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. There are absolute contraindications against the use of shock wave therapy in people who have had 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 may be released too quickly if shock waves are applied to them. ESWT is contraindicated in pregnant patients, especially in the abdominal and pelvic regions, because of potential risks to the developing fetus. Although treating distal extremities may pose a lower risk, avoiding out-of-hospital therapy during pregnancy is generally recommended. The current recommendation is that shock wave therapy should not be used unless the underlying health condition has been present for six months or more.
Conservative therapy should 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 may be an excellent long-term solution. 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 are known (such as pain during ESWT and minor bruising), but serious complications are not expected if done as recommended. Contraindications are severe coagulopathy for high-energy ESWT and ESWT that focuses on the fetus or embryo and focuses on serious infection.
The use of ESWT should be taught to improve results. Courses must be organized by national societies, as the conditions of the legal framework are different from country to country. Extracorporeal shock wave therapy (ESWT) is a non-invasive form of treatment that has been developed based on ESWL (extracorporeal lithotripsy). by shock waves).
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 its amplitude.
The simplest oscillations, the so-called harmonic oscillations, are described mathematically by means of the angular functions of the sine or the cosine. The most complicated oscillations can be understood as superpositions of such simple oscillations. 11 Shock waves are mechanical waves, they propagate in a medium that also deforms or changes its density. The media that we must take into account are water and human tissues; water, because 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 time after the ESWT. If, for example, extrasensory therapy is used to treat tendons or bones, appropriate precautions must be taken to ensure that post-treatment stress 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 the cure takes time. Comorbidities should be discussed with patients, for example, those that may also have an effect on the healing process.29 We consider the fact that the treatment itself is unpleasant or painful to be 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 ESWT have been described, but it has not been possible to demonstrate that ESWT causes such changes with energy levels. recommended. 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 has weak points 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. While 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. Haake and 3 others published the first important article on the treatment of eSWT in radial epicondylitis, who, however, included a bias in the study. However, electrostatic therapy in radial epicondylitis was quickly established, but it is undoubtedly the one that has the worst results of all the recognized indications.
It is disappointing that other forms of treatment, such as cortisone injections, do not have better results, aside from short-term pain relief. ESWT is often offered on the elbow, but the evidence must be demonstrated in future studies. National Library of Medicine 8600 Rockville Pike Bethesda, MD 20894. 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.
Your healthcare provider should also give you instructions on how to prepare for treatment, such as avoiding certain activities or wearing loose-fitting clothing. Your provider should know the appropriate technique and dosage for the condition being treated, which can help minimize the risk of complications. If you experience any serious side effects, it's important to seek immediate medical attention. And finally, be sure to follow your provider's instructions on how to prepare for treatment to help prevent side effects from occurring in the first place.
However, deciding whether to choose shock wave therapy over another type of healing technique is ultimately up to you and your doctor. The uses of shockwave therapy have increased since this treatment was invented more than 50 years ago, and researchers are still discovering new ways to use low-energy shockwaves to help patients deal with pain and regenerate tissues. 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. Shockwave therapy is also known as extracorporeal shockwave therapy (ESWT) or radial shockwave therapy (RSWT).
Extracorporeal shock wave therapy is a non-invasive procedure that uses shock waves. to treat musculoskeletal conditions. 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. Generalized shock waves, such as those produced by SofWave therapy, combine the advantages of both, since they allow surface and deep tissues to be treated without causing microtrauma.
The current recommendation is that shock wave therapy should not be used unless the underlying health problem has been present for 6 months or more. While Shockwave is suitable for a large number of conditions, both tested and experimental, with minimal side effects, there are some conditions, also known as contraindications, for which Shockwave is not an option. In the 1990s, scientists began studying the effects of high-energy shockwave therapy on soft tissue injuries. The best way to minimize the risks associated with shock wave therapy is to choose a qualified provider.
Using shockwave therapy too close to open or post-surgical wounds could lead not only to wound degradation, but also to increased bleeding and delayed healing. In many cases, a combination of focused shock wave therapy and radial pressure waves provides optimal results. Both high-energy and low-energy shock wave treatments work by sending pulses of energy to the injured area.