The effects of shockwaves on the human body became apparent during the Second World War. The explosion of depth charges near human beings led to lung disruption despite the fact that there were no signs of outer physical trauma. This led scientists to believe the shockwave experienced even at distance from the explosion created damage to the vulnerable lung tissue (Krause, 1997).
In the 1950s there was a flurry of studies into shockwave use in medicine. Lab experiments had shown that shockwaves could disintegrate ceramic when shot through water. Although shockwave was being experimented with around the world Frank Rieber, New York, USA, applied for the first patent of an electrohydraulic shockwave generator (patent number 2.559.277).
During the 1960s into the early 1970s the German Department of Defence researched the effects of shockwaves on animals. They were particularly interested in high energy shockwaves and their effects over distance and observed the side effects of the shockwave as it passed through soft tissues. They noted that the low level side effects were a danger in the lung, brain and abdominal organs. Of interest, they described the best way of applying shockwave to living tissue was through water, or a water based gel, as it was later discovered that shockwaves provide one of the best methods of mapping under water areas as there is very low dissipation of shockwave energy through water (Haeusler & Kiefer, 1971). The first non-direct contact disintegration of a kidney stone was described in 1971 by Haeusler & Kiefer. Further experiments showed similar disintegration and in 1974 the Department of Research and Science of Germany financed the first application of shockwave therapy. In 1980 a prototype machine, The Dornier Lithotripter HM1, treated the first patient for kidney stones (Chaussy et al, 1980).
In 1983 the first commercial lithotripter, The Dornier Lithotripter HM3, became available in Germany.
Since 1985 other organs such as the gall bladder, bile duct, pancreas and salivary glands have been treated with shockwave (Iro et al, 1989, Iro et al, 1992, Sauerbruch et al, 1986, Sauerbruch et al, 1987).
In 1986 a prototype lithotripter which did not need a bath of water was used in Mainz. The most recent machines work without the need for a body of water and are often equipped with xray or ultrasound localisation systems.
During the next 10 years shockwave machines were trialled and have been used to treat orthopaedic disorders, including non-union fractures, pseudo-arthroses, osteochondrosis and various tendinopathies (Haupt, 1997).
Because the original shockwave machines were designed for application in urology but had now found a place in orthopaedic medicine there was an immediate need to develop a specific orthopaedic shockwave device. In 1993 OssaTron (HMT AG) developed a machine with a freely movable head. The 1990s research into heel spurs and epicondylitis led to the development of many new shockwave devices with massively increased durability.
Shockwave continues to increase in popularity but remains a relatively new technology for orthopaedic medicine. The treatment is described by many names, the most popular being shockwave therapy or, more correctly, extracorporeal shockwave therapy.