Understanding the Three Phases of Shockwave Therapy: Angiogenesis, the Proliferation and Cytokine Phase, and the Inflammatory Phase
Published: May 7, 2024
In modern healthcare, the search for innovative therapeutic modalities to replace or supplement prescription pain medication has led to the development of shockwave therapy as a promising intervention. With its origins in physical therapy and sports medicine, shockwave therapy has garnered attention for its efficacy in addressing various musculoskeletal ailments.
There are three pivotal phases of shockwave therapy, and understanding how each phase works proves the transformative potential for this modality in the field of healing.
Understanding how each phase of shockwave therapy works proves the transformative potential for this modality in the field of healing.
A New Dawn of Rejuvenation
Phase 1: Angiogenic Phase
Healing typically commences with the restoration of blood flow, a fundamental requirement for tissue repair and regeneration. Shockwave therapy harnesses mechanical energy to initiate angiogenesis, the process of forming new blood vessels.
Angiogenesis: the process of forming new blood vessels
The European Society of Cardiology produced a study on the angiogenic responses of shockwave therapy and concluded that “a central role of the innate immune system, namely Toll-like receptor 3, mediates angiogenesis upon the release of cytoplasmic RNAs.”
Dr. Allen Mansion of Columbia Advanced Chiropractic explains, “With Toll-like receptor 3, it initiates an immune response. This creates a very very very fast anti-inflammatory effect.” This also recruits angiogenesis, which is “what we need to recruit stem cells.”
The study concluded that because of these responses, “Shockwave treatment protects from neuronal degeneration and downregulation [and is] a promising treatment option for the devastating complication of spinal cord ischemia after aortic repair.”
Shockwave treatment protects from neuronal degeneration and downregulation
By inducing microtraumas at the cellular level, shockwaves trigger a cascade of events that lead to the release of growth factors such as vascular endothelial growth factor (VEGF). These growth factors orchestrate the sprouting of fresh blood vessels, revitalizing ischemic or injured tissues.
Additionally, the therapy enhances the production of endothelial nitric oxide synthase (eNOS), promoting vasodilation and facilitating the proliferation of endothelial cells. The outcome is an augmented blood supply, laying the groundwork for accelerated healing and tissue regeneration.
Phase 2: Proliferation and Cytokine Phase
Cellular proliferation is the cornerstone of tissue repair and regeneration.
Shockwave therapy initiates a series of cellular responses characterized by heightened activity in tissue regeneration pathways.
As cells proliferate, they lay down the framework for tissue reconstruction, heralding in a new generation of cellular rejuvenation. Concurrently, the therapy triggers an upsurge in growth factors, signaling the body to intensify its reparative efforts.
By orchestrating an interplay of cytokines and cellular signaling, shockwave therapy creates an optimal environment for tissue regeneration to flourish.
Notably, the modulation of inflammation emerges as a pivotal aspect of this phase, striking a delicate balance between acute and chronic inflammatory responses. By orchestrating an interplay of cytokines and cellular signaling, shockwave therapy creates an optimal environment for tissue regeneration to flourish.
Phase 3: Inflammatory Phase
Amidst the process of healing, the inflammatory phase emerges as a crucial element in the journey towards restoration.
Shockwave signals and communicates through the cells to the body [...] which leads to the most important phase: the “inflammatory phase.”
While inflammation often carries negative connotations, shockwave therapy has a dual nature, harnessing its power for therapeutic benefit.
Through meticulous modulation of inflammatory pathways, the therapy navigates between acute and chronic inflammation, avoiding detrimental outcomes. Neuropeptide modulation, TLR3 regulation, and macrophage modulation emerge as pivotal mechanisms, orchestrating inflammatory responses.
By fostering a positive acute inflammatory response while quelling chronic inflammation, shockwave therapy paves the way for sustained healing and tissue revitalization.
StemWave Therapy paves the way for sustained healing and tissue revitalization.
A New Dawn of Rejuvenation
In the field of regenerative medicine, shockwave therapy stands as a beacon of hope, unraveling the intricacies of cellular responses and tissue regeneration. With its three transformative phases, the therapy unveils a comprehensive approach to healing.
As healthcare practitioners embrace this paradigm-shifting modality, they are introducing a new era of patient care, marked by accelerated healing and restored vitality alongside, less prescription drug use and lower chances for addiction and harmful side effects during pain management.
