Piezoelectric Shock Wave Sources: Are they Still the Cinderella to Treat Musculoskeletal Disorders?

Technical Notes | Volume 2 | Issue 2 | JRS Jul – Dec 2022 | Page 03-06 | Daniel Moya, Achim M. Loske
DOI: 10.13107/jrs.2022.v02.i02.51

Author: Daniel Moya [1], Achim M. Loske [2]

[1] Department of Orthopaedics, Hospital Británico de Buenos Aires, Argentina,
[2] Centro de Física Aplicada y Tecnología Avanzada, Universidad Nacional Autónoma de México,
Blvd. Juriquilla 3001, Querétaro, México.

Address of Correspondence
Dr. Daniel Moya, MD
Department of Orthopaedics, Hospital Británico de Buenos Aires, Argentina.


There are three types of focused shock wave generators: electrohydraulic, electromagnetic and piezoelectric. Although it has been postulated that there are no differences in clinical efficacy between the three, the information available on the results of the use of piezoelectric generators to treat musculoskeletal disorders is very limited.
The objective of this publication is to demonstrate the little existing evidence on piezoelectric generators and to highlight their versatility and promising future.

Keywords: Musculoskeletal disorders, Shock waves, ESWT, Piezoelectric.


1. Collins English Dictionary. Available from: [Last accessed on 2022 Feb].
2. Loske AM. Medical and Biomedical Applications of Shock Waves. Cham, Switzerland: Springer International; 2017.
3. Moya D, Ramón S, Schaden W, Wang CJ, Guiloff L, Cheng JH. The role of extracorporeal shockwave treatment in musculoskeletal disorders. J Bone Joint Surg Am 2018;100:251-63.
4. Loske AM, Moya D. Shock waves and radial pressure waves: Time to put a clear nomenclature into practice. J Regen Sci 2021;1:4-8.
5. Schmitz C, Császár NB, Milz S, Schieker M, Maffulli N, Rompe JD, et al. Efficacy and safety of extracorporeal shock wave therapy for orthopedic conditions: Asystematic review on studies listed in the PEDro database. Br Med Bull 2015;116:115-38.
6. National Library of Medicine. National Institutes of Health. Available from: [Last accesed on 2022 Jan].
7. Albisetti W, Perugia D, De Bartolomeo O, Tagliabue L, Camerucci E, Calori GM. Stress fractures of the base of the metatarsal bones in young trainee ballet dancers. Int Orthop 2010;34:51-5.
8. Louwerens JK, Sierevelt IN, Kramer ET, Boonstra R, van den Bekerom MP, van Royen BJ, et al. Comparing ultrasound-guided needling combined with a subacromial corticosteroid injection vs high-energy extracorporeal Shockwave therapy for calcific tendinitis of the rotator cuff: A randomized controlled trial. Arthroscopy 2020;36:1823-33.e1.

9. Moya D, Gómez D, Serrano DV, Domínguez PB, Lazzarini ID, Gómez G. Treatment protocol for rotator cuff calcific tendinitis using a single-crystal piezoelectric focused shock wave source. J Vis Exp 2022;190:e64426.
10. Zwerver J, Hartgens F, Verhagen E, van der Worp H, van den Akker-Scheek I, Diercks RL. No effect of extracorporeal shockwave therapy on patellar tendinopathy in jumping athletes during the competitive season: A randomized clinical trial. Am J Sports Med 2011;39:1191-9.
11. Thijs KM, Zwerver J, Backx FJ, Steeneken V, Rayer S, Groenenboom P, et al. Effectiveness of shockwave treatment combined with eccentric training for patellar tendinopathy: A double-blinded randomized study. Clin J Sport Med 2017;27:89-96.
12. PEDro: Physiotherapy Evidence Database. Available from: [Last accessed on 2022Jan].
13. Liang HW, Wang TG, Chen WS, Hou SM. Thinner plantar fascia predicts decreased pain after extracorporeal shock wave therapy. Clin
Orthop Relat Res 2007;460:219-25.
14. Bannuru RR, Flavin NE, Vaysbrot E, Harvey W, McAlindon T. High-energy extracorporeal shock-wave therapy for treating chronic calcific tendinitis of the shoulder: A systematic review. Ann Intern Med 2014;160:542-9

15. Bechay J, Lawrence C, Namdari S. Calcific tendinopathy of the rotator cuff: A review of operative versus nonoperative management. Phys Sportsmed 2020;48:241-6.
16. Thiele S, Thiele R, Gerdesmeyer L. Lateral epicondylitis: This is still a main indication for extracorporeal shockwave therapy. Int J Surg 2015;24:165-70.
17. Sansone V, Ravier D, Pascale V, Applefield R, Del Fabbro M, Martinelli N. Extracorporeal shockwave therapy in the treatment of nonunion in long bones: Asystematic review and meta-analysis. J Clin Med 2022;11:1977.
18. 23rd 2021 International Society for Medical Shockwave Treatment Congress. Available from: [Last accessed on 2022 Feb].
19. Külkens C, Quetz JU, Lippert BM, Folz BJ, Werner JA. Ultrasound-guided piezoelectric extracorporeal shock wave lithotripsy of parotid gland calculi. J Clin Ultrasound 2001;29:389-94.
20. Duarsa GW, Tirtayasa PM, Duarsa GW, Pribadi F. The efficacy and safety of several types of ESWL lithotripters on patient with kidney stone below 2 cm: A meta-analysis and literature review. Teikyo Med J 2022;45:5613-24.

