Extracorporeal Shock Wave Therapy ESWT

Shockwave therapy begins with a tissue scan using the highest resolution ultrasound equipment. Once we identify the treatment area, we map the focal region, including target size and depth. Next, we mark the area to be treated and set our transducer at the appropriate depth. We use high-resolution ultrasound imaging to guide the shockwave procedure, to ensure accuracy. To follow up after the shockwave procedure, we use high-resolution ultrasonography to monitor the healing process and visualize any changes in the tissues over time.

Dr.Kalika has over 20 years of experience in ultrasound guided procedures. He has been an active member of the International Society of Medical Shockwave Therapy (ISMST) since 2007, and has treated thousands of patients using ESWT. Our clinic features the only shockwave equipment available that lets us combine focused, defocused and radial shock waves.

Contact us »

We’re located on 25th street in Manhattan NYC.
Open Monday-Friday, 10am-8pm.

Some Important Facts about Shockwave Therapy

  • While there is no perfect regenerative modality, research shows ESWT to be the leading regenerative treatment, surpassing the effectiveness of stem cell and platelet-rich plasma (PRP) injections. 
  • Shockwave therapy is completely non-invasive, with no known side effects.
  • ESWT is the best treatment modality for tendon injuries.
  • ESWT is second only to Stecco fascial manipulation and ultrasound guided dry needling for treating myofascial pain and releasing myofascial trigger points.
  • To treat any pathology, shockwave should be done using ultrasound imaging, to determine the depth of damaged tissues and deliver focused treatment. It is impossible to deliver the most effective combination of shockwaves without visualizing the tissues.
  • Some pathologies have multiple components and need to be treated with a combination of energy waves (focused, radial and unfocused). For example, Achilles tendinopathy can require focused waves mid-body, the peritenon may need defocused waves, and the myotendinous junction may need radial. At the same time, the Kager’s fat pad may need focused waves where the Achilles tendon meets the fat pad, while the tendon itself may need less focused energy.
  • EMTT can be used to treat pathologies that shockwave does not work for, and to improve or speed up the results of shockwave therapy. When combined with shock wave therapy for pain relief, EMTT makes ESWT 20% more effective.

Actions Achieved with Shockwave Therapy

Most injuries involve multiple types of tissues at varying depths, covering varying amounts of area. The majority of clinics that offer shockwave therapy as a service only offer radial EPAT therapy, which is only effective for limited types of conditions. At NYDNRehab, we combine different types of shockwaves to penetrate varying depths, cover specific areas, and apply appropriate energy for individual tissue types.

Different types of shockwaves can be combined to accomplish multiple goals in a single session:

  • Neovasculogenesis
  • Autologous stem cell proliferation 
  • Nitric oxide release
  • Collagen remodeling
  • Bone regeneration
  • Pain neuromodulation
  • Tendon regeneration
  • Restoration of hyaluronic acid
  • Scar softening
  • Nerve regeneration
  • Breakup of soft tissue calcifications
  • Release of growth factors
Dr. Lev Kalika

Clinical director & DC RMSK

Verified Expert Profiles

About Shockwave Therapy Specialist Dr. Lev Kalika

Dr. Kalika is an esteemed member of the International Society for Medical Shockwave Treatment ((SMST). He is the only clinician in New York certified by the ISMST to perform extracorporeal shockwave therapy. Dr. Lev Kalika is a world-renowned expert in musculoskeletal ultrasonography, and has published multiple peer-reviewed articles about ultrasound guided procedures. The clinic at NYDNRehab features the most advanced focused, defocused, linear and radial shockwave equipment available in NYC, enabling us to effectively target different tissue types by adjusting the frequency, intensity and depth of the focal zone, and allowing us to select and combine different types of shockwaves to treat specific types of tissues. Our use of ultrasound imaging to guide shockwave procedures ensures that the shockwaves hit their mark, to produce optimal results. Dr. Kalika’s 20+ years of experience and expertise in ESWT and diagnostic ultrasound imaging make NYDNRehab the clinic of choice for extracorporeal shockwave therapy in NYC.

Reviews

Tom M
3 months ago
★★★★★
My passion is hiking the peaks of the northeast, pushing my limits and enjoying the mountains with my hiking buddies. So it was a sad situation when I found myself with a severe foot injury which put me on the sidelines for several months.

Initial treatment with a podiatrist, x-rays and MRI, and multiple PT doctors were not getting me anywhere and just walking around town remained a painful, hobbling experience.I didn’t think that they had the diagnosis right.

I was fortunate to find Dr. Lev Kalika and his innovative practice using all the latest technologies. During an initial hour long evaluation using his high-resolution diagnostic ultrasound setup, Dr. Kalika was able to identify the severe plantar fasciitis and multiple soft tissue tears in my foot and recommend a customized treatment plan based on extracorporeal shock wave therapy. Once a week for seven weeks, Dr Kalika used his three different shock wave treatment devices, pinpointing the treatments using the high-resolution ultrasound. I had achieved a 90-95% pain free condition under his care. At this point, I began seeing Daniella who guided me through a physical therapy program to get me back to full function. Daniella’s patient and no-nonsense approach has gotten me back into the mountains that I love. I feel so fortunate to have found the incredible caring team at NYDNRehab that have done wonders for me.
Lori Shecter
10 months ago
★★★★★
Living with EDS has never been easy, but Dr. Lev Kalika really helped me turn things around. At his clinic, he started with a thorough diagnosis, including an ultrasound . I was really surprised—no one had ever done that before starting shockwave therapy. It made me realize how detailed and precise his approach is. We combined physical therapy, prolotherapy injections, and shockwave therapy, and I finally feel like I have control over my symptoms. It’s made such a difference in my life
Rohit Bagalkot
A year ago
★★★★★
I went to see Dr. Kalika for a recurring lower back pain issue. I have had it for over 10 years with not much progress in recovery. It hampered my daily active life and I was have seen several PTs over the years with not much permanent relief.

I was impressed by Dr. Kalika’s modern approach to diagnosis and he was extremely thorough in his initial consultation and was able to very quickly assess my overall condition. He developed a plan for shockwave therapy, EMTT, dry needling and PT for 10 weeks. I felt better after a couple of sessions and continued the rest of my treatment to good effect. I must also praise Dr. Tatiana for her dry needling skills. She was instrumental in getting rid of long standing muscle tightness.

Overall it was a great experience and I am now looking forward to getting my other muscle injuries treated as well. They are expensive however and much of the treatments are not covered by insurance, atleast in my case.
Alina Lapin
8 months ago
★★★★★
I hurt my ankle during a hiking fall and couldn’t walk without pain. Dr. Lev Kalika used ultrasound to pinpoint the problem and treated it with shockwave therapy and fascial work. Now I’m pain-free and back on my feet.
Boyd MacReid
2 years ago
★★★★★
I found Dr. Kalika after researching alternative treatments for lower back pain, as I was not willing to take the long-term risks of the standard steroid injections. He treated me over a period of a couple of months with shockwave therapy. Although insurance did not cover the cost, I am thrilled to report that the treatment was hugely successful. I am hugely grateful for Dr. Kalika's help.

I also received PT for achilles tendonitis from Michael, who works with Dr. Kalika. Michael is an exceptional Physical Therapist and his help has been wonderful.

It would be remiss of me not to mention that Dr. Kalika's staff are all so kind and caring. It is refreshing to find such caring group of health care professionals.
Olga Kagan
2 years ago
★★★★★
My friend reccomended Dr Kalika to me, after hearing my stories of never ending backpain. I have tried many local dr's, went through tests, procedures, PT etc. I had been living with pain the last 3 years, as nothing helped to get back to normal life until I had my first appointment with Dr. Kalika. Shockwave therapy provided tremendous relief after the 1st session. After diagnosing me with more issues than just 1 bulging disc as I was previously diagnosed by HSS dr's (MRI, XRAY and other images did not reveal any more issues than a bulging disc), Dr Lev Kalika came up with an 8 week treatment plan, including shock wave therapy, magnit therapy, needles and ultimately PT. Fastforward 5 months, I feel great, I am in good shape, I am able to do things that were put on hold due to constant pain, I am active every day, as we all should be. And all thanks to Dr Kalika, who is very knowledgeble, skilful, attentive, honest and who literally helps people to get back on their feet. Thank you Doctor and the NYDNRehab team!!
D.E. Boone
2 years ago
★★★★★
I was very satisfied with the initial examination conducted by Dr. Kalika, which was detailed and comprehensive. I initially sought help for a stiff neck and pain that was affecting my gait and mobility. Additionally, I was experiencing left shoulder pain with limited movement and more. The prescribed treatment protocols, which included Shockwave therapy and EMTT, were designed to provide regeneration and relief.

