Sound & Shock Wave Therapy for Injuries & Erectile Dysfunction

Acoustic sound wave treatment (also known as Low Impact Extracorporeal Shock Wave Therapy) has been used for the past 30 years. High-intensity extracorporeal shock waves have been used to break up kidney stones (a procedure called lithotripsy). In the context of kidney calcifications, the mechanism of action is purely biomechanical: sound waves shatter renal calculi into tiny fragments. These fragments are detoxified from the body through the urinary tract.

At ChillRx, we use lower-impact radial acoustic shock waves to heal soft-tissue injuries and generate new tissue, muscle, nerves, bone, and blood vessels. Radial shock waves penetrate the skin in a more diffuse way than focused shock waves; radial shock waves “radiate”, creating a broader treatment area. The depth of penetration is shallower and more diffuse. Radial shock wave therapy has many benefits, including patient comfort and a lower risk for tissue destruction.

ChillRx sound wave therapy works in two distinct ways: biomechanically & biochemically.

Biomechanically, radial shock waves encounter calcifications in tendons and ligaments and break them apart. This mechanism of action is similar to lithotripsy—but the depth of penetration and the amount of energy applied is much lower. This mechanism of action is also effective in alleviating ganglion cysts, neuromas, scar tissue, and other conditions. Radial shock waves break apart thickened or otherwise dysfunctional tissue.

Biochemically, LI-ESWT has been shown to have significant biochemical effects. There are several mechanisms of action at work here.

1. Cavitation: acoustic sound waves are unique. When applied, they create positive and negative forces on cells (called shear forces). This force causes millions of microscopic bubbles to form in the area; these bubbles rupture, creating microtrauma to the local region. This microtrauma stimulates a cascade of biological effects, including immune system activation, leading to new tissue generation.
2. Cell permeability: Shearing forces increase cell membrane permeability (in contrast to the cell destruction that can occur with injury). This increased permeability allows the migration of cellular contents such as RNA. Neighboring cells perceive the presence of RNA via cellular receptors called Toll-like receptor cells 3 TLRC 3. The body is fooled into thinking that there has been injury (there hasn’t—just increased cell permeability). The natural biological repair system is activated. TLR3 is known to regulate both the immune and inflammatory responses of cells and to initiate the biological cascade associated with tissue regeneration or repair. Soon after the TLR3 receptors are activated, stem cell attractants are produced. Within hours, stem cells begin arriving from neighboring tissue, including from bone marrow, where many stem cells reside. These stem cells produce original tissue, not scar tissue, and can even remodel existing scar tissue. This stem cell activation has a profound capacity to regenerate tissue, bone, muscle, and nerves.

This schematic illustrates the biological cascade triggered by acoustic waves.

As you can see from the graphic, various growth factors and stem cells are triggered by LI-ESWT. These include:

1. VEGF: Vascular endothelial growth factor. This stem cell is angiogenic; it differentiates into new blood vessels.
2. eNOS: Endothelial Nitric Oxide Synthase, which has numerous effects on endothelial cells: enhancement of proliferation and migration, inhibition of apoptosis, and further vascular endothelial growth factor and fibroblast growth factor (FGF) release.
3. PCNA: Proliferating Cell Nuclear Antigen: essential for cell replication
4. 4Growth Factors: IGF-1, IL-6, TGF-B (important for collagen expression), transforming growth factor β-1.
5. Fibroblasts and Fibroblast growth factor-2 FGF-2, TGF-B1 (necessary for collagen regrowth), and PGDF (platelet-derived growth).
6. BDNF: Brain-derived neurotrophic factor—a protein produced inside nerve cells that builds and maintains the brain circuits which allow the nerve signals to travel.
7. Mesenchymal stem cells

The mechanism of action is the triggering of these stem cells, which then induces the neovascularization that improves blood supply and increases cell proliferation and eventual tissue regeneration.

Timing is everything! The rise in angiogenic markers occurred around 1 week after treatment and lasted approximately 8 weeks. Data suggests that 4 to 8 weeks following shock wave treatment, there can be a 400% increase in blood vessels of all sizes. Neovascularization was first noted at 4 weeks and persisted for more than 12 weeks, along with cell proliferation. The effects of shock wave therapy are dose-dependent, and symptoms will improve over time (typically within 12 weeks after treatment).

Permanent blood supply has been shown to increase following shock wave treatment, which helps fight infections. Bacterial levels drop dramatically, and the biofilms that protect them are also destroyed. Shock wave treatment also decreases pain, swelling, and inflammation.

Acoustic sound waves modulate inflammation to optimize the healing process. Acoustic sound waves modulate the inflammatory response in human endothelial cells by stimulating Toll-like receptor 3 (part of the innate immune system). Acoustic sound waves initially stimulate TLR3, which is pro-inflammatory; a middle and late phase of inflammatory suppression follows. Healing is optimized through this delicate balance of acute inflammation followed by inflammation suppression.  This modulation of inflammation is a prerequisite for angiogenesis and repair of injured tissue.

ChillRx is dedicated to the non-invasive, pain-free application of acoustic sound waves to repair and regenerate all kinds of tissue. We successfully treat all kinds of soft tissue injuries, including plantar fasciitis, Achilles tendonitis, bursitis, tennis and golf elbow, lower back pain, and many more. We also successfully treat erectile dysfunction with acoustic sound waves by stimulating improved blood flow and activating tissue and nerve regeneration through endogenous stem cells.

ChillRx is committed to treating injuries and disease processes with non-invasive, drug and pain-free treatments. Both cryotherapy and acoustic sound wave therapy stimulate the body’s own endogenous healing processes—not relying on exogenous resources such as drugs or surgical interventions.

Please contact us for more information on how acoustic sound waves can help you!!