Shock Away Pain from Knee OA with ESWT


Osteoarthritis (OA) is a common affliction that causes stiffness, crackling, swelling and tenderness in your joints. While it may occur in any joint, OA is particularly debilitating in the knee, as it can become quite painful when walking, causing you to limp and restricting your daily activities.

It is estimated that OA affects up to low grade chronic inflammation, a condition also associated with metabolic disease.

Traditional treatments for knee OA include:

  • Self care like exercise, weight loss, icing and OTC menthol rubs
  • Medications including NSAIDs, analgesics, nutritional supplements and narcotics
  • Physical therapy, stretching, acupuncture and hydrotherapy
  • Surgery, including arthroscopy and joint replacement

ESWT and Knee OA

Thanks to treat OA. Shock waves are a sequence of sonic pulses with a high peak pressure, rapid pressure rise, and short duration, that are generated outside the body and focused on the arthritic joint.

ESWT can be painful, both during and immediately following the procedure. Other side effects from ESWT are minor skin bruising, reddening, and swelling around the treated area. However, studies have demonstrated ESWT to effectively reduce pain over time, resulting in improved quality of life for knee OA sufferers.

In one recent study, patients with knee OA were given three to six days apart. After the course of treatment, 85% of participants demonstrated considerable improvement, with reduced morning stiffness, increased joint function, reduced pain and improved quality of life.


The sports medicine team of professionals at NYDNRehab have extensive experience treating knee pain. We use cutting edge technology, combining diagnostic ultrasonography and extracorporeal shockwave therapy to recovery from knee OA.


In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)


Complete tear of rectus femoris
with large hematoma (blood)


Separation of muscle ends due to tear elicited
on dynamic sonography examination

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