The Role of Extracorporeal Shockwave Treatment in Musculoskeletal Disorders
Two pages on PainSci cite Moya 2018: 1. Does Ultrasound or Shockwave Therapy Work? 2. Adding injury to injury: shockwave therapy’s big idea (Member Post)
PainSci notes on Moya 2018:
This paper is a high-level description of the use of shockwave therapy in orthopedic medicine, with a strong focus on the biological effects, especially the specific mechanisms of action originally proposed by Haupt in 1997.
Even these authors — some of the researchers most responsible for shockwave hype — acknowledge that “the mechanism of action of ESWT remains unknown” … but Moya et al. then talk about those MOAs with scholarly excitement. It’s almost like they think they are indeed known, and that saying “unknown” was just performative humility!
They are clearly “true believers” in shockwave therapy, a collaboration of several authors from around the world who have generated most of the shockwave therapy research currently indexed by PubMed. There are issues with the quality of their review, but it is (at least) a fine overview of what these shockwave proponents believed as of 2018, and likely still believe now.
Common issues and characteristics relevant to this paper: ?Scientific papers have many common characteristics, flaws, and limitations, and many of these are rarely or never acknowledged in the paper itself, or even by other reviewers. I have reviewed thousands of papers, and described many of these issues literally hundreds of times. Eventually I got sick of repeating myself, and so now I just refer to a list common characteristics, especially flaws. Not every single one of them applies perfectly to every paper, but if something is listed here, it is relevant in some way. Note that in the case of reviews, the issue may apply to the science being reviewed, and not the review itself.
- A high (and possibly unacknowledged) risk of bias and its consequences (p-hacking, etc).
related content
- “Use of extracorporeal shock waves in the treatment of pseudarthrosis, tendinopathy and other orthopedic diseases,” Haupt, J Urol, 1997.
This page is part of the PainScience BIBLIOGRAPHY, which contains plain language summaries of thousands of scientific papers & others sources. It’s like a highly specialized blog. A few highlights:
- Common interventional procedures for chronic non-cancer spine pain: a systematic review and network meta-analysis of randomised trials. Wang 2025 BMJ.
- Gabapentinoids and Risk of Hip Fracture. Leung 2024 JAMA Netw Open.
- Classical Conditioning Fails to Elicit Allodynia in an Experimental Study with Healthy Humans. Madden 2017 Pain Med.
- Topical glyceryl trinitrate (GTN) and eccentric exercises in the treatment of mid-portion achilles tendinopathy (the NEAT trial): a randomised double-blind placebo-controlled trial. Kirwan 2024 Br J Sports Med.
- Placebo analgesia in physical and psychological interventions: Systematic review and meta-analysis of three-armed trials. Hohenschurz-Schmidt 2024 Eur J Pain.