Investigation of the immediate analgesic effects of extracorporeal shock wave therapy for treatment of navicular disease in horses.
Authors: Brown, Nickels, Caron, Mullineaux, Clayton
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: Extracorporeal Shock Wave Therapy and Navicular Disease Brown and colleagues (2006) investigated whether a single ESWT treatment produces immediate pain relief in horses with navicular disease, using ground reaction force analysis as an objective measure of lameness. Nine client-owned horses with unilateral forelimb navicular lameness were trotted over a force plate before and after radial ESWT (1500 pulses at 4 bar, applied to frog and heel bulb regions), with peak vertical force measurements recorded at 15 minutes and daily for seven days post-treatment. Despite the lame limbs showing significantly reduced vertical loading compared to contralateral limbs pre-treatment (4339 N versus 5236 N, P<0.05), ESWT produced no measurable improvement in this parameter across the entire monitoring period—a finding confirmed by the fact that palmar digital nerve analgesia did normalise the lameness response, validating the experimental model. For practitioners considering ESWT as an immediate analgesic intervention, this study suggests single-session treatment does not provide acute pain relief; however, the authors acknowledge that competitive regulations banning ESWT may warrant reconsideration pending further investigation of long-term therapeutic effects, and repeated or alternative treatment protocols remain unexplored.
Read the full abstract on PubMed
Practical Takeaways
- •Single ESWT treatment shows no measurable immediate pain relief for navicular disease lameness—do not expect improved gait within 7 days post-treatment
- •Current competition bans on pre-competition ESWT appear unjustified based on acute analgesic properties, though long-term benefits remain unproven
- •Objective gait analysis (force plate assessment) should be used to evaluate ESWT efficacy rather than relying on subjective lameness grades alone
Key Findings
- •Single ESWT treatment produced no significant change in peak vertical force between lame and contralateral limbs at 15 minutes or days 1-7 post-treatment (P > 0.05)
- •Pre-treatment PVF difference between lame (4339±626 N) and contralateral (5236±515 N) limbs remained unchanged after ESWT (P < 0.05)
- •Palmar digital analgesia successfully eliminated lameness differences (5144±430 N vs 5082±586 N; P > 0.05), confirming navicular disease diagnosis
- •Single ESWT application does not provide acute analgesic effects in horses with navicular disease despite regulatory restrictions on pre-competition use