Don't worry; I am not going to talk about the shock therapy depicted in the 1970s Jack Nicholson film "One Flew Over the Cuckoo's Nest." Extracorporeal shock wave therapy (ESWT) isn't a cure for your horse's emotional or mental problems, but it might be a treatment option for a number of your equine athlete's orthopedic and soft tissue ailments.

ESWT has been around since the 1970s. In humans with urolithiasis (bladder stones), doctors use ESW lithotripsy to fracture stones within the bladder so they can pass without surgery. Since then, ESWT's use as a therapeutic tool in human and veterinary medicine has flourished. The first use of ESWT in the horse was reported in the late 1990s for treating proximal suspensory ligament desmitis (inflammation at the origin of the suspensory ligament) and osteoarthritis of the hock.

With the increasing popularity of ESWT, scientists have evaluated mechanisms of action and clinical efficacy and safety for use on equine bone and soft tissue. The effects of ESWT are apparent at gross anatomic and molecular levels. Recent studies revealed ESWT's ability to decrease inflammation; hasten healing time; enhance neovascularization (blood vessel formation) and cellular proliferation; improve fiber alignment in tendon repair; increase cellular bone morphogenic protein (BMP) production, leading to faster bone healing; and recruit stem cells to injured tissues. Scientists also showed it alleviates pain from degenerative diseases.

Currently, veterinarians treat an array of diseases and ailments with ESWT, including navicular syndrome, collateral ligament desmitis of the coffin joint, tendoniti