Extracorporeal
Shockwave
Therapy
ESWT / EPAT

Our physicians and staff at New York Dynamic Neuromuscular Rehabilitation are now pleased to offer Extracorporeal Shock Wave Therapy, or ESWT and Extracorporeal Pulse Activation Technology or EPAT to our patients who suffer from neuromuscular disorders. Dr.Kalika has been an active member of ISMST (international society of medical shockwave) since 2007 and performed over two thousand procedures for different tendon anatomical locations. Our results with extracorporeal shockwave therapy have been exceptional because we perform targeted treatment under diagnostic ultrasound guidance and combine it with very comprehensive rehabilitation approaches such as eccentric training and biomechanical correction.

Extracorporeal Shockwave Therapy (ESWT) and Extracorporeal Pulse Activation Technology (EPAT) are the most advanced and highly effective non-invasive treatments for neuromuscular disorders approved by the FDA. This proprietary technology is based on a unique set of pressure waves that stimulate the metabolism, enhance blood circulation and accelerate the healing process. Damaged tissue gradually regenerates and eventually heals. This non-invasive office/clinic based procedure represents a breakthrough treatment option for a broad range of musculoskeletal conditions. Plantar fasciitis is a common injury suffered by people who play sports, especially sports that require a lot of running and jumping on hard surfaces. Between 2000 and 2005, about a million people visited their doctor with this disorder. The plantar fascia, a thick band of fibrous tissue that begins at the heel then subdivides to end at the base of all five toes. This band helps to support the arch of the foot when a person stands up and stabilizes the foot when he or she walks. With plantar fasciitis, the band becomes inflamed. It’s also not unusual for the doctor to discover a spur of bone at the heel when the foot is X-rayed. The spur results because the heel bone, or calcaneus is irritated by the tendon that fixes it to the plantar fascia. The bone responds by depositing calcium in the area. A person who has plantar fasciitis will experience pain on the underside of his or her heel that’s usually at its worst when he or she first wakes up in the morning. Interestingly, exercise may stop the pain, but it will return later. Pain may also flare up after the person rests for a long period. A bone spur, if it’s present, will also cause pain.

ESWT is a regenerative of treatment for tendon, muscle and bone disorders. This technology produces high frequency sound waves which initiate body’s own reparative reaction in case of chronic degenerative tendon condition. It is also very effective treatment for myofascial pain syndrome. ESWT and EPAT are used interchangeably even though the wave delivered to the tissues is different. In first case it is a true shockwave energy delivered to the tissues. In the second case it is mechanical pressure wave which is delivered to the tissues. With exception of small tendons and places where access to tendon is anatomically restricted shockwave and pressure waves have similar effect. Years of research have proved that high energy or low energy waves produce similar effect over different time frame. At DNR we use both technologies depending on the clinical presentation and on the nature of the patient’s injury.

As with a surprising number of other therapies, a bit of damage needs to be done to the body to get it to repair the injury. In the case of shock wave and pressure wave therapies, tiny ruptures are created in the capillaries that serve the bones and the tendons of the area of injury. This prompts the body to start producing new blood vessels to replace the ones that were damaged. These tiny blood vessels in turn increase the blood supply to the area of the injury. When the blood supply is increased, so is the amount of healing oxygen.

The inflammation of plantar fasciitis can also be reduced by actually increasing the number of substances which cause inflammation. Chronic inflammation occurs when the inflammation response is not completely halted. It can damage healthy areas in the body and can result in chronic pain. The activity of mast cells, which are involved in inflammatory process, may be increased by pervasive acoustic waves. EPAT test Extracorporeal Shock Wave Therapy can stimulate mast cells, which produce inflammatory substances like cytokines and chemokines. These substances can also help the body heal and regenerate healthy cells. The shock and pressure wave therapies can also cause the body to produce more collagen. Collagen is a protein that’s found all over the body that helps give tendons and ligaments their structure. The collagen the body produces after shock wave therapy produces tendons that are stiffer and denser than usual.

In growth of Neovascularization nutrient blood flow is necessary to start and maintain the repair processes of damaged tissue structure. The application of acoustic waves creates capillary micro-ruptures in tendon and bone and significantly increasing the expression of growth indicators such as the eNOS, VEGF, PCNA and BMP. These two processes stimulate the growth and remodeling of new arterioles. The new blood vessels will improve the blood supply and the oxygenation resulting in the faster healing of both tendon and bone.

The production of sufficient amounts of collagen is a necessary precondition of the tissue repair process. Shockwave therapy hastens procollagen synthesis. The newly created collagen fibers are forced into a longitudinal structure. These newly formed tendon fibers are denser and stiff. Trigger points are the principal cause of pain in the back, neck, shoulder and limbs. They are associated with palpable nodules in taut bands of muscle fibers and have extremely contracted sarcomeres. The dysfunctional sarcomeres contract so tightly that they begin to cut off their own blood supply. This causes the build-up of waste products which in turn, irritates the sensory nerve endings which then causes yet more contraction. This vicious cycle is referred to as a metabolic crisis. Although the precise medical effects of acoustic wave therapy are still unclear, it can be assumed that the delivered acoustic energy unblocks the calcium pump. Thus, it reverses the metabolic crisis in the myofilaments and releases these trigger points.

