McClure S, Dorfmuller C. Extracorporeal shock wave therapy: theory and equipment. Clincial applications and regulation. Clin Tech Equine Pract 2003;2:348–357.
McClure SR, Weinberger T. Extracorporeal shock wave therapy: clinical applications and regulation. Clin Tech Equine Pract 2003;2:358–367.
McCarroll GD, McClure SR. Initial experiences with extracorporeal shock wave therapy for treatment of bone spavin in horses. Vet Comp Orthop Traumatol 2002;3:184–186.
McClure SR, Van Sickle DV, Evans R, et al. The effects of extracorporeal shock wave therapy on the ultrasonographic and histologic appearance of collagenase induced equine forelimb suspensory ligament desmitis. Ultrasound Med Biol 2004;30:461–467.
Kersh KD, McClure SR, Evans RB, et al. Ultrasonographic evaluation of extracorporeal shock wave therapy on collagenase induced superficial digital flexor tendonitis, in Proceedings. 50th Annu Meet Am Assoc Equine Pract 2004;257–260.
Crowe O, Dyson SJ, Wright IM, et al. Treatment of 45 cases of chronic hindlimb proximal suspensory desmitis by radial extracorporeal shock wave therapy, in Proceedings. 48th Annu Meet Am Assoc Equine Pract 2002;322–325.
Palmer SE. Treatment of dorsal metacarpal disease in the thoroughbred racehorse with radial extracorporeal shock wave therapy, in Proceedings. 48th Annu Meet Am Assoc Equine Pract 2002;318–321.
Lischer CJ, Ringer S, Schnewlin M, et al. Extracorporeal shock wave therapy (ESWT) in the management of chronic musculoskeletal disorders, in Proceedings. Annu Meet Eur Coll Vet Surg 2002;137–142.
McClure SR, Sonea IM, Evans RB, et al. Evaluation of analgesia resulting from extracorporeal shock wave therapy and radial pressure wave therapy in the limbs of horses and sheep. Am J Vet Res 2005;66:1702–1708.
Bolt DM, Burba DJ, Hubert JD, et al. Determination of functional and morphologic changes in palmar digital nerves after nonfocused extracorporeal shock wave treatment in horses. Am J Vet Res 2004;65:1714–1718.
Haake M, Thon A, Bette M. Unchanged c-Fos expression after extracorporeal shock wave therapy: an experimental investigation in rats. Arch Orthop Trauma Surg 2002;122:518–521.
Haake M, Thon A, Bette M. Absence of spinal response to extracorporeal shock waves on the endogenous opiod systems in the rat. Ultrasound Med Biol 2001;27:279–284.
Haist J, von Keitz-Steeger D. Die Stosswellentherapie knochennaher Weichteilschmerzen—Ein neues Behandlungskonzept. In:Chaussy C, Eisenberger F, Jocham D, et al, eds.Die Stosswelle—Forschung und Klinik. Tuebingen, Germany: Attempto Verlag, 1995;162–165.
Ohtori S, Inoue G, Mannoji C, et al. Shock wave application to rat skin induces degeneration and reinnervation of sensory nerve fibers. Neurosci Lett 2001;315:57–60.
Waldern NM, Welshaupt MA, Imboden I, et al. Evaluation of skin sensitivity after shock wave treatment. Am J Vet Res 2005;66:2095–2100.
Schelling G, Delius M, Gscchwender M, et al. Extracorporeal shock waves stimulate frog sciatic nerves indirectly via a cavitation-mediated mechanism. Biophys J 1994;66:133–140.
Takahashi N, Wada Y, Ohtori S, et al. Application of shock waves to rat skin decreases calcitonin gene-related peptide immunoreactivity in dorsal root ganglion neurons. Auton Neuroscience 2003;107:81–84.
Haake M, Thon A, Bette M. No influence of low-energy extracorporeal shock wave therapy (ESWT) on spinal nociceptive systems. J Orthop Sci 2002;7:97–101.
Bjurholm A, Kreicbergs A, Brodin E, et al. Substance P- and CGRP-immunoreactive nerves in bone. Peptides 1988;9:165–171.
Jones KB, Mollano AV, Morcuende JA, et al. Bone and brain: a review of neural, hormonal, and musculoskeletal connections. Iowa Orthop J 2004;24:123–132.
Ju G, Hokfelt T, Brodin E, et al. Primary sensory neurons of the rat showing calcitonin gene-related peptide immunoreactivity and their relationship to substance P-, somatostatin-, galanin-, vasoactive intestinal polypeptide- and cholecystokinin-immunoreactive ganglion cells. Cell Tissue Res 1987;247:417–431.
Lee Y, Takami K, Kawai S, et al. Distribution of calcitonin gene-related peptide in the rat peripheral nervous system with reference to its coexistence with substance P. Neuroscience 1985;15:1227–1237.
Maier M, Averbeck B, Mila S, et al. Substance P and prostaglandin E2 release after shock wave application to the rabbit femur. Clin Orthop Relat Res 2003;406:237–245.
Fortier LA, Nixon AJ. Distributional changes in substance P nociceptive fiber patterns in naturally osteoarthritic articulations. J Rheumatol 1997;24:524–530.
Dahlberg J, McClure SR, Evans RB, et al. Force platform evaluation of lameness severity following resulting from focused extracorporeal shock wave therapy in horses with unilateral forelimb lameness. J Am Vet Med Assoc 2006;229:100–103.
Brown KE, Nickols FA, Leron JP, et al. Investigation of the immediate analgesic effects of extracorporeal shock wave therapy for treatment of navicular disease in horses. Vet Surg 2005;34:554–558.
Advertisement
Objective—To evaluate the effect of focused extracorporeal shock wave therapy (ESWT) and radial pressure wave therapy (RPWT) on immunohistochemical staining for substance P and calcitonin gene-related peptide (CGRP) in the skin and periosteum of sheep.
Animals—36 sheep.
Procedures—All 4 limbs of 36 sheep were treated with ESWT, RPWT, or a sham treatment. For 14 days after treatment, at least 2 sheep were euthanized daily and tissue was harvested for histologic evaluation of nerves via staining for substance P and CGRP in the skin and periosteum.
Results—No effects of ESWT or RPWT were observed on the number of nerves with stain uptake for substance P or CGRP in the skin or periosteum.
Conclusions and Clinical Relevance—Substance P- and CGRP-containing nerve fibers are not disrupted by EWST or RPWT. Further studies are needed to identify the mechanism of analgesia observed in association with these treatment modalities.
The authors thank Dave Cavanaugh for assistance with immunohistochemical staining.