The HillDT Blog

Acoustic compression therapy (ACT), or extracorporeal shock wave therapy, is a relatively new treatment, but in the few decades that it’s been used to treat patients, it’s made big waves. Used to reduce pain and improve conditions related to scar tissue, nonunions and delayed unions, myofascial pain syndrome, and more, ACT is a powerful therapy that produces results, even when other treatments fail. But what is it, and who is a candidate for ACT?

How Does It Work?

Acoustic compression therapy as it is used today emerged from a groundbreaking treatment for kidney stones, extracorporeal shock wave lithotripsy (ESWL). Lithotripsy was introduced as a nonsurgical solution to removing kidney stones in the early 1980s, and quickly became the preferred method of treating renal, proximal, and mid-ureteral stones. In lithotripsy, sound waves known as high energy shock waves move through the body to break up stones into tiny pieces, usually no bigger than grains of sand, that can easily be passed.

After ESWL became more widely used, physicians who used it to treat their patients noticed new tissue growth and increased bone density around the targeted treatment area, leading to different applications now collectively known as ACT or ESWT. While these two terms can be used interchangeably, acoustic compression therapy gives a more accurate impression of the treatment for people who are unfamiliar with lithotripsy, and is becoming more widely used in practices around the country.

ACT requires specialized equipment with the ability to create the focused sound waves at the correct depth and wavelength, which depends on the patient and their condition. It is non-invasive, and therefore eliminates the risks associated with surgical solutions. The treatment requires the use of coupling gel, which patients may associate with ultrasound, but the highly targeted nature of ACT makes it comparatively much more effective. With some devices, the patient may experience an uncomfortable feeling of pressure during the treatment; with others like the Piezo Wave, the patient should not feel any sensation until the device passes over an area of disfunction.

When Is It Effective?

While ACT is an extremely safe treatment with only minor side effects, candidates should be carefully selected based on their health and condition to ensure the best possible improvement and overall outcome. Here are a few conditions that respond well to treatment with ACT:

• Plantar Fasciitis: Characterized by a stabbing pain near the heel on the bottom of the foot, plantar fasciitis is a common cause of heel pain. Running, obesity, and constant standing or walking wears on the plantar fascia, causing inflammation and tears. If left untreated, plantar fasciitis may result in chronic pain that inhibits ability to perform regular daily functions. ACT stimulates blood flow in the fascia, reducing pain and promoting healing for long-term improvement.

• Tendinopathy: The term tendinopathy covers a range of conditions related to pain or disease of the tendons. This includes acute and chronic injuries, with or without the presence of inflammation. Patients with tendinopathy often benefit from pain relief with ACT while stimulated blood flow and tissue growth work to heal the tendon.

• Myofascial Pain Syndrome: A type of chronic muscle pain, myofascial pain syndrome is usually the result of stress-related muscle tension or repetitive motion. It is often difficult to treat, as pain originates from a trigger point, but can sometimes be felt in other parts of the body that seem unrelated, which is known as referred pain. ACT is ideal for treating myofascial pain syndrome because of its ability to target specific areas within the body and therefore heal the condition at its source. It’s important to note that not all ACT devices are capable of following pain from trigger points to the areas of referred pain, so if you are seeking a solution for patients with myofascial pain syndrome, be sure to take note of the device’s capabilities.

• Radiculopathy: Cervical radiculopathy refers to problems originating from a compressed nerve in the cervical spine. These problems can include pain, numbness, tingling, loss of muscle control, and weakness in the neck, and in some cases, symptoms can be felt throughout the arms. Treatment with ACT targets the affected nerve to reduce pain and increase blood flow.

Acoustic compression therapy devices can also be used in some cases as a nonpharmacologic pain management treatment for soft tissue injuries and acute pain. For example, ACT can be used after a spinal decompression therapy or manual adjustment treatment session to reduce the muscle soreness that can occur.

While acoustic compression therapy is still relatively new to the medical world, it has shown immense potential for its ability to treat difficult conditions without the risks of surgery. New medical technologies open up vast possibilities for practices of all sizes, and ACT is a powerful example of all of the potential breakthroughs that can be achieved with electromagnetic devices.