Halfway through the treatment, my shoulder has remarkably improved. I can now lift it, use it, and even sleep on my left side for the first time in years. As for my neck, I've noticed progressive improvement in mobility and much less pain. Needless to say, I am extremely pleased with the results.

Dr. Kalika's dedication and passion for healing are evident in the way he approaches his patients, and it's not surprising that I've seen such positive results. The kindness and professionalism of the staff at the clinic also contributed to my overall positive experience. I highly recommend Dr. Kalika and his team for their exceptional care and effective treatment methods.
Nichole Barmin
3 years ago
★★★★★
I had such bad neck and back pain that I could hardly sleep. I went to multiple physical therapists, and all of them focused on correcting my posture, which provided zero relief. A colleague finally recommended Dr. Kalika at NYDNRehab. He was the first therapist to tell me that my pain was not caused by poor posture.
Dr. Kalika used diagnostic ultrasound and discovered that the fascia in my middle back had been damaged from a car accident several years ago. He used shockwave therapy and referred me to their acupuncturist for dry needling, and my pain completely disappeared in just three days after treatment.
The whole experience was great. I could tell that the staff there really loves what they’re doing, and I was really impressed with the sophisticated technology they used for diagnosis and treatment. I highly recommend Dr. Kalika and NYDNRehab.
Courtney Helm
3 years ago
★★★★★
My Podiatrist sent me to see Dr. Kalika about three weeks before the marathon that I was determined to run but I had some painful issues with the fascia in both feet. I booked every appointment that I could for ESWT & INDIBA therapy and it has made a major change. Both are pretty intense but they worked and with taping i was able to run the race with very little discomfort.

The staff was lovely and Julia is very straight forward and I appreciated her getting me right in. I have already referred Dr. Kalika to my friends. I am very happy to know him! He is very patient and passionate about helping you recover. If there is a need in the future I will not hesitate to go and see him for treatment.
Colleen Geib
4 years ago
★★★★★
Dr. Kalika is a godsend. He’s a very patient person who genuinely cares about his patients. He’s one of the most caring doctors I have had the pleasure of having. In a nutshell, I feel fortunate and blessed to have found Dr. Kalika when I did! From April through early August 2021, I had seen 2 orthopedic doctors, 2 chiropractors, 1 physical therapist, 2 acupuncturists, and 1 MFR therapist, to help diagnose and tackle my painful hip/groin pull (acute from a recent injury) and my low back pain (chronic) that left me feeling miserable and incapable of being physically active. After x-rays and a MRI, the ortho doctors tried to give me hydrocortisone shots and said I was a candidate for surgery for a partial tear in my hip labrum. I told them ‘no way, good-bye’! I continued to live with pain, popping 800-1,600 mg of Advil per day, walked with a limp, and started having difficulty with squatting or bending over. Acupuncture was the only temporary fix. I just knew I had to keep looking for answers and found relief after finding Dr. Kalika’s website and watching all of the videos about ultrasound, dry needling and shockwave therapies. I took a leap of faith and called his office. Since Day 1, my treatment has been a personalized, holistic approach at tackling my pain and targeting my ‘real’ health issues. During my first appointment, Dr. Kalika spent a great deal of time using the ultrasound to discover several tendinopathies, issues with my psoas muscle, hamstrings, adductors, and several other muscles in/around my low back that were contributing to my pain and limited mobility. He explained the benefits of shockwave therapy (ESWT) and dry needling. We discussed a treatment plan that included coming in 2-3x per week taking a team approach to tackle my pain and health concerns. It was a big commitment for me to pursue, but I seriously just wanted my life back where I wasn’t struggling with constant pain, completely unable to ride my bike, hike, play with my nephews, or do any of my ‘fun’ physical activities.
I am seen by his entire team – Dr. Yo for physical therapy (2-3x/week), Dr. Agyakwah for soft tissue and myofascial release (1-2x/week), and Tatiana for dry needling acupuncture (1x/week). I have had 4 weeks of shockwave therapy. All of these combined therapies are magically working together to help me feel better. This comprehensive, holistic approach is relieving my pain and has helped increase my mobility and flexibility. It is remarkable! His team, to include Julia (she’s the best, thank you for everything), is absolutely wonderful. They go the extra mile to make sure all is well during and after my treatments. I’m on a healing journey and recognize the healing will continue over the next 2-3 months from the shockwave therapy. I will post an update in a month or so on my progress as I continue with my weekly treatments.
In closing, Dr. Kalika and his team always take the time to explain things to me in terms that I can understand. He’s diligent in making sure my health is the best it can be. He’s proactive, curious, and always asking me – how do you feel today – show me where it hurts. He won’t stop until he discovers the root cause of your health issues. He helped solve my mystery, which is a huge relief in knowing I do not need hip surgery. I would highly recommend Dr. Kalika to anyone seeking a kind, compassionate, and brilliant doctor! You will not be disappointed. Thank you Dr. Kalika and Team :)
david frost
3 years ago
★★★★★
My elderly mother suffers from very severe knee arthritis, and she has difficulty walking more than a few blocks. We had consulted with a few orthopedic surgeons, and every one of them recommended knee replacement surgery. She was given a couple of plasma injections, but they didn’t really help.

Because my mother has a heart condition, she was very reluctant to have knee replacement surgery. While searching online for alternative treatments for knee osteoarthritis, I found Dr. Kalika and made an appointment.

Dr. Kalika was very kind and attentive to my mother. He used diagnostic ultrasound imaging to look at her knee, where he found multiple soft tissue problems. He used a combination of shockwave, magnetic, and radio-frequency Tecar wave therapy to regenerate the damaged soft tissues and reduce inflammation. He then sent her to his acupuncturist for dry needling from her low back to her feet.

After two months of treatment, my mother’s knee dramatically improved. She is now able to walk for longer distances with only mild discomfort. Dr. Kalika clearly knows what he is doing. He did a manual and ultrasound exam before each treatment session, and adjusted her treatment protocol accordingly. My mother is so grateful to Dr. Kalika, and I would recommend him to anyone with knee arthritis.
Julia Shamis
3 years ago
★★★★★
I’ve been receiving treatments from Dr. Kalika and his staff for a meniscus tear in my knee. My impression has been overwhelmingly positive. What differentiates Dr. Kalika is his excellent diagnostic skills aided by cutting-edge technology. Dr. Kalika used diagnostic ultrasound to examine the tissues inside my knee -- that’s something I’ve never seen anywhere else. The regimen he prescribed includes some unique treatments (ShockWave therapy and magnet therapy), as well as PT and dry needling. You get a lot of individualized attention at this practice. Dr. Kalika is truly focused on solving your problem -- as opposed to the assembly-line in-and-out approach you experience with so many doctors today. Dr. Yoo as well spent a lot of time with me on physical therapy and I can tell she is genuinely interested in helping me recover. Since I started treatments, my knee pain went away and I can feel my knee getting stronger. I highly recommend Dr. Kalika’s practice to anyone seeking help with orthopedic problems.
Ally DeSanto
3 years ago
★★★★★
I was struggling with terrible neck pain that kept getting worse, and my regular doctor told me I probably had disc disease and might need surgery, which I was not willing to do. My friend told me about Dr. Kalika and how he uses non-surgical approaches, so I made an appointment. Dr. Kalika used diagnostic ultrasonography to figure out that the root of my problem was fascial adhesions of the nerves in my shoulder and under my pectoral muscles, while my the orthopaedic doctor wanted to do surgery on the discs in my neck. Dr. Kalika used different types of shockwave therapy to break up the adhesions, and my pain is completely gone. I wish I had gone to NYDNRehab sooner!
anna bhattacharjee
3 years ago
★★★★★
I have been receiving treatments from Dr. Lev Kalika for arthrosis with joint line osteophytes, patellofemoral narrowing of both my knees. I had already completed PRP (Platelet rich plasma) which did improve my movement however there was a constant pain which made walking difficult. I feel fortunate and blessed that I was able to find Dr. Lev Kalika. The treatment he prescribed includes Shockwave (ESWT) and Magnet therapy (EMTT). He has been extremely accommodating with my treatment I have been receiving individualized attention. He is keen on decreasing my pain. After a few sessions my knee pain has decreased, and I can feel my knee getting stronger. I am extremely grateful to Dr. Kalika and his team. I highly recommend Dr. Kalika to anyone who is suffering from knee pain.
Mickey Pomer
3 years ago
★★★★★
When my general practitioner referred me to NYDNRehab for low back pain physical therapy I was skeptical. I had been struggling with low back pain for a couple of years, and I couldn’t see how physical therapy could help. Boy, was I surprised! The one-on-one personal treatment I received was amazing! Dr. Kalika used a combination of shockwave therapy, ultrasound guided dry needling and physical therapy to eliminate pain and inflammation and balance the muscles in my low back and pelvic region. He also did some chiropractic manipulation on my spine. My back pain is completely gone, and I learned tons about preventing it in the future. I highly recommend this clinic!
Turner Nelson
5 years ago
★★★★★
Dr. Kalika and his team have been absolutely phenomenal. I've been dealing with chronic pelvic pain for over three years and have seen several pelvic specialists in the city with little or no success/improvements. Dr. Kalika has treated my pain by looking at my whole body, not just the pelvis in a vacuum, and identifying areas of concern and working diligently and compassionately to help heal my whole body. Through a multimodal approach with PT, dry needling, ultrasound, shock wave therapy and other movement techniques, I will soon be pain free again. Previously, I didn't think I'd ever see a pain-free day again, but with Dr. Kalika I'll be back to a healthy, pain free lifestyle soon. I'd 100% recommend him.
Inna Letsve
3 years ago
★★★★★
I developed sciatic nerve pain about five month ago.The pain was so strong that I could not sit . I did acupuncture , tried couple guided steroid injections and oral steroids , but it wasn’t getting any better. My sister suggested sciatica physical therapy and referred me to the NYDNRehab clinic. I am so glad I went! Dr. Kalika used shock wave therapy and ultrasound guided dry needling, along with chiropractic care and physical therapy to strengthen my pelvic floor and other core muscles. My sciatica is completely gone, and I am able to sit. This is a great clinic with great people.
David Torres
3 years ago
★★★★★
Our son is a very active soccer player and was experiencing knee pain. After coming to Dr. Kalika's office, he determined he had knee tendonitis and began treating him for it with shockwave therapy. After only a few sessions our son began feeling better. Dr. Kalika and his staff are very attentive and take their time with their patients. I will definitely recommend him to anyone experiencing any pain.
Robert Owens
2 years ago
★★★★★
After four years of unsuccessful diagnoses and treatments by orthopedists, neurologists and a spinal surgeon for a weak leg condition resulting in a limp, I found Dr. Kalika's website online and decided to give him a try. His use of ultrasonography and ESWT and EMTT technology to diagnose and treat my condition has resulted in the strengthening of my leg and virtual elimination of my limp. I would highly recommend Dr. Kalika and his staff.
Camile Sardina
3 years ago
★★★★★
I came to NYDN Rehab with chronic low back pain, which, to that day, had never been properly treated. I had been to a handful of other clinics, but my low back pain still overpowered my life. At first, I thought I might try NYDN Rehab's dry needling treatment, because I've never tried it before; but after a very thorough examination using diagnostic ultrasonography, Dr. Kalika recommended that I start with shockwave therapy to my low back joints, then transition to dry needling.

