In the realm of modern medicine, the quest for innovative, non-invasive treatments has led to the emergence of Shockwave Therapy (SWT) and Extracorporeal Pulse Activation Therapy (EPAT). This groundbreaking approach, often referred to simply as "SWT" or "EPAT," harnesses the potency of targeted sound waves to treat an array of conditions, from kidney stones and orthopedic injuries to musculoskeletal disorders and even erectile dysfunction. In this comprehensive exploration, we dive into the transformative potential of SWT and EPAT, their mechanisms, applications, and what the future holds for this revolutionary treatment.

Understanding the Essence of These Powerful Sound Therapies

Shock Wave Therapy (SWT), also known as Acoustic Wave, Gainswave, or Extracorporeal Pulse Activation (EPAT), has its roots dating back to the early 1980s when it was initially introduced as a cutting-edge solution for urologic conditions. The remarkable success of this technology in treating urinary stones paved the way for its evolution into a non-invasive and highly effective modes of treatment.

SWT and EPAT utilize precisely calibrated sound waves to stimulate targeted tissues within the body. These waves possess a unique set of characteristics, featuring nonlinearity, high peak pressure followed by low tensile amplitude, short rise time, and a brief duration. This distinctive sonic profile generates a dual-phase effect: a direct mechanical impact and the creation of cavitation and gas bubbles that implode at high speeds, producing secondary shockwaves.

In comparison to conventional ultrasound waves, SWT and EPAT exhibit an astonishing peak pressure approximately 1000 times greater, highlighting their exceptional potency.

The Mechanisms Underlying SWT and EPAT

While the precise mechanisms driving SWT and EPAT are still the subject of ongoing research, several compelling theories have been proposed:

  • Neovascularization: SWT and EPAT are believed to promote neovascularization at the tendon-bone junction, enhancing blood supply to the treated area.
  • Cell Stimulation: They stimulate the proliferation of tenocytes, cells responsible for maintaining and repairing tendons.
  • Osteoprogenitor Differentiation: SWT and EPAT may encourage osteoprogenitor differentiation, a vital process in bone health and healing.
  • Leukocyte Infiltration: They increase leukocyte infiltration, contributing to the body's natural healing responses.
  • Growth Factor Amplification: SWT and EPAT can amplify growth factor and protein synthesis, triggering collagen production and tissue remodeling.

The Pillars of SWT and EPAT: Principles and Protocols

SWT and EPAT operate on a simple yet powerful premise: delivering transient pressure disturbances rapidly in three-dimensional space. These waves create cavitation effects, resulting from the negative phase of wave propagation, leading to hematoma formation and focal cell death. This, in turn, triggers the regeneration of new tissue or bone—an essential element of the healing process.

Applications of SWT and EPAT

The versatility of SWT and EPAT extends across various medical domains, with a particular focus on musculoskeletal conditions. Some of the key areas where These Treatments have demonstrated their effectiveness include:

  • Tendinopathies: SWT and EPAT serve as valuable options for addressing both upper and lower extremity tendinopathies.
  • Chronic Pain Syndromes: Conditions like greater trochanteric pain syndrome and medial tibial stress syndrome have shown positive responses to SWT and EPAT.
  • Erectile Dysfunction: SWT and EPAT have emerged as potential treatment options for erectile dysfunction, especially in cases unresponsive to medication or for those seeking non-invasive therapies.

Differentiating SWT and EPAT from Radial Wave Treatment

To gain a comprehensive understanding of the SWT and EPAT landscape, it is essential to distinguish them from Radial Wave, a similar-sounding alternative often advertised for the treatment of erectile dysfunction. Here are the primary differences:

Shockwave Therapy (SWT) and Extracorporeal Pulse Activation Therapy (EPAT)

  • Supported by data indicating their potential to stimulate blood flow and foster the growth of new blood vessels.
  • Require administration by a licensed medical professional with the requisite training.
  • SWT and EPAT have yet to receive approval from the Food and Drug Administration (FDA) for the treatment of erectile dysfunction.

Radial Wave Therapy

  • Falls into the category of Class I medical devices, exempting it from FDA regulation.
  • Administration does not necessitate medical licensure or specialized training.
  • Can be used as a home device to treat erectile dysfunction, such as Launch Medical’s Phoenix device

Cost Considerations and Ideal Candidates for SWT and EPAT

Given that SWT and EPAT are relatively new and typically not covered by insurance, patients and urologists may explore alternative ED treatment options initially. A standard SWT and EPAT regimen typically comprises six separate sessions, with each session costing between $400 and $500 out-of-pocket. The decision to pursue SWT and EPAT, its cost implications, and alternatives will be discussed thoroughly between the patient and the healthcare provider.

SWT and EPAT are most effective for individuals with mild erectile dysfunction who fall into one of the following categories:

  • Those not responding adequately to medication.
  • Individuals averse to medication-based treatments.
  • Those intrigued by regenerative therapy aimed at addressing the root causes of ED.

However, the effectiveness of SWT and EPAT in individuals with severe ED or underlying health conditions like diabetes, prostate cancer, or heart disease has not undergone extensive study.

The SWT and EPAT Procedure: Minimally Invasive and Efficient

The SWT and EPAT procedure takes place in an exam room and typically does not require anesthesia. Patients need not make any special preparations before their appointment.

During the treatment, a urologist employs a device, such as the DUOLITH®, emitting gentle pulses that enhance blood flow. The entire procedure usually lasts around 15 minutes. Following the treatment, patients can safely return home. Discomfort, if experienced, can typically be managed with over-the-counter pain relievers like acetaminophen or ibuprofen.

Most individuals can resume their regular activities the day after SWT and EPAT, though the urologist may provide guidance on any necessary restrictions.

Understanding Potential Risks of SWT and EPAT

While side effects are rare, they may include:

  • Pain at the treatment site.
  • Minor bleeding or bruising in the treated area.
  • Presence of blood in the urine.
  • Skin infection at the treatment site.
  • Painful erections or a worsening of penile curvature.

Clinical studies generally support the effectiveness and safety of SWT and EPAT. However, ongoing research is crucial to identifying potential risks and refining treatment protocols for those with erectile dysfunction.

The Timeline of SWT and EPAT Results

For many individuals undergoing **SWT the results really depend on a lot of different factors. Many times if you have other health issues or factors inside of your body's ecosystem causing your ED you will not see as powerful results as someone who is only struggling with a blood flow issue. 

Because blood flow may not even be the core issue causing your ED the best place to start is to take a short assessment to find out if Blood Flow is even at the source of your issue. This way you can save time by focusing on the right things that are unique to where your Erectile Failures are coming from specifically.

This assessment was put together by a revolutionary research group based out of Broomfield Colorado.

You can take a assessment free here.

~ Mad River Chicago