additionally, the results reinforce the importance of anatomical knowledge for optimizing the safe and precise application of f-ESW'T in clinical settings. Understanding the interaction between shock waves and different tissue types contributes to refining treatment protocols and improving therapeutic outcomes. In conclusion, while this study provides valuable insights into shock wave penetration across different tissues, future research should incorporate precise penetration depth measurements, energy quantification, and clinical validation to strengthen the study's impact and applicability. These advancements would not only enhance the reproducibility and precision of the findings but also facilitate more accurate comparisons with existing literature and improve the clinical relevance of shock wave therapy.

Product Advantages

Piezoelectric Crystal   Precision Device

Shock wave energy, hundreds of piezoelectric ceramic crystals are geometrically arranged in a concave bowl-shaped applicator, when stimulated by ahigh-voltage pulse, the piezoelectric ceramic element briefly expands a few microns along its axis, generating pressure waves in the focal volume and the ensuing shock wave.

Comfortable Treatment    Painless Treatment                                    

Although piezoelectric shock wave has a very high peak pressure value at the focal point, its wave source aperture angle is relatively large, and the energy density on the skin surface is low, which minimizes the pain on the skin surface and rarely causes tissue pain and discomfort.

Variable Focus            Fine Focus

Eight interchangeable gel pads allow for fine, accurate depth of penetration. According to the depth of the treatment site, select the appropriate gel pad to transmit the shock wave energy to achieve effective treatment. The maxi-mum focus size is 3mm in radial direction and 10mm in axial direction, targeting the lesion with almost no collateral damage to adjacent tissues.

Ultra Quiet         Low Noise

Whether it is pneumatic type or other focused type, the noise generated during working is relatively large, which may easily cause discomfort or even side effects to patients. Piezoelectric shock wave adopts the ultra-precisely designed anti-hemispherical surface integration technology, the piezoelectric elements are assembled, providing a vibration-free and low-noise treatment environment.

Long Life of Wave Source    Low Maintenance Cost

Other types of shock wave handles have a shorter service life and higher

 maintenance costs. Piezoelectric shock wave design is precise and stable, with almost no wear parts, and basically no maintenance, low maintenance cost, and long service life.

Intelligent Operation      Humanized Design

High-resolution 12-inch color touch screen, fast and convenient operation; cart-type design, with storage space inside; display energy flux density, treatment time, and energy during treatment, the gel heating function.

XY-CJB-II  from Sunnyou 

Penetration: Adjustable from 0 to 120 mm

Gel Pads: Equipped with 8 types of gel heads to choose from based on different disease needs

Max energy density: 0.73 mJ/mm²

Energy Level:1-23 levels

Shock frequency: 1 to 8HZ.  With a step of 1 Hz

Modes:  Single shock mode and continuous shock mode

Display: The machine comes with a high-resolution smart color touchscreen,12 inches, with a bilingual menu (Chinese and English) for easy operation

Conclusions

The complementary effects of ESWT in the treatment of musculoskeletal pathologies make it an effective form of therapy that can be used alone or in combination with other therapeutic modalities. Not to be underestimated is the possibility of using ESWT as a supportive measure for any myofascial imbalances and functional movement restrictions underlying the pathologies. This is explained by the effects of ESWT on the myofascial units, such as the reduction in muscle tone, the decreased inflammatory activity and the effect on trigger points. Further studies, especially clinical studies, are needed for the future use of ESWT, To date, there is still minimal evidence on the ideal treatment settings,  intensity, duration, localization and applied energy to provide the best possible