21. Rabenstein T, Radespiel-Tröger M, Höpfner L, Benninger J, Farnbacher M, Greess H, et al. Ten years’ experience with piezoelectric extracorporeal shockwave lithotripsy of gallbladder stones. Eur J Gastroenterol Hepatol 2005;17:629-39.
22. Muller-Ehrenberg H, Licht G. Diagnosis and therapy of myofascial pain syndrome with focused shock waves. Med Orthop Tech 2005;5:1-5.
23. Broegaard A. Extracorporeal shockwave therapy in the treatment of bone disorders: Fracture nonunions, delayed unions, chronic stress fractures and bone marrow edema: A case report series in a private practice setting. J Fract Sprains 2021;2:1008.
24. Moya D, Rodríguez G. Focused Shockwaves in Dental Pathology-Preliminary Report. ISMST22-0038Use. p. 37. Available from: [Last accessed on 2022 Jan].



How to Cite this article: Moya D, Loske AM |Piezoelectric Shock Wave Sources: Are they Still the Cinderella to Treat Musculoskeletal Disorders?. | Journal of Regenerative Science | Jul – Dec 2022; 2(2): 03-06.

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2022 Chinese Expert Consensus Statement on the Management of Extracorporeal Shockwave Therapy in Musculoskeletal Disorders during Novel Coronavirus Pandemic Prevention and Control

Review Article | Volume 2 | Issue 1 | JRS Jan – Jun 2022 | Page 27-31 | Fuqiang Gao , Xiangwei Ma , Wei Sun , Zirong Li , Jike Lu

DOI: 10.13107/jrs.2022.v02.i01.41

Author: Fuqiang Gao [1,2], Xiangwei Ma [3], Wei Sun [1,4], Zirong Li [1,2], Jike Lu [5]

[1] Shockwave Center, Department of Orthopedics, China-Japan Friendship Hospital, Chaoyang, Beijing, China.

[2] Beijing Key Laboratory of Immune Inflammatory Disease, China-Japan Friendship Hospital, Chaoyang, Beijing, China.

[3] Department of Rehabilitation Medicine, China-Japan Friendship Hospital, Chaoyang, Beijing, China.

[4] Department of Orthopaedic Surgery, School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

[5] Department of Orthopedics, Beijing United Family Hospital, Chaoyang, Beijing, China.

Address of Correspondence
Dr. Wei Sun, Shockwave Centers,
Department of Orthopedics, China-Japan Friendship Hospital, Chaoyang, Beijing, China.


Novel coronavirus pneumonia (corona virus disease 2019, [COVID-19]) is a novel respiratory infectious disease that has rapidly spread in many countries or regions around the world [1, 2, 3] . With the approval of the State Council, COVID-19 was included in the category B infectious diseases under the Law of the People’s People’s Republic of China on the Prevention and Control of Infectious Diseases, and the preventive and control measures for category A infectious diseases were adopted. Given the severity of the COVID-19 epidemic, the wide spread of transmission, and the human-to-human transmission, some patients with musculoskeletal disorders visiting hospitals and health care
workers engaged in medical shockwave technology are at potential risk of COVID-19 infection. The 2022 Chinese expert consensus statement on the Management of Musculoskeletal Disease Extracorporeal Shock Wave during the Prevention and Control of Novel Coronavirus Epidemic is formulated..

Keywords: Chinese expert consensus, Extracorporeal shockwave, Management, Musculoskeletal disorders, Novel coronavirus pandemic.


