Our Patient
Our patient is a 29 year-old female with Ehlers-Danlos syndrome who was experiencing
sharp and burning thoracic pain. She is tender to the touch, which reproduces her pain.
The Challenge
The patient had had correction surgery for scoliosis as a child, where growing rods were implanted that can be lengthened periodically as the child grows.
Our Diagnostic Approach
We used high-resolution ultrasound to visualize the patient’s thoracic spine and found
two screws in the area of pain, lateral to the T 3 spinous process. There was thickening of the fascial plane between the middle trapezius and paraspinal muscles, where the medial branch of the T-3 dorsal rami nerve was being crushed, and friction was occurring with neck and thoracic spine flexion.
Our Solution
The patient underwent 6 sessions of nano energy focused shockwave therapy, which totally eliminated her pain. We offered her the option of an interfacial plane injection, but she opted for the non-invasive approach.
Conclusion
Focused extracorporeal shockwave therapy (fESWT) is an effective and non-invasive modality of choice for treating cases of fascial nerve interference.
About the Author
Dr. Lev Kalika is a world-recognized expert in musculoskeletal ultrasonography, with 20+ years of clinical experience in advanced rehabilitative medicine. In addition to operating his clinical practice in Manhattan, he regularly publishes peer-reviewed research on ultrasound-guided therapies and procedures.
Dr. Kalika is an esteemed member of the International Society for Medical Shockwave Treatment ((SMST), and the only clinician in New York certified by the ISMST to perform extracorporeal shockwave therapy. He is also an active member of the American Institute of Ultrasound in Medicine (AIUM), and has developed his own unique approach to dynamic functional and fascial ultrasonography.
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