Five weeks after shockwave therapy and ultrasound guided dry needling sessions, my pain was 80% gone. I can't stress how life changing that was for me. I was able to sleep more, dance more (something I love to do), and feel happier.

After those five weeks, I started to work with their physio, who taught me to activate my deep core muscles. Soon after, I was pain free.

I highly recommend NYDN Rehab for anyone with back pain. My entire experience was immaculate, from the efficient front desk, effective treatments, and the physicians and staff who truly care. Dr. Kalika loves what he does and it reflects on his work and team.
Dominic Barrett
2 years ago
★★★★★
After a referral from my doctor, I went to Dr.Kalika for shockwave therapy. Seemed odd at first, but it really did help me! This gave me enough physical relief to then do physical therapy with Daniela Escudero, which has been amazing.

Front desk is helpful and communicative, everyone is kind and happy to explain various aspects of your treatment. I'm happy with my service here and would recommend to others.
Gina St. Louis
4 years ago
★★★★★
I was in a limousine accident almost 3 years ago. I’ve been suffering from chronic neck and back pain and spasms. I saw 3 physiatrists, 5 physical therapists, 3 acupuncturists, 2 chiropractors and 2 neurologists. I found Dr. Shawn Volney on Zocdoc who recommended me to Dr. Kalika. After just 2 sessions of shockwave therapy and one of dry needling I started getting relief. I was able to stop the pain killers and reduce the use of heating pads. At this rate, I’m confident I’ll be pain free by the end of the treatment. I highly recommend Dr. Kalika.
Serge S
12 years ago
★★★★★
First time I met Dr. Kalika was about 10 years ago. He helped me with my leg pain in 2 visits that other doctors just couldn't do anything about. And then he moved to another office and I lost him. I was recalling him couple times with my shoulder and back pain, but couldn't find him.
Years after I have a terrible heel pain due to a heel spur, for 3 months. One office with therapy, another office with homeopathic shots, nothing, just more pain. So I started research myself and found that a shock wave treatment might help. I looked up on the internet and found this office and, oh my God, the doctor was that same doctor Kalika that i lost for years.
I'll tell you this, my pain almost dissipated in 2 weeks, the one that I suffered so much, that my whole foot got inflamed and swallowed!
In addition I was really surprised how much equipped this office with very expensive machines, unlike most of cheap offices. Even the massage tables feel like a bed in a good hotel!
Highly recommend Dr. Kalika as a very professional and knowledgeable specialist, who will not just heal your symptoms, but will teach you how to prevent future problems.
Nicolas Robert
6 years ago
★★★★★
Went in to see Lev Kalika for pain I was having in my elbow (tennis elbow). He quickly diagnosed by problem and came up with a treatment plan to make sure that it didnt become a recurring injury. I went through 4 sessions of shockwave therapy and some PT. Very satisfied with the attention of the clinic. Have done some work with Mo and Christina as well - both very knowledgeable and professional. I would recommend their services to anyone.
Agatha Ventura
4 years ago
★★★★★
I am the biggest fan of this place. I started about almost 5 months ago and have been coming twice a week and I have never felt this level of relief and strength.

I was recently diagnosed with Hypermobile Ehler's Danlos Syndrome and have chronic pain aka this is not my first round of physical therapy (and I have gone to other great places), but this is the most in depth, and holistic approach to my healing that I've experienced-- and they knew what it was!! Having PT, Chiro, and Acupuncture (and several useful machines like a Pilates one, K.A.R.E.N [which I'm excited to try], etc) and attending to my joints from all angles simultaneous has been amazing.

I also underwent Shockwave Therapy (4 sessions) and have seen immediate results in the strength and stability of my hip that would ache once a week (if lucky). Painful, but looking forward to strengthening it more now that it feels more stable.

Also the most helpful front desk team! Always helpful and kind.

Dr. Kalika, Michelle, HyunJu, Tatyana, and everyone in the front really care about their patients and their individual needs. All I can say is, THANK YOU!! (and see you next week)
J J
3 years ago
★★★★★
I had surgery on my spine and suffered from PTSD and chronic pain, tried many different places for PT, nothing helped much. This place is a game changer, the found treatment specifically for me and absolutely different from what i was used to, honestly thought id never get better, i felt great after just one full treatment, i did massage, PT, shockwave therapy. I felt like I could move my neck again and felt free from pain and fear to do anything, I really appreciate the help and it pushed me to do more with myself and not be scared. Id highly recommend for people who tried everything and suffer from pain daily.
Adriana Rojas
10 years ago
★★★★★
My first appointment at this facility and WOW! Courteous, professional staff at Front Desk, got me in quickly, did my paperwork, set me up and off I was to sit down with Dr. Kalika to evaluate my condition. He was thorough - listening to and answering my questions and explaining all the steps involved in the upcoming treatment - a true evaluation. To address my condition - plantar fascia (right foot) - his staff combined shockwave therapy, acupuncture and conditioning exercises. I like the concept of treating the condition as part of a "whole" - after all, this pain doesn't happen in a vacuum, it does affect other parts of thebody, such as the way one walks - with one side trying to compensate for the discomfort on the other side. I've set up my 3 visits for next week. A great first impression which encourages me to recommend them to others.
Dennis Lynch
11 years ago
★★★★★
For the last four weeks, I have been receiving Shockwave treatment for my tennis elbow pain at DNR. Huge Improvement! In fact, my elbow pain is virtually nonexistent at this point. Lev Kalika, the clinical director at DNR, was extremely kind and helpful through the process. He was very patient, encouraging and knowledgeable when I asked him (a lot of!) questions. I highly recommend DNR and Lev for anyone suffering from elbow or heel pain, and any other physical therapy related matters.
Ellen Selip
4 years ago
★★★★★
My plantar fascitis is GONE. Dr. Kalika treated me with shock wave therapy. Visits with an orthopedist with 2 cortisone injections did nothing to heal me. Thanks to NYDN I am pain free for the first time in six months.
Gillian Small
2 years ago
★★★★★
I am a long distance runner and have been using them for several years - always with a great outcome. Shockwave therapy has been very successful and Dr. Kalika is very thorough.
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Dr. Kalika recently participated in the 27th International Society for Medical Shockwave Treatments (ISMST) World Conference in Bogotá, Columbia, where he showcased his work in two presentations before some of the world’s leading experts in regenerative medicine and orthobiologics. He also led a workshop on ultrasonography.

