If you are pregnant; if you have a blood clotting disorder (including thrombosis); if you are taking oral anticoagulants; if you have received a steroid. While there are a large number of cases and situations in which shock wave therapy is appropriate and where experiments have shown that they produce minimal side effects, contraindications have demonstrated that, in some conditions, the use of shock waves is not a safe option. In those cases, the Shockwave method is not suitable because it could cause serious harm to the patient. Professional evaluation is always necessary to take such determination.
Experience has shown that people with certain medical histories and conditions tend to have an adverse reaction to Shockwave. The current recommendation is that shock wave therapy should not be used unless the underlying health condition has been present for 6 months or longer. However, there is increasing anecdotal evidence presented by professional and professional sports teams across Europe that indicates that the risks associated with the early use of shockwave therapy are low. Avoiding more conservative guidelines and using Shockwave in situations where there are contraindications involves many serious risks. The consequences of using Shockwave incorrectly can be dire.
While expanding the boundaries of shockwave therapy can sometimes offer benefits, the “safety first” approach protects the lives and health of the general population. The use of shock wave therapy in a localized area, such as the ankle of a pregnant woman, is not recommended, but it poses minimal risk to the fetus. Treating a 70-year-old patient with chronic tendinopathy with shock waves may seem safe, but if a previously administered cortisone injection caused a tendon to rupture, shock wave therapy would cause unbearable pain. Contraindications are designed to protect people.
Contraindications for the use of shock wave therapy can be divided into two groups. They are absolute contraindications and relative contraindications. Conditions that have absolute contraindications for the use of shock wave therapy mean that it should not be used at all. In cases where there are relative contraindications, shock wave therapy should be used with extreme caution.
However, regardless of how clear and distinct a patient's symptoms are, it is essential that they undergo appropriate screening tests so that the shockwave doctor has the accurate information needed to decide if he is a suitable and safe candidate for shockwave treatment. Patients with chronic pain often ask for and request shock wave treatment despite its numerous and serious contraindications, as it has the potential to alleviate pain quickly and durably without the need for injections or surgery. However, if used following appropriate protocols, shock wave therapy can cause positive biological effects that can promote healing, improve blood flow and accelerate tissue regeneration. Contraindications should make doctors reflect on contraindications. The therapy can cause serious long-term health problems if contraindications are ignored and Shockwave is used indiscriminately.
The use of shock wave therapy on, near or around eye tissue is strictly prohibited. The tissue in and around the eye is fragile and delicate. This makes the eye very susceptible to being negatively affected by shock waves and to suffering serious, serious, debilitating and permanent damage that can affect the patient's ability to see clearly. There are absolute contraindications designed to warn Shockwave professionals against using the therapy in any area near or around the brain.
It is clearly established that the shock wave can release destructive forces, which, observed in transitions, have demonstrated their ability not only to potentially damage brain matter, but also to destroy it. The risk of serious and permanent brain damage is too high to attempt to obtain the therapeutic benefits of shockwave therapy anywhere near the brain or brain tissue. The use of shock wave therapy should be avoided in areas close to or near major blood vessels, both the neck and of the thigh. The presence of the shock wave in or around those sensitive areas has the potential to damage major blood vessels in those areas and put patients at an extremely high risk of suffering catastrophic bleeding.
It is forbidden to use shock wave treatment on or near open or postoperative wounds, regardless of whether or not they have been stabilized by the use of glue, stitches or strips. It is very clear that the shock wave can cause serious damage to tissues and local circulation. Using shockwave therapy too close to open or post-surgical wounds could lead not only to wound degradation, but also to increased bleeding and a delay in healing. There are absolute contraindications against the use of shock wave therapy in people who have implanted devices or hormones implanted.
Shockwave therapy uses waves that are both positive and negative. Any of these types of waves has the potential to damage nerve stimulators and other types of implanted devices. Waves can cause unwanted effects and equipment failures. Implanted hormones could be released too quickly if shockwaves were applied to them. Shockwave therapy is dangerous to use in people with open growth plates.
This is because shock waves can damage the plates. As a result, the growth plates may close too quickly, their growth may be delayed, or the shock wave may cause excessive growth of the plates. None of this bodes well for the patient. Shock wave treatment in areas close to the genitals is usually excluded. However, research on shockwave therapy for erectile dysfunction has shown that, if done with care, shockwave treatment in the genital area can be safe and effective.
Shockwave treatment in the stomach area of a pregnant woman is an absolute contraindication because, even at low doses, shock waves can negatively affect the fetus. However, using the Shockwave treatment on a pregnant woman's foot can be relatively safe if done with care. If proper precautions are taken during treatment, shock wave therapy can be used in patients with coagulation disorders or those who are taking blood thinners. The danger is that high-pressure or high-frequency shock waves can cause bleeding.
Shockwave therapy used in appropriate environments can prepare patients to receive new implants by loosening previously implanted joints. Shock waves can also stimulate bone growth around implanted joints. If these are not the results desired by the doctor, shock wave therapy is contraindicated and should not be used. There are relative contraindications for the use of shock wave therapy in people with infections.