With each pulse of energy, shockwave therapy heralds a dawn of rejuvenation, offering solace to those embarking on the journey towards healing and restoration.
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For practitioners in search of advanced healing modalities, shockwave therapy presents a compelling choice. StemWave’s unique approach spans the phases of angiogenesis, proliferation and cytokine release, and inflammatory modulation; distinguishing this modality in the medical field.
By integrating shockwave therapy into treatment protocols, practitioners can offer patients comprehensive care that targets each stage of the healing process effectively.
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Keywords: Shockwave therapy, angiogenic phase, cellular response, tissue repair, tissue regeneration, growth factors, vascular endothelial growth factor (VEGF), endothelial nitric oxide synthase (eNOS), vasodilation, inflammatory modulation, cytokines, cellular signaling, neuropeptide modulation, DLR3 regulation, macrophage modulation, musculoskeletal disorders, physical therapy, sports medicine, chronic inflammation, acute inflammation, regenerative medicine, healthcare practitioners, accelerated healing, vitality, rejuvenation.
Disclosure Statement
The content provided in this blog post is for informational purposes only and should not be considered medical advice. The opinions expressed are those of medical professionals and are based on a collective analysis of publicly available studies and data.
Our company’s product is a Class I medical device, and while it may be related to the topics discussed in this post, it is important to note that our product may not cause similar effects as stated in the post. Additionally, this post should not be interpreted as a guarantee of any specific outcome or result.
It’s important to consult with a qualified healthcare professional for personalized medical advice and treatment. We encourage readers to consult the FDA’s website for information on our product’s clearance and any relevant labeling information.
Reference Index
- An overview of shock wave therapy in musculoskeletal disorders. (2003, April 1). PubMed.
- Speed, C. (2001). Therapeutic ultrasound in soft tissue lesions. British Journal of Rheumatology, 40(12), 1331–1336.
- Huang, T., Sun, C., Chen, Y., Wang, C., Yin, T., Lee, M. S., & Yip, H. (2016). Shock Wave Therapy Enhances Angiogenesis through VEGFR2 Activation and Recycling. Molecular Medicine, 22(1), 850–862.
- Holfeld, J., Tepeköylü, C., Blunder, S., Lobenwein, D., Kirchmair, E., Dietl, M., Kozaryn, R., Lener, D., Theurl, M., Paulus, P., Kirchmair, R., & Grimm, M. (2014). Low energy shock wave therapy induces angiogenesis in acute Hind-Limb ischemia via VEGF receptor 2 phosphorylation. PloS One, 9(8), e103982.
- De Oliveira, R. F., Oliveira, D. a. a. P., & Soares, C. P. (2011). Effect of low-intensity pulsed ultrasound on l929 fibroblasts. Archives of Medical Science/Archives of Medical Science (Online), 2, 224–229.
- Cacchio, A., Giordano, L., Colafarina, O., Rompe, J. D., Tavernese, E., Ioppolo, F., Flamini, S., Spacca, G., & Santilli, V. (2009). Extracorporeal Shock-Wave Therapy Compared with Surgery for Hypertrophic Long-Bone Nonunions. Journal of Bone and Joint Surgery. American Volume/the Journal of Bone and Joint Surgery. American Volume, 91(11), 2589–2597.
- Holfeld, J., Tepeköylü, C., Reißig, C., Lobenwein, D., Scheller, B., Kirchmair, E., Kozaryn, R., Albrecht-Schgoer, K., Krapf, C., Zins, K., Urbschat, A., Zacharowski, K., Grimm, M., Kirchmair, R., & Paulus, P. (2015). Toll-like receptor 3 signalling mediates angiogenic response upon shock wave treatment of ischaemic muscle. Cardiovascular Research, 109(2), 331–343.
- Schmitz, C., Császár, N. B. M., Milz, S., Schieker, M., Maffulli, N., Rompe, J. D., & Furia, J. P. (2015). Efficacy and safety of extracorporeal shock wave therapy for orthopedic conditions: a systematic review on studies listed in the PEDro database. British Medical Bulletin, ldv047.
- Wang, F., Wang, C., Huang, H., Chung, H., Chen, R., & Yang, K. D. (2001). Physical shock wave mediates membrane hyperpolarization and RAS activation for osteogenesis in human bone marrow stromal cells. Biochemical and Biophysical Research Communications, 287(3), 648–655.