Not only was it an honor to present before such esteemed and inspiring colleagues, but the conference was an incredible learning opportunity. Especially appreciated was the warmth and energy of the shockwave family—a group that not only advances science, but also knows how to celebrate life together.

Ultrasound Guidance for Fast Results

Technology provides us with sophisticated tools for treating musculoskeletal disorders, but technology alone is not enough to successfully repair damaged tissues. Tissue regeneration is an incredibly complex process that requires a broad understanding of physics, biology, anatomy, movement, and imaging.

Prior to your first regenerative shockwave treatment, we perform a diagnostic ultrasound scan. Ultrasound imaging lets us identify the precise area of concern, and helps us to select the right pulse frequency and gauge the size and depth of the targeted tissues. This allows us to select the most appropriate machine, as focal zones and wave types differ for different injuries. We then mark the area to be treated and set our equipment to the appropriate depth and angle, ensuring that the focused shockwaves render the greatest benefit.

Ultrasound guidance enables us to:
  • Precisely locate the affected tendon or soft tissue
  • Identify the most affected part of the tissue
  • Measure the desired depth of penetration
  • Measure tissue density using sonoelastography, to select the most effective type of shockwave and the pulse frequency
  • Classify the state of the tissue before and after treatment
Ultrasound guided shockwave therapy is the gold standard for shockwave treatment. Ultrasound guidance ensures that the focused shockwaves precisely reach the intended site of treatment. Diagnostic ultrasound also allows us to visualize any changes in the treated tissues, to help track the healing process.  A growing body of research shows that ultrasound guided procedures are 40% more effective than procedures performed blind. Every pathology is unique to the individual patient, and without detailed imaging, the clinician cannot accurately diagnose and treat musculoskeletal disorders.  Ultrasound imaging enables us to visualize minute details, such as: 
  • Types of tissues involved – most injuries involve multiple tissue types
  • Type of tissue pathology 
  • Tissues surrounding the application field that may be affected
  • Depth and anatomical course of involved tissues to determine shockwave type and penetration depth
  • Multiple radiologic parameters of tissue quality to determine the type of shockwave and energy used
  • The ability to image multiple joints, tendons, ligaments, muscles and fascia, to  understand the cause of pain, which almost always originates somewhere away from its locus
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Advanced Shockwave Therapy at
NYDNRehab

Extracorporeal Shockwave Therapy (ESWT), Myofascial Acoustic Compression Therapy (MyACT), SoftWave Electro-Hydraulic Shockwave, and Extracorporeal Magnetic Transduction Therapy (EMTT) are the most advanced and highly effective non-invasive treatment technologies approved by the FDA for neuromuscular disorders. The latest research shows that using a combination of different types of shockwaves provides the best therapeutic results, often 20-30% greater than using only a single shockwave technology. A combination of focused electromagnetic (FemESWT) and defocused electro-hydraulic (Deh-ESWT) provides the greatest versatility for treating a  large variety of musculoskeletal pathologies. Results are even greater when fascial adhesions and densifications are addressed. At NYDNRehab, we combine different shockwave types in the same session, with no extra cost to the patient.

Focused Extracorporeal Shock Wave Therapy (ESWT)

At NYDNRehab, we use three different shockwave machines for focused, defocused, linear and radial shockwave treatment. Each type of shockwave has its own advantage over the others, to address different types of tissues. Most pathologies involve multiple tissue types, and they are all connected. With multiple options for treatment, we are able to vary the depth and width of penetration, zoom in to focus on specific tissues, and zoom out to cover larger areas.

This proprietary technology is based on a unique set of pressure waves that stimulate the metabolism, enhance blood circulation and accelerate the healing process. After treatment, damaged cells gradually regenerate and damaged tissues eventually heal. These non-invasive outpatient procedures represent breakthrough treatment options for a broad range of musculoskeletal conditions.

Extracorporeal Magnetic Transduction Therapy (EMTT)

Radial vs Focused Shockwaves

Focused shockwave therapy penetrates deeper tissues, causing tissue membranes to vibrate and create pressure waves in their surrounding fluids without losing energy. Focused shockwaves target a smaller focal area. Ultrasonography is often used in conjunction with focused shock wave therapy to accurately visualize deep tissues. Focused shock waves are most often used for:
  • Acute athletic injuries
  • Bone fractures
  • Shin splints
  • Groin pain
  • Achilles tendon pain
  • Medial and posterior tibial pain
  • Ankle sprains
  • Wound healing
Radial shockwave therapy is the most common form of ESWT, used for a larger treatment area at a more superficial level. Radial shockwaves emit their greatest energy at the skin’s surface, and lose power as their energy penetrates deeper tissues.

Radial shock waves are most often used for:

  • Superficial tendinopathy 
  • Superficial trigger points
  • Myofascial pain
  • Plantar Fasciitis
  • Greater trochanter (hip) pain
  • Spasticity management for stroke, cerebral palsy, multiple sclerosis, dystonia and writer’s cramp

Radial and focused shockwaves are often used in combination to treat acute and repetitive overuse injuries in athletes.

Focused Extracorporeal Shock Wave Therapy (ESWT)

EPAT vs ESWT

EPAT radial waves are often advertised as shockwave therapy, but they are not true shockwaves – they are mechanical pressure waves that have only very mild regenerative effects on muscles and fascia.

EPAT has very shallow penetration depth, 3-4 times less than focused shockwaves. Its mechanical waves do not stimulate stem cell production, and its energy waves are dispersed and cannot be focused. EPAT cannot be used near bone surfaces or entheses, as it causes too much pain. EPAT is ineffective for tendon pathologies where the entheses – the transitional cells between tendon and bone – are responsible for generating biological growth factors.

EPAT can be beneficial for fascial collagen remodeling and elimination of fascial densifications, and helps increase the blood supply to superficial muscle tissue. At NYDNRehab, we combine different types of shockwaves supplemented with EPAT, to make the treatment more holistic without additional cost to the patient.

Extracorporeal Pulse Activation Technology (EPAT)

Conditions We Treat with ESWT, EPAT
and EMTT

ESWT for Myofascial Pain

Shockwaves have been used successfully for years to treat bone fractures, tendon ruptures and soft tissue injuries, and it is widely accepted that shockwaves have different effects on different tissue types. Until recently, little research has been done to measure the effects of ESWT on myofascial tissue.

Fascia has unique characteristics compared to other tissue types, and data from research on tenocytes and skin fibroblasts cannot automatically be translated to fascial tissue. Fascia is highly innervated with both sensitive and autonomic nerve fibers, and alterations to fascia can generate myofascial pain that affects movement quality.

The fibrotic component of fascia shares certain characteristics with tendons in the respect that it is highly collagenous. Type 1 collagen is a major component of fascia, and type 3 collagen plays a key role in the early stages of fascial injury repair. But unlike tendon tissue, fascia has gliding and elastic properties that depend on the presence of hyaluronan (HA), a polymer that binds to water, with the capacity to retain up to 1000 times its weight in water.

A recent 2022 study explored the effect of ESWT on fascia, and demonstrated for the first time that shockwaves can lead to in-vitro production of hyaluronan-rich vesicles, immediately after treatment. ESWT has been shown to stimulate an increase in cell proliferation and synthesis, and remodeling of the extracellular matrix.

The researchers observed an immediate release of hyaluronan-rich vesicles, along with type 1 and type 3, as soon as one hour post-treatment. Tissue proliferation increased at 4 hours, and was maintained at 24 hours. They concluded that fascial cells respond to ESWT by regulating and remodeling the extracellular matrix (ECM).

At NYDNRehab, we use a combination of focused and defocused shockwaves to treat myofascial pain, in conjunction with fascial manipulation therapy.

ESWT and Chronic Inflammation

ESWT can be used to reverse chronic inflammation that occurs when the inflammatory response is not completely halted. Chronic inflammation can damage healthy areas of the body, causing chronic pain. ESWT stimulates mast cells to release pro-inflammatory compounds like cytokines and chemokines. This stimulates the regeneration of healthy cells and helps restore normal healing.