1. Chang D, Lin M, Wei L, Xie L, Zhu G, Cruz CS, et al. Epidemiologic and clinical characteristics of novel coronavirus infections involving 13 patients outside Wuhan, China. JAMA2020;323:1092-3.
2. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: Adescriptive study. Lancet 2020;395:507-13.
3. Liu K, Fang YY, Deng Y, Liu W, Wang MF, Ma JP, et al. Clinical characteristics of novel coronavirus cases in tertiary hospitals in Hubei Province. Chin Med J Engl 2020;133:1025-31.
4. Riou J, Althaus CL. Pattern of early human-to-human transmission of Wuhan 2019 novel coronavirus (2019-nCoV), December 2019 to January 2020. Euro Surveill 2020;25:2000058.
5. Wölfel R, Corman VM, Guggemos W, Seilmaier M, Zange S, Müller MA, et al. Virological assessment of hospitalized patients with COVID-2019. Nature 2020;581:465-9.
6. General Office of the National Health Commission, Office of the State Administration of Traditional Chinese Medicine. Pneumonia Diagnosis and Treatment Program for Novel Coronavirus Infection. 9th ed. New Delhi: General Office of the National Health Commission; 2022. Available from: last accessed on 2022.
7. Wei Y, Lu Y, Xia L, Yuan X, Li G, Li X, et al. Analysis of 2019 novel coronavirus infection and clinical characteristics of outpatients: An epidemiological study from a fever clinic in Wuhan, China. J Med Virol 2020;92:2758-67.
8. Krishnan A, Hamilton JP, Alqahtani SA, Woreta TA. A narrative review of coronavirus disease 2019 (COVID-19): Clinical, epidemiological characteristics, and systemic manifestations. Intern Emerg Med 2021;16:815-30.
9. Zhang J, Zhang B, Ni X. Questions about the implementation of management specifications for environmental surface cleaning and disinfection in medical institutions. Chin J Hosp Infect Dis 2018;28:473-6.
10. Fathizadeh H, Maroufi P, Momen-Heravi M, Dao S, Köse Ş, Ganbarov K, et al. Protection and disinfection policies against SARS-CoV-2 (COVID-19). Infez Med 2020;28:185-91.
11. Bielecki M, Patel D, Hinkelbein J, Komorowski M, Kester J, Ebrahim S, et al. Air travel and COVID-19 prevention in the pandemic and peri-pandemic period: A narrative review. Travel Med Infect Dis 2021;39:101915.
12. Wu W, Guan H, Fang Z, Guo F, You H, Xiao J, et al. Standardized process of orthopedic diagnosis and treatment during the outbreak of novel coronavirus pneumonia Recommendation. Orthopedics 2020;11:93-9.
13. Wilder-Smith A, Freedman DO. Isolation, quarantine, social distancing and community containment: Pivotal role for old-style public health measures in the novel coronavirus (2019-nCoV) outbreak. J Travel Med 2020;27:taaa020.
14. Wong JS, Cheung KM. Impact of COVID-19 on orthopaedic and trauma service: An epidemiological study. J Bone Joint Surg Am 2020;102:e80.
15. Hirschmann MT, Hart A, Henckel J, Sadoghi P, Seil R, Mouton C. COVID-19 coronavirus: Recommended personal protective equipment for the orthopaedic and trauma surgeon. Knee Surg Sports Traumatol Arthrosc 2020;28:1690-8.

16. Wu S, Wang Y, Jin X, Tian J, Liu J, Mao Y. Environmental contamination by SARS-CoV-2 in a designated hospital for coronavirus disease 2019. Am J Infect Control 2020;48:910-4.
17. Tanaka MJ, Oh LS, Martin SD, Berkson EM. Telemedicine in the era of COVID-19: The virtual orthopaedic examination. J Bone Joint Surg Am 2020;102:e57.
18. Xie X, Zhong Z, Zhao W, Zheng C, Wang F, Liu J. Chest CT for typical coronavirus disease 2019 (COVID-19) pneumonia: Relationship to negative RT-PCR testing. Radiology 2020;296:E41-5.
19. Pan Y, Guan H, Zhou S, Wang Y, Li Q, Zhu T, et al. Initial CT findings and temporal changes in patients with the novel coronavirus pneumonia (2019-nCoV): Astudy of 63 patients in Wuhan, China. Eur Radiol 2020;30:3306-9.
20. Shockwave Medicine Professional Committee of China Research Hospital Association. Guidelines for extracorporeal shockwave therapy for musculoskeletal diseases in China. Chin J Med Front 2019;11:1-10.
21. Gao F, Sun W, Xing G. Interpretation of the latest diagnosis and treatment consensus of the International Society of Medical Shockwaves: Indications and contraindications of extracorporeal shockwave. Chin Med J 2017;97:2411-5.
22. Chinese Medical Association Physical Medicine and Rehabilitation Branch, Expert Consensus Group on Extracorporeal Shockwave Therapy for Musculoskeletal Diseases. Expert Consensus on Extracorporeal Shockwave Therapy for Musculoskeletal Diseases. Chin J Phys Med Rehabil 2019;41:481-7.


How to Cite this article: Gao F, Ma X, Sun W, Li Z, Lu J | 2022 Chinese Expert Consensus Statement on the Management of Extracorporeal Shockwave Therapy in Musculoskeletal Disorders during Novel Coronavirus Pandemic Prevention and Control. | Journal of Regenerative Science | Jan – Jun 2022; 2(1): 27-31.

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