Journal
NEUROSCIENCE LETTERS
Volume 315, Issue 1-2, Pages 57-60Publisher
ELSEVIER SCI IRELAND LTD
DOI: 10.1016/S0304-3940(01)02320-5
Keywords
shock wave; protein gene product 9.5; calcitonin gene-related peptide; sensory nerve fibre; degeneration; reinnervation
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There have been several reports on the use of extracorporeal shock waves in the treatment of pseudarthrosis, calcifying tendinitis, and tendinopathies of the elbow. However, the pathomechanism of pain relief has not been clarified. To investigate the analgesic properties of shock wave application, we analyzed whether it produces morphologic changes in cutaneous nerve fibres. In normal rat skin, the epidermis is heavily innervated by nerve fibres immunoreactive for protein gene product (PGP) 9.5 and by some fibres immunoreactive for calcitonin gene-related peptide (CGRP). There was nearly complete degeneration of epidermal nerve fibres in the shock wave-treated skin, as indicated by the loss of immunoreactivity for PGP 9.5 or CGRP. Reinnervation of the epidermis occurred 2 weeks after treatment. These data show that relief of pain after shock wave application to the skin results from rapid degeneration of the intracutaneous nerve fibres. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.
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