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Re: ESWT Benefits

Posted by David L on 2/21/00 at 00:00 (016158)

Mike,
I read your response to Jan's problem and just wanted to make a couple of points:
1. ESWT is NON-INVASIVE. It is an acoustic shock wave that sends pulses of energy directly to the point of pain. High energy machines such as the Ossatron require the use of anesthesia (that is invasive; however, ESWT devices such as the Sonocur & some Dornier treatments are low energy and don't require any anesthesia. (note: they are also more effective as the patient directs the treatment to the most tender area)

2. 'It is expensive'. With the Canadian $ exchange rate, a series of treatments for about US$500 (granted, travel to Canada not included) is quite reasonable compared to months and months of time and physio. As for a guarantee, I know of no medical treatments that guarantee relief of pain...but a 75-90% success rate is very good.

3. ESWT is not new....it's treated over 300,000 patients in Germany for 5 years with tremendous results and very few problems.

4. You are right that ESWT does not address the underlying cause of PF. It is a device for the relief of pain. It is very important that people who have ESWT use orthotics, physio, braces, splints etc.

ESWT has the following effects which relieves pain:

The effective result of this graduated program of Extracorporeal Shockwave Therapy is a change in the physical, chemical and biological composition of the soft tissue. Researchers have hypothesized that the treatment causes the following changes:

Extracorporeal Shockwave Therapy causes physical changes in the cell membrane of nerves inhibiting the sensation of pain.

Shock waves cause chemical alteration and/or formation of chemical compounds in the affected area resulting in a reduction of painful stimuli.

Hyperstimulation analgesia occures when low energy shock waves stimulate nerves through a complicated pathway eventually inhibiting pain transmission. This effect allow the patient to experience minimal increase in pain during the procedure.

Neovascularization: Shock waves focused by the Extracorporeal Shockwave Therapy therapy device induce increased blood supply in the treated area.

Regards,
David E. Lowy
Vice President, Canada
Sonorex Therapy Centers
501-1367 West Broadway
Vancouver, BC V6H 4A7
Tel: (604) 714-0523 Toll Free: 1 (877) 766-6287 Fax: (604) 714-0542
http://www.sonorex.com dlowy@sonorex.com



eswt


Re: ESWT Benefits

rekha.s on 2/21/00 at 00:00 (016161)

just wondering: does ESWT treat bursitis?
eswt

Re: ESWT Benefits

David L on 2/21/00 at 00:00 (016163)

Yes...very effectively. Bursitis, as long as it is 'point specific' is highly successful. Is it in your hip... ie...trochanteric bursitis?
The effect of ESWT on the injury is much the sams as on tendinitis.
Increased vascularity directly to the point of pain reduces the inflammation.
David
eswt

Re: ESWT Benefits

Jan P on 2/21/00 at 00:00 (016164)

read information from David L
eswt

Re: ESWT Benefits

rekha.s on 2/21/00 at 00:00 (016169)

wow! that is great news....

I developed infrapatellar bursitis after being casted for PF.
I knelt a lot while in a cast, which caused the bursa just underneath the patella to get inflamed. It has calmed down a bit, but not gone & is painful when climbing stairs etc.. I was thinking about going to Canada for ESWT before being casted, but my husband thought I should wait for knee to heal. Maybe I can have right knee and left foot done at once.

Can I e-mail you with further ques?
eswt


Re: ESWT Benefits

Dr. Zuckerman on 2/21/00 at 00:00 (016170)

I am in agreement with David L. ESWT isn't new at all. The underlying problem if it is a tear of the PF, the ESWT is treating the cause. As in any treatment whether it be ESWT or surgery or PT,the underlying cause must be addressed or an attempt to address it .I am havng some great results with ESWT in the past month. I have been using the orbasone which is much like the osstran execept that I am a podiatrist who is practicing in the good old USA. So don;t travel to Canada, stay in the USA . If you want the addresses of the three docs in the USA e-mail at (email removed)
eswt

Re: ESWT Benefits

Dr. Zuckerman on 2/21/00 at 00:00 (016171)

I will be performing a trochanteric bursistis on a nurse from my hospital in the next few weeks. The orthopedica surgeon who is treating her found out about ESWT and want to do this before open excision which is a down time of six -eigth weeks.
So long as it insertional pain and point pt, there is a very good chance of cure with ESWT
eswt

Re: ESWT Benefits

Duane E on 2/22/00 at 00:00 (016175)

Would you say that the low energy ESWT, which the Sonocur performs, induces little or no inflammation in the treated region?


eswt


Re: ESWT Benefits

David L on 2/22/00 at 00:00 (016189)

I agree with your husband about waiting for the knee to heal.
R.I.C.E. should be the first line of treatment. I'm sure you have tried that, as well as anti-inflammatories.
ESWT should definitely be tried before casting. You just have to decide whether you want low energy or high energy ESWT, and compare the costs of the treatments. Where do you live? That may be a deciding factor.
eswt

