Shock wave over hand muscles: A neurophysiological study on peripheral conduction nerves in normal subjects

Background and purpose: shock waves are defined as a sequence of single sonic pulses largely used in the treatment of bone and tendon diseases and recently on muscular hypertonia in stroke patients. Our purpose is to investigate the short and long term effect of extracorporeal shock wave therapy (ESWT) on the peripheral nerve conduction and central conductions from the treated muscles in normal human subjects in order to define safety criteria. Methods: we studied 10 patients normal subjects. Motor and sensory nerve conduction velocity and F response from right ipothenar eminence (abductor digiti minimi) of the hand was recorded. Furthermore MEP latency and amplitude and central conduction from the same muscles by transcranial magnetic stimulation was evaluated. In all subjects each neurophysiological measures were monitored before, immediately after, 15 minutes and after 30 minutes from the active ESWT treatment (1600 shots with an energy applied of 0.030 mj/mm²). Results: no significant short or long term changes were noted in sensory and motor peripheral nerve conduction and in central motor conduction in all the subjects evaluated after ESWT. Conclusions: the ESWT has no effect on sensory and motor peripheral nerve conduction and in central motor conduction. The ESWT using low level of energy represent a safety method for treating the muscles in human subjects without involvement of motor or sensory nervous trunks. Different mechanisms of action of ESWT are discussed.