ESWT and Tendon Healing

ESWT can help the body to produce more collagen. Collagen is a protein found throughout the body that gives tendons and ligaments their structure. The collagen fibers produced by the body after shock wave therapy are forced into longitudinal structures that make tendons stiffer and denser, stopping and reversing tendon degeneration.

ESWT and Trigger Point Therapy

Trigger points are tightly contracted bands of muscle tissue that are the principal cause of pain in the back, neck, shoulders and limbs. Their dysfunctional sarcomeres contract so tightly that they begin to cut off their own blood supply. This causes a buildup of waste products, which in turn irritates the sensory nerve endings, causing even more pain. This vicious cycle is called a metabolic crisis. 

Although the precise mechanisms of ESWT’s effect on trigger points is unclear, it is assumed that the delivered acoustic energy unblocks the calcium pump in the sarcomere, causing the trigger point to release and immediately stopping pain.

ESWT and Motor Disorders

ESWT can be successfully used to treat and manage spasticity after stroke, and in motor disorders such as cerebral palsy, multiple sclerosis, dystonia and severe writer’s cramps.

Exciting New Research Supports Shockwave
Efficacy for Pelvic and Reproductive Disorders

Our years of experience using shockwave therapy have helped hundreds of patients to successfully eliminate musculoskeletal pain and dysfunction. Today, a treasure trove of research is emerging that supports the efficacy of shockwave therapy for treating pelvic and reproductive disorders.

Recent research has found shockwave therapy to have long-term success in treating:

Pelvic disorders are common in both men and women, but patients are often reluctant to seek treatment due to embarrassment. Shockwave therapy provides a safe, non-invasive and effective solution for a broad range of pelvic and reproductive disorders, with minimal discomfort for the patient. Treatment sessions are brief, and many patients report improvement after their very first session.

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Combined RegenerativeTechnologies
Bring Fast Therapeutic Results

The human body has its own innate healing mechanisms, but it sometimes needs a nudge to accelerate the healing process. Regenerative technologies help to jump-start healing by stimulating tissue repair at the cellular level. Our outpatient regenerative therapies expedite recovery with minimal discomfort for the patient.

Focused Extracorporeal Shock Wave Therapy (ESWT)

Focused Extracorporeal Shock Wave Therapy (ESWT)

Focused ESWT is used as a regenerative treatment for damaged tendon, muscle and bone tissue. This technology produces high frequency sound waves to stimulate the body’s own reparative mechanisms. It is especially effective for chronic degenerative tendon disorders and myofascial pain syndrome.


SoftWave Electro-Hydraulic Shockwave Therapy

SoftWave is a groundbreaking regenerative mechanotransduction technology that accelerates tissue healing. Its patented electro-hydraulic applicator delivers high-speed soundwaves that can penetrate up to six inches in depth. SoftWave’s defocused and linear focused shockwaves recruit maximum stem cells to the treatment site to promote healing. SoftWave’s wider and deeper penetration using defocused energy is a preferred treatment option for a broad spectrum of conditions, ranging from orthopedic injuries to pelvic health.

SoftWave Electro-Hydraulic Shockwave Therapy
Myofascial Acoustic Compression Therapy (MyACT)

Myofascial Acoustic Compression Therapy (MyACT)

MyACT is a new type of focused shockwave technology that allows for deeper compression of the focused waves. Its higher frequency allows for precise neuro modulation under ultrasound guidance, with a special linear head for treating myofascial pain. This innovative shockwave technology transforms the mechanical energy of shockwaves into biochemical signals that precisely target damaged tissues. Its versatile controls let us fine-tune its output levels for precise and personalized patient care.


Extracorporeal Magnetic Transduction Therapy (EMTT)

EMTT is a fairly new technology that transmits high energy magnetic pulses to targeted tissues. The magnetic waves synchronize with the body’s own magnetic fields, causing a disturbance that triggers a regenerative response. EMTT waves can penetrate deep tissues up to 18 cm beneath the skin’s surface, to target difficult-to-reach tendons, muscles, bones and nerves.

Extracorporeal Magnetic Transduction Therapy (EMTT)
Extracorporeal Pulse Activation Technology (EPAT)

Extracorporeal Pulse Activation Technology (EPAT)

EPAT, sometimes called defocused shock wave therapy, is not a true shockwave. It uses mechanical pressure waves to enhance blood circulation, improving oxygen and nutrient delivery to muscle and fascia tissues, but has minimal regenerative properties. We combine EPAT with different types of shockwaves for holistic treatment, without additional cost to the patient.


High Energy Inductive Therapy (HEIT)

HEIT uses electromagnetic fields to penetrate cells, tissues, organs and bones, to reactivate the electrochemical function of cells and cell membranes. HEIT generates a magnetic field 600 times stronger than the field of a normal magnet, to stimulate healing of nerves, muscles and blood vessels.

High Energy Inductive Therapy (HEIT)

Ultrasound Guided Dry Needling

Myofascial trigger points often contribute to pain syndromes and motor dysfunction.  Dry needling is an outpatient procedure that inserts non-medicated needles into the trigger point to evoke a twitch response, releasing the trigger point and immediately relieving pain. Ultrasound guidance eliminates the need for multiple insertions, reducing pain and discomfort for the patient.

Why Choose NYDNRehab for Shockwave Therapy

Dr.Kalika has spent over 20 years refining his approach to diagnostic musculoskeletal ultrasonography. He has extensively studied the qualities of different shockwaves and their effect on different tissue types, and has perfected his approach to local and global shockwave therapy.

Many practitioners who perform shockwave therapy are under-qualified:

  • They are not certified
  • They perform blind procedures without imaging.
  • They apply shockwaves at the locus of pain, without fully understanding the patient’s diagnosis and individual pathology.
  • They do not understand the principle of tensegrity and the role of fascia in the greater kinetic chain.
  • They perform more shockwave applications than are safe, effectively breaking down tissue instead of regenerating it.

When applied appropriately by a trained and certified clinician, shockwave therapy is the most effective and broadest regenerative treatment available, but its inappropriate application can be completely ineffective.  Shockwaves deliver immediate anesthetic relief to patients, but when performed too frequently, they can destroy tissues instead of healing them.

Don’t settle for shockwave therapy that falls short of its promises. To get the safest, most accurate and effective shockwave therapy in NYC, contact NYDNRehab today!

$500

1-hour initial evaluation with Dr. Kalika

Using high-resolution diagnostic ultrasound imaging

$275

Focused Stortz shockwaves

Combination of Stortz Focused, Softwave defocused, and Radial Shockwave

$175

Focused and Radial Shockwaves with Dr. Agyakwah

Imaging not included – please bring any available MRI or xray images

*Requires $200 pre-treatment evaluation

Clinical Case Studies
NYDNRehab


Case Study: Thoracic Pain Post Scoliosis Surgery

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 […]

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    Shockwave Therapy at NYDNRehab

    Shockwave Therapy FAQs

    Is Shockwave Therapy Safe?
    Shockwave therapy is a noninvasive FDA-approved treatment method. When delivered by an experienced clinician, ESWT is considered safe, inexpensive, fast and effective. Shockwave therapy spares the patient from the dangers of unnecessary surgical procedures and the negative side effects of medications.
    How many shockwave therapy sessions will I need?
    The number of shockwave therapy sessions needed to heal your injury will depend on the specifics of your condition and your body’s response to treatment. Most people need between 3-6 sessions, spaced about a week apart. Too many sessions, too close together, can actually cause the tissue to break down instead of heal, so beware of clinics recommending too many or too frequent treatments.
    What conditions are most successfully treated with shockwave therapy?
    ESWT is especially effective for treating injured tendon tissues in the ankles, knees, hips, shoulders, wrists and elbows. It is also used to treat bone fractures and muscle injuries, along with conditions like plantar fasciitis and carpal tunnel syndrome. It is important to note that shockwave therapy is not a magic bullet on its own, and you may benefit from complementary therapies that enhance the effectiveness of ESWT.
    Who should avoid shockwave therapy?
    Avoid shockwave therapy if you are pregnant, have a blood clotting disorder, are taking blood thinners, have cancer, or have neuropathy or an active infection in the treatment area. ESWT is contraindicated if you have a pacemaker, or have had a recent steroid injection at the treatment site. You should consult your doctor prior to getting shockwave therapy.
    Who should avoid shockwave therapy?
    Avoid shockwave therapy if you are pregnant, have a blood clotting disorder, are taking blood thinners, have cancer, or have neuropathy or an active infection in the treatment area. ESWT is contraindicated if you have a pacemaker, or have had a recent steroid injection at the treatment site. You should consult your doctor prior to getting shockwave therapy.  

