What is Shockwave Therapy?

What is Shockwave Therapy?

What is Shockwave Therapy?

Extracorporeal shockwave therapy (ESWT) has been used to treat knee pain, heel pain, Achilles pain, and calcific tendonitis.

Extracorporeal shockwave therapy is a procedure, which stimulates the body’s natural healing process. Shockwave therapy produces micro-trauma in the affected area’s tissues with energy pulses. The body responds to the minute tears caused by extracorporeal shock wave treatment with increased blood flow, delivering nutrients and reducing pain. Sixty-five to 91 percent of patients have experienced successful healing with extracorporeal shock wave therapy.

Initially, ESWT was developed for breaking up kidney stones deep within the body. When extra healing benefits were noticed in kidney stone patients, doctors began using shockwave therapy for heel pain, knee pain, calcific tendinitis, and Achilles pain.

Shockwave Therapy for Achilles Pain

Shockwave Therapy for Achilles Pain

Shockwave therapy for Achilles pain is similar to the treatment for plantar fasciitis, except it focuses on a different area of the foot. The therapy has been successful at repairing degenerative damage caused by repetitive strain on the Achilles. The largest tendon in the body is instrumental to so many strenuous activities, such as jumping and running, that it can often wear down.

ESWT reduces the inflammation these activities cause by strengthening the tendon in much the same way heel pain is treated.

Shockwave Therapy for Calcific Tendinitis

Shockwave Therapy for Calcific Tendinitis

Calcific tendinitis (or tendonitis) forms from small calcium deposits developing within a tendon. The condition often occurs in the rotator cuff of the shoulder. Shockwave therapy for tendinitis is effective at breaking up these deposits and mitigating the irritation they cause.

A study reported in the Journal of Orthopaedics and Traumatology found that ESWT treatment was just as effective as surgery for treating calcific tendonitis. However, shockwave treatment has the benefit of being non-invasive and often requires no anesth

Shockwave Therapy for Heel Pain

Shockwave Therapy for Heel Pain

Plantar fasciitis is a painful condition experienced by many people. The condition is often aggravated from long periods of standing or walking, though it can occur without these activities. Heel pain develops when the tendon running from the ball of the foot to the heel becomes inflamed, causing soreness in the arch of the foot. ESWT strengthens the connective tissues reducing the inflammation and pain.

Shockwave therapy for the heel significantly reduces discomfort for most patients with heel spurs as well by breaking up calcium deposits irritating the soft tissues of the foot.

Shockwave Therapy for Knee Pain

Shockwave Therapy for Knee Pain

Shockwave therapy for knee pain has also been found to be highly effective. The knee is comprised of numerous connective tissues, which become inflamed and irritated with overuse and overexertion.

According to a study in the North American Journal of Sports Physical Therapy, chronic tendinopathy is a musculoskeletal disorder in the knee common to all levels of athletes. The condition is often referred to as “jumper’s knee,” and is a frequent occurrence for basketball and volleyball players. The knee pain associated with the injury can often be debilitating for weightlifters too.

Methods for treating chronic tendinopathy often include restriction or modification, ice, eccentric stretching, massage or taping. When these management practices have been found ineffective, extracorporeal shock wave treatment has been found highly productive at treating the tendon degenerati

Research at NYDNRehab

Comparative Study of Dry Needling under Ultrasound Guidance and Extracorporeal Shock Wave Therapy for Myofascial Pain and Spasticity Management Meeting: 2019 International Congress R. Bubnov, L. Kalika (Kyiv, Ukraine) https://www.researchgate.net/publication/336115785_Comparative_Study_of_Dry_Needling_under_Ultrasound_Guidance_and_Extracorporeal_Shock_Wave_Therapy_for_Myofascial_Pain_and_Spasticity_Management
Comparative Study of Dry Needling under Ultrasound Guidance and Extracorporeal Shock Wave Therapy for Myofascial Pain and Spasticity Management Meeting: 2019 International Congress R. Bubnov, L. Kalika (Kyiv, Ukraine) (part2) https://www.researchgate.net/publication/336115785_Comparative_Study_of_Dry_Needling_under_Ultrasound_Guidance_and_Extracorporeal_Shock_Wave_Therapy_for_Myofascial_Pain_and_Spasticity_Management
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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)

image

Complete tear of rectus femoris
with large hematoma (blood)

image

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

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