Systematic Review of Complementary and Alternative Veterinary Medicine in Sport and Companion Animals: Extracorporeal Shockwave Therapy.
Authors: Boström Anna, Bergh Anna, Hyytiäinen Heli, Asplund Kjell
Journal: Animals : an open access journal from MDPI
Summary
# Editorial Summary: The Evidence for Extracorporeal Shockwave Therapy in Equine and Small Animal Practice Shockwave therapy has gained considerable clinical uptake for musculoskeletal conditions in sport horses and companion animals, yet Boström and colleagues' systematic review of 36 published studies (27 equine, nine canine, none feline) reveals a concerning evidence gap underlying this popularity. The researchers assessed studies from 1980–2020 covering diverse indications including tendinopathy, ligament injury, navicular disease, bone healing, and osteoarthritis, typically administered in one to three sessions at 1–3 week intervals, then evaluated study quality and risk of bias systematically. Whilst most conditions showed very limited scientific support with frequent methodological shortcomings and poor replication of positive findings, three areas emerged with more promising signals: short-term analgesia, ligament injuries, and osteoarthritis management. The disparity between widespread clinical adoption and modest evidence base suggests practitioners should temper expectations, maintain critical evaluation of individual cases, and prioritise participation in well-designed trials—particularly for equine applications where the evidence base is largest yet remains substantially underdeveloped; feline research is notably absent and represents an entirely under-investigated population.
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Practical Takeaways
- •ECSWT remains an experimental treatment with insufficient evidence for routine clinical use in equine or companion animal practice
- •If considering ECSWT, reserve use for short-term analgesia, ligament injury, or osteoarthritis cases where conventional options have failed, while acknowledging limited scientific support
- •Request high-quality outcome data from ECSWT providers and maintain realistic client expectations regarding evidence base for this therapy
Key Findings
- •27 relevant articles identified on ECSWT in horses, 9 in dogs, 0 in cats published 1980-2020
- •Scientific evidence for ECSWT clinical effects is very limited across all indications studied
- •Many studies had methodological flaws with favorable results typically not replicated in independent studies
- •Most promising results found for short-term pain relief, ligament ailments, and osteoarthritis warranting further high-quality research