It can increase cell production and that can negatively affect people with infections. However, shock waves stimulate the growth of healthy tissue and may be useful for treating cysts. Shockwave therapy has relative contraindications when treating cancerous tissue because, while it can stimulate cell growth, shockwaves can also destroy cancerous tissue. Steroid injections can weaken an area and the use of shock wave therapy immediately afterward can cause serious damage.
Doctors are advised to wait 4 to 6 weeks after the injection before using shockwave therapy. The relative and absolute contraindications for the use of shock wave therapy are designed to provide guidance to professionals and protect patients. Before receiving shockwave therapy, it's important to talk to your shockwave therapy provider about any underlying medical conditions or medications you're taking. Certain medical conditions may prevent you from receiving shockwave therapy, while certain medications should not be taken before treatment.
An official website of the United States government Official websites use. gov A. The gov website belongs to an official government organization of the United States. Extracorporeal shock wave therapy (ESWT) is a safe therapy and only a few side effects (such as pain during ESWT and minor bruising) are known, but serious complications are not expected if done as recommended.
Contraindications are severe coagulopathy in the case of high-energy ESWT and ESWT, which focuses on the fetus or embryo and focuses on serious infections. The use of the ESWT should be taught to improve the result. Courses must be organized by national societies, as the conditions of the legal framework are different from one country to another. Extracorporeal shock wave therapy (ESWT) is a non-invasive form of treatment that has been developed based on ESWL (extracorporeal shock wave lithotripsy).
The development of the EWST, basic theoretical physical knowledge and different application devices, such as focusing devices (electrohydraulic, piezoelectric, flat electromagnetic, cylindrical electromagnetic) and radial devices, which are also called ballistic, began with the first applications that were tested on bones by orthopedic surgeons and traumatologists in Germany and Bulgaria. Several researchers from different locations discovered and tried to use the effects of shock waves on bones relatively simultaneously. 1,2 In orthopedics, many other indications have emerged relatively quickly, in addition to application to bones, and the ESWT has expanded rapidly. This was almost the end of orthopedic and traumatology surgery, but an initiative of the German Society for Orthopedics and Traumatology contributed to its further development. Three multicenter studies were initiated, the results of which put the ESWT in a new scientific position.
Although the work of the working groups around Michael Haake (Philipps-Universität-Marburg Resp. The University of Regensburg) did not find any positive ESWT results in the treatment of lateral epicondylitis3,4.The multicenter study conducted by Ludger Gerdesmeyer (Technische Universität München) showed significantly better results with ESWT than with a placebo.5 Extracorporeal shock wave therapy was developed based on extracorporeal shock wave lithotripsy (ESWL). Lithotripsy studies on the effects of shock waves on the different tissues of the body that come into direct or indirect contact with shock waves have also focused on bones and other tissues of the musculoskeletal system, demonstrating that shock waves can have a positive effect on a wide variety of tissues, 6-11 The various ESWT devices produce different types of pressure waves and shock waves that generate. All of these devices produce more or less concentrated pressure waves and shock waves, except radial devices, which produce pressure waves, which are not focused and have the greatest energy in the area where the applicator supplies mechanical energy to the body, superficially on the skin.
To be able to address the nature of shock waves, one has to deal with waves in general, then one can deal with the differences between more or less high energy pressure waves and shock waves. According to Harten, an “oscillating structure” has a well-defined rest position in which it can remain permanently. 12 If it deviates from this position, the driving forces attempt to return it to the rest position. The characteristic value of the oscillation is its natural frequency and amplitude. The simplest oscillations, the so-called harmonic oscillations, are described mathematically using the angular functions of the sine or cosine.
The most complicated oscillations can be understood as superimpositions of such simple oscillations. 11 Shock waves are mechanical waves, they propagate in a medium which also deforms or changes its density. The media that we must take into account are water and human tissue; water, due to the fact that all measurements are performed in water, and human tissue, because it is the objective of the ESWT in all orthopedic indications. The deformation is reversible thanks to its restorative force.
The transmission of a shock wave or pressure wave produces effects on the tissue. The transformation of physical energy into a biological response is similar to a cascade process. First, the cell skeleton's attachments are activated, leading to the release of mRNA from the cell nuclei. This is followed by the activation of cellular organs, such as mitochondria and the endoplasmic reticulum, and cellular vesicles, which release proteins specific to the healing process.
Wang's research group showed several working mechanisms that fit this idea of mechanotransduction, as ESWT users call the cascade. 15 Animal models show that ESWT induces free radicals and oxygen radicals, which induce the production of a series of growth factors. 16 urologists have used ESWL to break down kidney stones. This must be explained to the patient accordingly and also affects the recommendations for the subsequent time.
to the ESWT. If, for example, ESWT is used to treat tendons or bones, appropriate precautions must be taken to ensure that stress after treatment does not compromise the healing process. As can be seen from the mechanisms of action, the technique of extracorporeal therapy can accelerate tissue healing, but basic principles must be guaranteed, such as immobilization during bone healing; otherwise, the regenerative tissue would be destroyed every time the fracture hole moved. It is very important to convey to the patient that healing takes time.