    Reviews

    Tom M
    3 months ago
    ★★★★★
    My passion is hiking the peaks of the northeast, pushing my limits and enjoying the mountains with my hiking buddies. So it was a sad situation when I found myself with a severe foot injury which put me on the sidelines for several months.

    Initial treatment with a podiatrist, x-rays and MRI, and multiple PT doctors were not getting me anywhere and just walking around town remained a painful, hobbling experience.I didn’t think that they had the diagnosis right.

    I was fortunate to find Dr. Lev Kalika and his innovative practice using all the latest technologies. During an initial hour long evaluation using his high-resolution diagnostic ultrasound setup, Dr. Kalika was able to identify the severe plantar fasciitis and multiple soft tissue tears in my foot and recommend a customized treatment plan based on extracorporeal shock wave therapy. Once a week for seven weeks, Dr Kalika used his three different shock wave treatment devices, pinpointing the treatments using the high-resolution ultrasound. I had achieved a 90-95% pain free condition under his care. At this point, I began seeing Daniella who guided me through a physical therapy program to get me back to full function. Daniella’s patient and no-nonsense approach has gotten me back into the mountains that I love. I feel so fortunate to have found the incredible caring team at NYDNRehab that have done wonders for me.
    Lori Shecter
    10 months ago
    ★★★★★
    Living with EDS has never been easy, but Dr. Lev Kalika really helped me turn things around. At his clinic, he started with a thorough diagnosis, including an ultrasound . I was really surprised—no one had ever done that before starting shockwave therapy. It made me realize how detailed and precise his approach is. We combined physical therapy, prolotherapy injections, and shockwave therapy, and I finally feel like I have control over my symptoms. It’s made such a difference in my life
    Rohit Bagalkot
    A year ago
    ★★★★★
    I went to see Dr. Kalika for a recurring lower back pain issue. I have had it for over 10 years with not much progress in recovery. It hampered my daily active life and I was have seen several PTs over the years with not much permanent relief.

    I was impressed by Dr. Kalika’s modern approach to diagnosis and he was extremely thorough in his initial consultation and was able to very quickly assess my overall condition. He developed a plan for shockwave therapy, EMTT, dry needling and PT for 10 weeks. I felt better after a couple of sessions and continued the rest of my treatment to good effect. I must also praise Dr. Tatiana for her dry needling skills. She was instrumental in getting rid of long standing muscle tightness.

    Overall it was a great experience and I am now looking forward to getting my other muscle injuries treated as well. They are expensive however and much of the treatments are not covered by insurance, atleast in my case.
    Alina Lapin
    8 months ago
    ★★★★★
    I hurt my ankle during a hiking fall and couldn’t walk without pain. Dr. Lev Kalika used ultrasound to pinpoint the problem and treated it with shockwave therapy and fascial work. Now I’m pain-free and back on my feet.
    Boyd MacReid
    2 years ago
    ★★★★★
    I found Dr. Kalika after researching alternative treatments for lower back pain, as I was not willing to take the long-term risks of the standard steroid injections. He treated me over a period of a couple of months with shockwave therapy. Although insurance did not cover the cost, I am thrilled to report that the treatment was hugely successful. I am hugely grateful for Dr. Kalika's help.

    I also received PT for achilles tendonitis from Michael, who works with Dr. Kalika. Michael is an exceptional Physical Therapist and his help has been wonderful.

    It would be remiss of me not to mention that Dr. Kalika's staff are all so kind and caring. It is refreshing to find such caring group of health care professionals.
    Olga Kagan
    2 years ago
    ★★★★★
    My friend reccomended Dr Kalika to me, after hearing my stories of never ending backpain. I have tried many local dr's, went through tests, procedures, PT etc. I had been living with pain the last 3 years, as nothing helped to get back to normal life until I had my first appointment with Dr. Kalika. Shockwave therapy provided tremendous relief after the 1st session. After diagnosing me with more issues than just 1 bulging disc as I was previously diagnosed by HSS dr's (MRI, XRAY and other images did not reveal any more issues than a bulging disc), Dr Lev Kalika came up with an 8 week treatment plan, including shock wave therapy, magnit therapy, needles and ultimately PT. Fastforward 5 months, I feel great, I am in good shape, I am able to do things that were put on hold due to constant pain, I am active every day, as we all should be. And all thanks to Dr Kalika, who is very knowledgeble, skilful, attentive, honest and who literally helps people to get back on their feet. Thank you Doctor and the NYDNRehab team!!
    D.E. Boone
    2 years ago
    ★★★★★
    I was very satisfied with the initial examination conducted by Dr. Kalika, which was detailed and comprehensive. I initially sought help for a stiff neck and pain that was affecting my gait and mobility. Additionally, I was experiencing left shoulder pain with limited movement and more. The prescribed treatment protocols, which included Shockwave therapy and EMTT, were designed to provide regeneration and relief.

    Halfway through the treatment, my shoulder has remarkably improved. I can now lift it, use it, and even sleep on my left side for the first time in years. As for my neck, I've noticed progressive improvement in mobility and much less pain. Needless to say, I am extremely pleased with the results.

    Dr. Kalika's dedication and passion for healing are evident in the way he approaches his patients, and it's not surprising that I've seen such positive results. The kindness and professionalism of the staff at the clinic also contributed to my overall positive experience. I highly recommend Dr. Kalika and his team for their exceptional care and effective treatment methods.
    Nichole Barmin
    3 years ago
    ★★★★★
    I had such bad neck and back pain that I could hardly sleep. I went to multiple physical therapists, and all of them focused on correcting my posture, which provided zero relief. A colleague finally recommended Dr. Kalika at NYDNRehab. He was the first therapist to tell me that my pain was not caused by poor posture.
    Dr. Kalika used diagnostic ultrasound and discovered that the fascia in my middle back had been damaged from a car accident several years ago. He used shockwave therapy and referred me to their acupuncturist for dry needling, and my pain completely disappeared in just three days after treatment.
    The whole experience was great. I could tell that the staff there really loves what they’re doing, and I was really impressed with the sophisticated technology they used for diagnosis and treatment. I highly recommend Dr. Kalika and NYDNRehab.
    Courtney Helm
    3 years ago
    ★★★★★
    My Podiatrist sent me to see Dr. Kalika about three weeks before the marathon that I was determined to run but I had some painful issues with the fascia in both feet. I booked every appointment that I could for ESWT & INDIBA therapy and it has made a major change. Both are pretty intense but they worked and with taping i was able to run the race with very little discomfort.

    The staff was lovely and Julia is very straight forward and I appreciated her getting me right in. I have already referred Dr. Kalika to my friends. I am very happy to know him! He is very patient and passionate about helping you recover. If there is a need in the future I will not hesitate to go and see him for treatment.
    Colleen Geib
    4 years ago
    ★★★★★
    Dr. Kalika is a godsend. He’s a very patient person who genuinely cares about his patients. He’s one of the most caring doctors I have had the pleasure of having. In a nutshell, I feel fortunate and blessed to have found Dr. Kalika when I did! From April through early August 2021, I had seen 2 orthopedic doctors, 2 chiropractors, 1 physical therapist, 2 acupuncturists, and 1 MFR therapist, to help diagnose and tackle my painful hip/groin pull (acute from a recent injury) and my low back pain (chronic) that left me feeling miserable and incapable of being physically active. After x-rays and a MRI, the ortho doctors tried to give me hydrocortisone shots and said I was a candidate for surgery for a partial tear in my hip labrum. I told them ‘no way, good-bye’! I continued to live with pain, popping 800-1,600 mg of Advil per day, walked with a limp, and started having difficulty with squatting or bending over. Acupuncture was the only temporary fix. I just knew I had to keep looking for answers and found relief after finding Dr. Kalika’s website and watching all of the videos about ultrasound, dry needling and shockwave therapies. I took a leap of faith and called his office. Since Day 1, my treatment has been a personalized, holistic approach at tackling my pain and targeting my ‘real’ health issues. During my first appointment, Dr. Kalika spent a great deal of time using the ultrasound to discover several tendinopathies, issues with my psoas muscle, hamstrings, adductors, and several other muscles in/around my low back that were contributing to my pain and limited mobility. He explained the benefits of shockwave therapy (ESWT) and dry needling. We discussed a treatment plan that included coming in 2-3x per week taking a team approach to tackle my pain and health concerns. It was a big commitment for me to pursue, but I seriously just wanted my life back where I wasn’t struggling with constant pain, completely unable to ride my bike, hike, play with my nephews, or do any of my ‘fun’ physical activities.
    I am seen by his entire team – Dr. Yo for physical therapy (2-3x/week), Dr. Agyakwah for soft tissue and myofascial release (1-2x/week), and Tatiana for dry needling acupuncture (1x/week). I have had 4 weeks of shockwave therapy. All of these combined therapies are magically working together to help me feel better. This comprehensive, holistic approach is relieving my pain and has helped increase my mobility and flexibility. It is remarkable! His team, to include Julia (she’s the best, thank you for everything), is absolutely wonderful. They go the extra mile to make sure all is well during and after my treatments. I’m on a healing journey and recognize the healing will continue over the next 2-3 months from the shockwave therapy. I will post an update in a month or so on my progress as I continue with my weekly treatments.
    In closing, Dr. Kalika and his team always take the time to explain things to me in terms that I can understand. He’s diligent in making sure my health is the best it can be. He’s proactive, curious, and always asking me – how do you feel today – show me where it hurts. He won’t stop until he discovers the root cause of your health issues. He helped solve my mystery, which is a huge relief in knowing I do not need hip surgery. I would highly recommend Dr. Kalika to anyone seeking a kind, compassionate, and brilliant doctor! You will not be disappointed. Thank you Dr. Kalika and Team :)
    david frost
    3 years ago
    ★★★★★
    My elderly mother suffers from very severe knee arthritis, and she has difficulty walking more than a few blocks. We had consulted with a few orthopedic surgeons, and every one of them recommended knee replacement surgery. She was given a couple of plasma injections, but they didn’t really help.