New York Dynamic Neuromuscular Rehabilitation uses several modalities to diagnose plantar fasciitis, including ultrasound and clinical examination. If the case is complicated, we can even analyze the patient’s gait using a computerized video. Patients who wonder about ESWT Extracorporeal Shock Wave Therapy Cost should know that New York Dynamic Neuromuscular Rehabilitation accepts most health insurance plans and will happily set up payment schedules with our patients. The good news about shock and pressure wave therapies are that they are very effective, with studies reporting a success rate of about 92 percent. Contact us for a consultation on the benefits of Extracorporeal Shock Wave Therapy ESWT plantar fasciitis.

Reversal of Chronic Inflammation

Chronic inflammation occurs when the inflammation response is not completely halted. It can damage healthy areas in the body and can result in chronic pain. The activity of mast cells, which are involved in inflammatory process, may be increased by pervasive acoustic waves. Mast cell activation may be followed by the synthesis of chemokines and cytokines. The releasing of pro-inflammatory compounds, when needed, may help to restore the normal healing and regenerative processes.

Stimulation of Collagen

The production of sufficient amounts of collagen is a necessary precondition of the tissue repair process. Shockwave therapy hastens procollagen synthesis. The newly created collagen fibers are forced into a longitudinal structure. These newly formed tendon fibers are denser and stiff.

Release of Trigger Points

Trigger points are the principal cause of pain in the back, neck, shoulder and limbs. They are associated with palpable nodules in taut bands of muscle fibers and have extremely contracted sarcomeres. The dysfunctional sarcomeres contract so tightly that they begin to cut off their own blood supply. This causes the build-up of waste products which in turn irritates the sensory nerve endings which then causes yet more contraction. This vicious cycle is referred to as a metabolic crisis. Although the precise medical effects of acoustic wave therapy are still unclear, it can be assumed that the delivered acoustic energy unblocks the calcium pump. Thus, it reverses the metabolic crisis in the myofilaments and releases these trigger points.

Treatable Disorders
  • Rotator cuff tendonitis
  • Plantar fasciitis
  • Tennis elbow (radial epicondylitis)
  • Golfers elbow (medial epicondylitis)
  • Tendinosis calcarea (calcific disease of rotator cuff tendons)
  • Hip bursitis/tendinosis
  • Sheen splints
  • Patellar tendonitis ( jumpers knee)
  • Tibialis anterior syndrome
  • Stress fractures
  • Stress reactions
  • Sesamoiditis
  • Metatarsalgia
  • Achilles tendonitis
  • Achillodynia
  • Low back pain
  • Scar tissue treatment
  • Morton’s neuroma
  • Many other conditions not listed above
  • SLAP
  • initial Spondylolysis
  • painful hip impingement caused by an Os acetabuli
  • necrosis of the femoral head
  • bone bruise of the femoral neck
  • Osteochondritis dissecans of the medial femoral condyle
  • Osgood-Schlatter disease
  • nonunion of a distal fibular fracture
  • 4th metatarsal stress fracture
  • navicular stress fracture
  • sesamoid Osteochondrosis
  • painful Os tibiale externum
  • apophysitis calcanei
  • Heel spurs
  • Hallux limitus
  • Hamstring disorders
  • Tendinosis of : peroneal tendons, tibialis posterior
  • Various chronic enthesiopathies (painful irritation of tendon attachments due to overexertion and improper strain, or due to a degenerative process)
  • TMJ
  • Frozen shoulders
  • Bone non unions
  • Osgood-Schlatters disease
  • Various sports injuries
  • Painful trigger points(acute and chronic painful neck, back, shoulder and etc. due to chronically shortened and thickened muscle tissue)
  • Bursitis (Bursitis is inflammation of a bursa. The major bursae are located adjacent to the tendons near the large joints, such as the shoulders, elbows, hips, and knees.)
What are the indications for ESWT?
Experience
Dr.Kalika has been an active member of ISMST (international society of medical shockwave) since 2007 and performed over two thousand procedures for different tendon anatomical locations. Our results with extracorporeal shockwave therapy have been exceptional because we perform targeted treatment under diagnostic ultrasound guidance and combine it with very comprehensive rehabilitation approaches such as eccentric training and biomechanical correction.
WHY CHOOSE US
  • Best way to treat tendon injuries
  • Used by professional athletes
  • We have treated over 2000 patients since 2008
  • FDA approved
  • The only shockwave machine which combines focused and radial (EPAT)

Extracorporeal Shockwave Therapy ESWT / EPAT

Testimonials

How-Myofascial-Release-Therapy-Helps-Reduce-or-Eliminate-Chronic-Pain

How Myofascial Release Therapy Helps Reduce or Eliminate Chronic Pain

Just as your skin surrounds and supports your entire body, your fascia provides a second system of support, forming a web of tissue that encompasses your muscles, connective tissue, bones, nerves, blood vessels, and visceral organs, right down to the cellular level. Healthy fascia is supple and elastic, providing support without restricting the underlying structures. […]

Read More (0)

February 27, 2018

10-Rules-for-Managing-Lower-Limb-Tendon-Pain

10 Rules for Managing Lower Limb Tendon Pain

Tendons are made of strong tough connective tissue that is continuous with your muscles. They cross over joints to anchor your muscles to bones, enabling movement. Because they are subjected to high forces when you sprint, jump and make rapid directional changes, tendons sometime become sore or even ruptured. Knowing how to properly treat your […]

Read More (0)

July 31, 2017

130 west 42 street, suite 1055 New York, NY 10036

Contact Us



You can call
or Send message
1-866-311-5889