Re: ESWT Benefits

Rob on 2/28/00 at 00:00 (016527)

Hello David L. I just want to point out two issues that you mentioned. The first is when you stated that patients directing the treatment to the most tender area with low intensity treatments are being treated more effectively such as with the Dornier and the Sonocur devices. From speaking with the germans for over three years now I don't believe that patient feedback to the most painful area is an acurate way to do ESWT. The pain caused from the tendon could start elsewhere and be transmitted to that one hot spot. It seems that a better way of treating is to treat the hot spot and a large area surrounding it as well. The more tissue that is treated the better your chances of eliminating the pain entirely. The other point I want to make is when you wanted to compare the results that were being seen in germany to what is expected in the U.S. Germans treat with multiple treatments with lower intensity than we plan on using in the states. They try to eliminate the use of anesthesia while we want to treat with one treatment at high intensities which requires anesthesia. We have to worry about cost effectiveness so our goal is to treat once. Since our treatment parameters will be different then theirs we may expect to see different side effects and/or possibly a higher or lower pain free rate. We will know in about 3-6 months.
posted to the eswt board

Re: ESWT Benefits

rekha.s on 2/21/00 at 00:00 (016161)

just wondering: does ESWT treat bursitis?
eswt

Re: ESWT Benefits

David L on 2/21/00 at 00:00 (016163)

Yes...very effectively. Bursitis, as long as it is 'point specific' is highly successful. Is it in your hip... ie...trochanteric bursitis?
The effect of ESWT on the injury is much the sams as on tendinitis.
Increased vascularity directly to the point of pain reduces the inflammation.
David
eswt

Re: ESWT Benefits

Jan P on 2/21/00 at 00:00 (016164)

read information from David L
eswt

Re: ESWT Benefits

rekha.s on 2/21/00 at 00:00 (016169)

wow! that is great news....

I developed infrapatellar bursitis after being casted for PF.
I knelt a lot while in a cast, which caused the bursa just underneath the patella to get inflamed. It has calmed down a bit, but not gone & is painful when climbing stairs etc.. I was thinking about going to Canada for ESWT before being casted, but my husband thought I should wait for knee to heal. Maybe I can have right knee and left foot done at once.

Can I e-mail you with further ques?
eswt


Re: ESWT Benefits

Dr. Zuckerman on 2/21/00 at 00:00 (016170)

I am in agreement with David L. ESWT isn't new at all. The underlying problem if it is a tear of the PF, the ESWT is treating the cause. As in any treatment whether it be ESWT or surgery or PT,the underlying cause must be addressed or an attempt to address it .I am havng some great results with ESWT in the past month. I have been using the orbasone which is much like the osstran execept that I am a podiatrist who is practicing in the good old USA. So don;t travel to Canada, stay in the USA . If you want the addresses of the three docs in the USA e-mail at (email removed)
eswt

Re: ESWT Benefits

Dr. Zuckerman on 2/21/00 at 00:00 (016171)

I will be performing a trochanteric bursistis on a nurse from my hospital in the next few weeks. The orthopedica surgeon who is treating her found out about ESWT and want to do this before open excision which is a down time of six -eigth weeks.
So long as it insertional pain and point pt, there is a very good chance of cure with ESWT
eswt

Re: ESWT Benefits

Duane E on 2/22/00 at 00:00 (016175)

Would you say that the low energy ESWT, which the Sonocur performs, induces little or no inflammation in the treated region?


eswt


Re: ESWT Benefits

David L on 2/22/00 at 00:00 (016189)

I agree with your husband about waiting for the knee to heal.
R.I.C.E. should be the first line of treatment. I'm sure you have tried that, as well as anti-inflammatories.
ESWT should definitely be tried before casting. You just have to decide whether you want low energy or high energy ESWT, and compare the costs of the treatments. Where do you live? That may be a deciding factor.
eswt

Re: ESWT Benefits

Rob on 2/28/00 at 00:00 (016527)

Hello David L. I just want to point out two issues that you mentioned. The first is when you stated that patients directing the treatment to the most tender area with low intensity treatments are being treated more effectively such as with the Dornier and the Sonocur devices. From speaking with the germans for over three years now I don't believe that patient feedback to the most painful area is an acurate way to do ESWT. The pain caused from the tendon could start elsewhere and be transmitted to that one hot spot. It seems that a better way of treating is to treat the hot spot and a large area surrounding it as well. The more tissue that is treated the better your chances of eliminating the pain entirely. The other point I want to make is when you wanted to compare the results that were being seen in germany to what is expected in the U.S. Germans treat with multiple treatments with lower intensity than we plan on using in the states. They try to eliminate the use of anesthesia while we want to treat with one treatment at high intensities which requires anesthesia. We have to worry about cost effectiveness so our goal is to treat once. Since our treatment parameters will be different then theirs we may expect to see different side effects and/or possibly a higher or lower pain free rate. We will know in about 3-6 months.
posted to the eswt board