Comorbidities should be discussed with patients, for example, those that may also affect the healing process. 29 We consider that the fact that the treatment itself is unpleasant or painful is a side effect, not a complication. ESWT can cause redness and superficial bruising on the skin, due to the pain that occurs during ESWT. The patient may develop a vago-vascular reaction and become dizzy, and deeper skin lesions are not unknown.
Complications that occurred after the ESWT have been described, but it has not been possible to demonstrate that the ESWT causes such changes with the recommended energy levels. The multiple cortisone infiltrations in the run-up to ESWT, which are described, are most likely to cause necrosis of the humeral head.30 ESWT has been more successful in the routine treatment of heel ailments, such as plantar fasciitis, and in insertive tendinopathy of the Achilles tendon and acylodynia of the middle portion. In this case, the data situation is quite good, despite the fact that the literature presents weaknesses in relation to this indication. The Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen47 thoroughly examined the evidence in favor of the use of ESWT in heel claims, and this research led to the conclusion that health insurance companies in Germany have to bear the costs of the ESWT without further ado because the examination provided sufficient evidence. The previous publications are much weaker; on the one hand, no significant success was achieved compared to a placebo when local anaesthesia was used,4,48 or a very heterogeneous patient population was invited to receive treatment, which would not have facilitated randomization, 49 although there were studies that had demonstrated good success of ESWT in plantar fasciitis, 49—57 The list could be expanded, but there are publications that have shown good results with radial and focusing devices.
There are also studies comparing ESWT with other therapies, such as cortisone. Although ESWT has no detrimental effect on tendon tissue, unlike cortisone, the results are inconclusive. As with plantar fasciitis, there are many publications on Achilles tendinopathy that show that ESWT can produce a good effect. Very quickly it was established that this treatment should not be carried out without recovery gymnastics, especially in achilodynia, 58 Rompe et al addressed recovery gymnastics and ESWT in subsequent studies and emphasized their positive interaction, after researching the two therapies and their effect compared to each other, and other colleagues also demonstrated the positive effect of ESWT in relieving pain in the Achilles tendon, 59-64 The use of ESWT in calcium the fixed shoulder was developed because it was initially wrongly assumed that the 'lime' may detach from the tendon, as can kidney stones, which are crushed and these fragments are then discharged down the ureter. But it became clear that it was the effect on the tissue that induced healing and not the “destructive” effect of shock waves. The first important article on ESWT in radial epicondylitis was published by Haake and 3 others, who, however, included a bias in the study.
However, treatment with eswtt in radial epicondylitis was quickly established, but it is undoubtedly the one with the worst results of all the recognized indications. It is disappointing that other forms of treatment, such as cortisone injections, have no better results, other than short-term pain relief. Extracorporeal therapy is often offered, but evidence must be demonstrated in studies futures. National Library of Medicine 8600 Rockville Pike Bethesda, MD 20894. ESWT is contraindicated in pregnant patients, especially in the abdominal and pelvic regions, due to potential risks to the developing fetus.
Although treating distal extremities may pose a lower risk, avoiding out-of-hospital electrostatic therapy during pregnancy is generally recommended. The current recommendation is that shockwave therapy should not be used unless the underlying health problem has been present for six months or more. Conservative therapy must be the first line of defense. This includes rest, ice, stretching, and strengthening through physical therapy exercises.
Often, this treatment, which is done consistently and over time, will alleviate the musculoskeletal problems mentioned above. Medications, such as NSAIDs and pain relievers, are often used. These treatments usually only provide short-term relief. Corticosteroid injections may also be beneficial for short-term pain relief.
If your condition causes chronic pain after conservative treatment and medication, shock therapy can be an excellent long-term solution. Shockwave therapy has been used in medicine for decades to treat urological problems, such as the removal of kidney stones. Extracorporeal shock wave therapy (ESWT) is a safe, non-invasive, clinically proven treatment that uses a probe to transmit shock waves directly through the skin to attack specific areas of damaged tissue. While there is an absolute contraindication against using shock wave therapy directly on major nerves, it is acceptable to use shock wave therapy treatment on areas around major nerves.
Shock wave therapy, also known as extracorporeal shock wave therapy, is delivered to a tendon or muscle through the skin with a small portable device similar to an ultrasound scanner. However, it's important to understand the potential risks and side effects of shockwave therapy before continuing treatment. It is strongly recommended not to apply shock wave treatments anywhere on the surface of the lungs or shock wave treatments to areas of the body that may cause the shock wave to be inadvertently directed towards the lungs. In the 1990s, scientists began studying the effects of high-energy shockwave therapy on soft tissue injuries.
If you've had an injury to a tendon, elbow, or hamstring, your doctor may recommend shock wave therapy. Shockwave therapy involves delivering shock waves to injured soft tissue to reduce pain and promote healing. The best way to minimize the risks associated with shock wave therapy is to choose a qualified provider.