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Use if ESWT for musculoskeletal injuries in children

I have not been able to find any info regarding risks, precautions or contra indications for the use of ESWT in children for MSK injuries. I have seen some sites just say not to be used on under 18 year olds and one soevifief Osgood Schlatters as an exception with no further info to support the statement. I am not talking about CP or spasticity in children but the use for routine MSK issues (eg, tendinitis and muscle injuries)
Surely there must be concerns about avoiding epiphyseal plates with ESWT as there are with other electrotherapy interventions? And why would therapists feel ESWT was even indicated in a child? Is there any research EBP out there?? Thanks - I am really concerned about the safety and wisdom of use with child athletes

Hannah Pearson

3 months ago

Back to General Electrotherapy

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Cliff Eaton
Cliff Eaton

Dear Hannah Firstly please accept our apologies for not getting back to you sooner. Unfortunately for the second time now this site has been attacked by hackers. The site therefore has not been active and panel members are still not being notified of new posts. Why hackers wish to attack a site like this beggars belief! Rok is correct. Lohrer et al., (2012) published a paper showing significant improvement on OS using RPWT (Radial Pressure Wave being the correct term NOT Radial Shockwave). They followed up the patients, who at the time had an average age of 14) and found not one reported as having any adverse effects. This finding led to the same group of authors phoning around Germany to find patients (av age 9-10) who had Rx by RPWT for Sever's disease. Again they found no adverse effects In the chapter I was asked to contribute to, on Shockwave therapy, in Tim Watson's and Ethne Nussbaum's new book EPA: Evidence Based Practice, we point to this research for the contraindications chapter. Here we put Shockwave Rxs as 'with precaution' over epiphyseal growth plates. There is NO evidence showing it will cause harm, yet some scant evidence suggesting it will not Also please bear in mind that professional bodies, like manufacturers will err on the side of caution. Manufacturers of EPAs, unless clearly proven otherwise, will contraindicate most things. That is because in order to get a licence to sell medical devices, in different countries, they need to demonstrate that their machines will NOT cause harm. Rather than going to the expense of clinical trials to demonstrate this they will blacketly contraindicate a lot of things I hope this helps Cliff

rok.zagar4
rok.zagar4

Hi Hannah

There have been some studies published in Germany on osgood-schlatter and sever's disease. Big difference is whether you mean focused or radial SW though.

As far as i remember those studies have been published on Storz RSWT, and showed beneficial clinical outcomes in pediatric population, but the dose and number of hits was low.

Get back, i you need some details i might be able to find those...

Regards

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