    Because my mother has a heart condition, she was very reluctant to have knee replacement surgery. While searching online for alternative treatments for knee osteoarthritis, I found Dr. Kalika and made an appointment.

    Dr. Kalika was very kind and attentive to my mother. He used diagnostic ultrasound imaging to look at her knee, where he found multiple soft tissue problems. He used a combination of shockwave, magnetic, and radio-frequency Tecar wave therapy to regenerate the damaged soft tissues and reduce inflammation. He then sent her to his acupuncturist for dry needling from her low back to her feet.

    After two months of treatment, my mother’s knee dramatically improved. She is now able to walk for longer distances with only mild discomfort. Dr. Kalika clearly knows what he is doing. He did a manual and ultrasound exam before each treatment session, and adjusted her treatment protocol accordingly. My mother is so grateful to Dr. Kalika, and I would recommend him to anyone with knee arthritis.
    Julia Shamis
    3 years ago
    ★★★★★
    I’ve been receiving treatments from Dr. Kalika and his staff for a meniscus tear in my knee. My impression has been overwhelmingly positive. What differentiates Dr. Kalika is his excellent diagnostic skills aided by cutting-edge technology. Dr. Kalika used diagnostic ultrasound to examine the tissues inside my knee -- that’s something I’ve never seen anywhere else. The regimen he prescribed includes some unique treatments (ShockWave therapy and magnet therapy), as well as PT and dry needling. You get a lot of individualized attention at this practice. Dr. Kalika is truly focused on solving your problem -- as opposed to the assembly-line in-and-out approach you experience with so many doctors today. Dr. Yoo as well spent a lot of time with me on physical therapy and I can tell she is genuinely interested in helping me recover. Since I started treatments, my knee pain went away and I can feel my knee getting stronger. I highly recommend Dr. Kalika’s practice to anyone seeking help with orthopedic problems.
    Ally DeSanto
    3 years ago
    ★★★★★
    I was struggling with terrible neck pain that kept getting worse, and my regular doctor told me I probably had disc disease and might need surgery, which I was not willing to do. My friend told me about Dr. Kalika and how he uses non-surgical approaches, so I made an appointment. Dr. Kalika used diagnostic ultrasonography to figure out that the root of my problem was fascial adhesions of the nerves in my shoulder and under my pectoral muscles, while my the orthopaedic doctor wanted to do surgery on the discs in my neck. Dr. Kalika used different types of shockwave therapy to break up the adhesions, and my pain is completely gone. I wish I had gone to NYDNRehab sooner!
    anna bhattacharjee
    3 years ago
    ★★★★★
    I have been receiving treatments from Dr. Lev Kalika for arthrosis with joint line osteophytes, patellofemoral narrowing of both my knees. I had already completed PRP (Platelet rich plasma) which did improve my movement however there was a constant pain which made walking difficult. I feel fortunate and blessed that I was able to find Dr. Lev Kalika. The treatment he prescribed includes Shockwave (ESWT) and Magnet therapy (EMTT). He has been extremely accommodating with my treatment I have been receiving individualized attention. He is keen on decreasing my pain. After a few sessions my knee pain has decreased, and I can feel my knee getting stronger. I am extremely grateful to Dr. Kalika and his team. I highly recommend Dr. Kalika to anyone who is suffering from knee pain.
    Mickey Pomer
    3 years ago
    ★★★★★
    When my general practitioner referred me to NYDNRehab for low back pain physical therapy I was skeptical. I had been struggling with low back pain for a couple of years, and I couldn’t see how physical therapy could help. Boy, was I surprised! The one-on-one personal treatment I received was amazing! Dr. Kalika used a combination of shockwave therapy, ultrasound guided dry needling and physical therapy to eliminate pain and inflammation and balance the muscles in my low back and pelvic region. He also did some chiropractic manipulation on my spine. My back pain is completely gone, and I learned tons about preventing it in the future. I highly recommend this clinic!
    Turner Nelson
    5 years ago
    ★★★★★
    Dr. Kalika and his team have been absolutely phenomenal. I've been dealing with chronic pelvic pain for over three years and have seen several pelvic specialists in the city with little or no success/improvements. Dr. Kalika has treated my pain by looking at my whole body, not just the pelvis in a vacuum, and identifying areas of concern and working diligently and compassionately to help heal my whole body. Through a multimodal approach with PT, dry needling, ultrasound, shock wave therapy and other movement techniques, I will soon be pain free again. Previously, I didn't think I'd ever see a pain-free day again, but with Dr. Kalika I'll be back to a healthy, pain free lifestyle soon. I'd 100% recommend him.
    Inna Letsve
    3 years ago
    ★★★★★
    I developed sciatic nerve pain about five month ago.The pain was so strong that I could not sit . I did acupuncture , tried couple guided steroid injections and oral steroids , but it wasn’t getting any better. My sister suggested sciatica physical therapy and referred me to the NYDNRehab clinic. I am so glad I went! Dr. Kalika used shock wave therapy and ultrasound guided dry needling, along with chiropractic care and physical therapy to strengthen my pelvic floor and other core muscles. My sciatica is completely gone, and I am able to sit. This is a great clinic with great people.
    David Torres
    3 years ago
    ★★★★★
    Our son is a very active soccer player and was experiencing knee pain. After coming to Dr. Kalika's office, he determined he had knee tendonitis and began treating him for it with shockwave therapy. After only a few sessions our son began feeling better. Dr. Kalika and his staff are very attentive and take their time with their patients. I will definitely recommend him to anyone experiencing any pain.
    Robert Owens
    2 years ago
    ★★★★★
    After four years of unsuccessful diagnoses and treatments by orthopedists, neurologists and a spinal surgeon for a weak leg condition resulting in a limp, I found Dr. Kalika's website online and decided to give him a try. His use of ultrasonography and ESWT and EMTT technology to diagnose and treat my condition has resulted in the strengthening of my leg and virtual elimination of my limp. I would highly recommend Dr. Kalika and his staff.
    Camile Sardina
    3 years ago
    ★★★★★
    I came to NYDN Rehab with chronic low back pain, which, to that day, had never been properly treated. I had been to a handful of other clinics, but my low back pain still overpowered my life. At first, I thought I might try NYDN Rehab's dry needling treatment, because I've never tried it before; but after a very thorough examination using diagnostic ultrasonography, Dr. Kalika recommended that I start with shockwave therapy to my low back joints, then transition to dry needling.

    Five weeks after shockwave therapy and ultrasound guided dry needling sessions, my pain was 80% gone. I can't stress how life changing that was for me. I was able to sleep more, dance more (something I love to do), and feel happier.

    After those five weeks, I started to work with their physio, who taught me to activate my deep core muscles. Soon after, I was pain free.

    I highly recommend NYDN Rehab for anyone with back pain. My entire experience was immaculate, from the efficient front desk, effective treatments, and the physicians and staff who truly care. Dr. Kalika loves what he does and it reflects on his work and team.
    Dominic Barrett
    2 years ago
    ★★★★★
    After a referral from my doctor, I went to Dr.Kalika for shockwave therapy. Seemed odd at first, but it really did help me! This gave me enough physical relief to then do physical therapy with Daniela Escudero, which has been amazing.

    Front desk is helpful and communicative, everyone is kind and happy to explain various aspects of your treatment. I'm happy with my service here and would recommend to others.
    Gina St. Louis
    4 years ago
    ★★★★★
    I was in a limousine accident almost 3 years ago. I’ve been suffering from chronic neck and back pain and spasms. I saw 3 physiatrists, 5 physical therapists, 3 acupuncturists, 2 chiropractors and 2 neurologists. I found Dr. Shawn Volney on Zocdoc who recommended me to Dr. Kalika. After just 2 sessions of shockwave therapy and one of dry needling I started getting relief. I was able to stop the pain killers and reduce the use of heating pads. At this rate, I’m confident I’ll be pain free by the end of the treatment. I highly recommend Dr. Kalika.
    Serge S
    12 years ago
    ★★★★★
    First time I met Dr. Kalika was about 10 years ago. He helped me with my leg pain in 2 visits that other doctors just couldn't do anything about. And then he moved to another office and I lost him. I was recalling him couple times with my shoulder and back pain, but couldn't find him.
    Years after I have a terrible heel pain due to a heel spur, for 3 months. One office with therapy, another office with homeopathic shots, nothing, just more pain. So I started research myself and found that a shock wave treatment might help. I looked up on the internet and found this office and, oh my God, the doctor was that same doctor Kalika that i lost for years.
    I'll tell you this, my pain almost dissipated in 2 weeks, the one that I suffered so much, that my whole foot got inflamed and swallowed!
    In addition I was really surprised how much equipped this office with very expensive machines, unlike most of cheap offices. Even the massage tables feel like a bed in a good hotel!
    Highly recommend Dr. Kalika as a very professional and knowledgeable specialist, who will not just heal your symptoms, but will teach you how to prevent future problems.
    Nicolas Robert
    6 years ago
    ★★★★★
    Went in to see Lev Kalika for pain I was having in my elbow (tennis elbow). He quickly diagnosed by problem and came up with a treatment plan to make sure that it didnt become a recurring injury. I went through 4 sessions of shockwave therapy and some PT. Very satisfied with the attention of the clinic. Have done some work with Mo and Christina as well - both very knowledgeable and professional. I would recommend their services to anyone.
    Agatha Ventura
    4 years ago
    ★★★★★
    I am the biggest fan of this place. I started about almost 5 months ago and have been coming twice a week and I have never felt this level of relief and strength.

    I was recently diagnosed with Hypermobile Ehler's Danlos Syndrome and have chronic pain aka this is not my first round of physical therapy (and I have gone to other great places), but this is the most in depth, and holistic approach to my healing that I've experienced-- and they knew what it was!! Having PT, Chiro, and Acupuncture (and several useful machines like a Pilates one, K.A.R.E.N [which I'm excited to try], etc) and attending to my joints from all angles simultaneous has been amazing.

    I also underwent Shockwave Therapy (4 sessions) and have seen immediate results in the strength and stability of my hip that would ache once a week (if lucky). Painful, but looking forward to strengthening it more now that it feels more stable.

    Also the most helpful front desk team! Always helpful and kind.

    Dr. Kalika, Michelle, HyunJu, Tatyana, and everyone in the front really care about their patients and their individual needs. All I can say is, THANK YOU!! (and see you next week)
    J J
    3 years ago
    ★★★★★
    I had surgery on my spine and suffered from PTSD and chronic pain, tried many different places for PT, nothing helped much. This place is a game changer, the found treatment specifically for me and absolutely different from what i was used to, honestly thought id never get better, i felt great after just one full treatment, i did massage, PT, shockwave therapy. I felt like I could move my neck again and felt free from pain and fear to do anything, I really appreciate the help and it pushed me to do more with myself and not be scared. Id highly recommend for people who tried everything and suffer from pain daily.
    Adriana Rojas
    10 years ago
    ★★★★★
    My first appointment at this facility and WOW! Courteous, professional staff at Front Desk, got me in quickly, did my paperwork, set me up and off I was to sit down with Dr. Kalika to evaluate my condition. He was thorough - listening to and answering my questions and explaining all the steps involved in the upcoming treatment - a true evaluation. To address my condition - plantar fascia (right foot) - his staff combined shockwave therapy, acupuncture and conditioning exercises. I like the concept of treating the condition as part of a "whole" - after all, this pain doesn't happen in a vacuum, it does affect other parts of thebody, such as the way one walks - with one side trying to compensate for the discomfort on the other side. I've set up my 3 visits for next week. A great first impression which encourages me to recommend them to others.
    Dennis Lynch
    11 years ago
    ★★★★★
    For the last four weeks, I have been receiving Shockwave treatment for my tennis elbow pain at DNR. Huge Improvement! In fact, my elbow pain is virtually nonexistent at this point. Lev Kalika, the clinical director at DNR, was extremely kind and helpful through the process. He was very patient, encouraging and knowledgeable when I asked him (a lot of!) questions. I highly recommend DNR and Lev for anyone suffering from elbow or heel pain, and any other physical therapy related matters.
    Ellen Selip
    4 years ago
    ★★★★★
    My plantar fascitis is GONE. Dr. Kalika treated me with shock wave therapy. Visits with an orthopedist with 2 cortisone injections did nothing to heal me. Thanks to NYDN I am pain free for the first time in six months.
    Gillian Small
    2 years ago
    ★★★★★
    I am a long distance runner and have been using them for several years - always with a great outcome. Shockwave therapy has been very successful and Dr. Kalika is very thorough.

    Lev Kalika Research at NYDNRehab

    Article

    2025

    EXTRACORPOREAL SHOCKWAVE THERAPY (ESWT) FOR NECK AND SHOULDER PAIN WITH SCAPULAR DYSKINESIS: NEUROPHYSIOLOGICAL EFFECTS AND OBJECTIVE EVALUATION

    • Lev Kalika
    • R. Bubnov
    https://cslide.ctimeetingtech.com/wcn25/attendee/eposter/poster/1170

    Article

    2025

    ENTHESES: EFFECT OF TARGETED ULTRASOUND-GUIDED EXTRACORPOREAL SHOCKWAVE THERAPY (ESWT) IN LIMB REHABILITATION

    • Lev Kalika
    • Rostyslav Bubnov
    https://cslide.ctimeetingtech.com/wcn25/attendee/eposter/poster/2221

    Article

    September 2025

    Extracorporeal shockwave therapy (ESWT) for neck pain and shoulder-scapular dyskinesis: An objective evaluation study

    • Lev Kalika
    • Rostyslav Bubnov
    https://nydnrehab.com/wp-content/uploads/2025/09/7-Kalika-ESWT-neck-pain-and-shoulder-dyskinesis.pdf

    Article

    June 6-9th 2024

    Precision and functional application of ultrasound-guided extracorporeal shock wave therapy in neuromusculoskeletal pathologies: A multicenter retrospective study. 26th ISMST World Congress

    • Lev Kalika
    • R. Bubnov
    https://www.researchgate.net/publication/381127702_Precision_and_functional_application_of_ultrasound-guided_extracorporeal_shock_wave_therapy_in_neuromusculoskeletal_pathologies_A_multicenter_retrospective_study

    Article

    Feb. 2024

    The efficacy of extracorporeal shock wave combined with platelet rich plasma in the treatment of knee osteoarthritis with meniscus injury: A retrospective analysis

    • Lev Kalika
    • R. Bubnov
    https://nydnrehab.com/wp-content/uploads/2024/04/The-efficacy-of-extracorporeal-shock-wave-combined-with-platelet-rich-plasma-in-the-treatment-of-knee-osteoarthritis-with-meniscus-injury.pdf

    Article

    Jul. 2022

    TARGETED ULTRASOUND-GUIDED SHOCKWAVE THERAPY OF LOW BACK PAIN USING FOCUSED, DEFOCUSED AND RADIAL SHOCKWAVE

    • Lev Kalika
    • R. Bubnov
    https://www.cochranelibrary.com/central/doi/10.1002/central/CN-02510614/full

    Article

    Sep. 2019

    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)

    • Lev Kalika
    • R. Bubnov
    https://nydnrehab.com/wp-content/uploads/2021/04/Comparative_study_of_dry_needling_under_ultrasound_guidance_and_extracorporeal_shock_wave_therapy_for_myofascial_pain_and_spasticity_management___Cochrane_Library.pdf

    Article

    Sep. 2019

    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)

    • Lev Kalika
    • R. Bubnov
    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?_sg=mRQnC1g9EnVayXXzNs6wiYywz6sFx87YOzXkkwtUuCIrHwoUq5nyuGNv_uRgJXcanxRV2TZai4VghWkRc13b1xLbt30QXxcjA01Wd3Gq.plPXULNE63bCBdXcVjAz8u89dZ1SRY8_Me-e-DuSYO9fWPmwQe1eKlT4KPs-GAQePOOGgcAGLVjtALvy-tJMPA
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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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