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Sonorex

Posted by Trish on 2/22/00 at 00:00 (016230)

I had my first Sonorex treatment last week. It definitely was painful, but only lasted about 10 minutes. Immediately after, and for about 24 hours, my foot felt good. Then it started to hurt again and got much worse over the weekend (both the treated foot and the untreated). I iced a lot and took some Celebrex on Sun. and Mon. It's feeling a somewhat better today. My concern is this: Since the treatment, I have pain in my arch, which I did not have before....Can the Sonorex actually damage previously undamaged tissue?? I sure hope this is just a temporary effect. I do realize that the benefits of shock wave therapy are usually not felt until 6 - 12 wks. after the last treatment, but i am worried about this new pain. Feedback, anyone? i go for my 2nd treatment on Thurs.
eswt

Re: Sonorex

Duane E on 2/23/00 at 00:00 (016232)

The high energy ESWT definitely damages tissue. Inducing inflammation is a large mechanism by which high energy ESWT works. Interfering with the inflammation process would impede healing. I don't know how much inflammation is typically induced by the Sonocur. David L hasn't responded to my inflammation question below.

After I was treated with the OssaTron there were many days where my foot was worse than before the treatment. You might want to talk with the people at Sonorex to get their opinion. Best of luck.

eswt

Re: Sonorex

Trish on 2/23/00 at 00:00 (016233)

Did you get any pain in new places, following the treatment? (such as the arch pain I now have).
eswt

Re: Sonorex

Duane E on 2/23/00 at 00:00 (016234)

I did get arch pain that lingered for several days, after I wore a new pair of running shoes. I switched back to my old shoes, and the arch pain dissipated over approximately three days.

eswt

Re: Sonorex

Dr. Zuckerman on 2/23/00 at 00:00 (016236)

I have found that patients will go a tired feeling in the arch after the high energy ESWT orbasone treatment at times. You need to rest the foot. Apply ice never go without shoes. Wear some kind of arch support. This does go away. The ESWT treatments do create trauma to the foot and you need to rest the foot. Most people get sorness, some get alot of pain. In my practice the pain goes away within a few days, but still don't go out and run the 100 yard dash. REST REST
eswt

Re: Sonorex

Trish on 2/23/00 at 00:00 (016248)

Thanks for your comments. I always wear orthotics or birks, never go without shoes and ice 2 or 3 times a day. At the Sonorex clinic, I was told to continue my activities as usual.....this I have been doing which includes teaching dance (tap and jazz) 3 times a week. On the weekend, when it was really sore I rested a lot; I definitely listen to my body. I am still worried about this new arch pain I have though, and will ask about it when I go for the treatment on Thurs. By the way, Sonorex is supposed to be low-energy shock waves, with 4 levels of intensity....I didn't make it past level 1...that was plenty PAINFUL for me!!! Also, there is no anasthetic or injection to freeze the area. I am still very hopeful!
eswt

Re: Sonorex

David L on 2/23/00 at 00:00 (016270)

Trish,
It's good that you are feeling pain after treatment, believe it or not. That means things have been 'stirred up' and blood flow is getting to the areas that it hasn't for awhile. When I had it done on my foot, I felt pain through the arch as well, but it subsided quickly.
You can continue with activities as normal with Sonocur, however, rest is better, as well as stretching.
On the topic of anasthetic, it is much more advantageous without it. You'll note how specific the shock waves are and if you are not right on the painful spot, it is not as successful. If you have to numb the area, your only guide is ultrasound or fluoroscopy. As you cannot 'see' pain, the chances are greater that the shock waves can miss the painful spot.
Regards
eswt

Re: Sonorex

Dr. Zuckerman on 2/23/00 at 00:00 (016271)

I have fluroscopy in my office. I find that palpation and knowing the anatomy of the foot and with attention to the medial tubercle is very important. I actually am doing in some bad cases the entire medial tubercle which is where all of the tendons and medial band PF attach to the heel. I will even do the lateral band insertion and the posterior aspect of the heel on the plantar surface where the achilles tendon attaches. This does take alot longer then twenty minutes, but the goal is rid the pateint of the patient with only one session if possible
eswt

Re: Sonorex

Trish on 2/23/00 at 00:00 (016273)

Thanks for your response. It seemed that EVERY spot was very painful, so what does that mean? Also, just because it hurt, I'm not about to give up. I'm still very hopeful, but not sure how to know where the 'right' spot is when every spot was really painful...Any thoughts on this?
eswt

Re: Sonorex

David L on 2/23/00 at 00:00 (016276)

Trish,
I understand about the painful spots. Glad to hear that you are going to stick with it. Essentially, the most tender spot is what you want to treat. I had 2 spots.....the inside front end of the heel and the outside of the ball of the foot. It resolved itself within a few days. It sounds like you've had it for a lot longer than me and it might take a while to heal. I stayed on 'level 1' for my first 2 treatments, then was able to go to level 2 for my last.
Regards,
David
eswt

Re: Sonorex

Duane E on 2/23/00 at 00:00 (016232)

The high energy ESWT definitely damages tissue. Inducing inflammation is a large mechanism by which high energy ESWT works. Interfering with the inflammation process would impede healing. I don't know how much inflammation is typically induced by the Sonocur. David L hasn't responded to my inflammation question below.

After I was treated with the OssaTron there were many days where my foot was worse than before the treatment. You might want to talk with the people at Sonorex to get their opinion. Best of luck.

eswt

Re: Sonorex

Trish on 2/23/00 at 00:00 (016233)

Did you get any pain in new places, following the treatment? (such as the arch pain I now have).
eswt

Re: Sonorex

Duane E on 2/23/00 at 00:00 (016234)

I did get arch pain that lingered for several days, after I wore a new pair of running shoes. I switched back to my old shoes, and the arch pain dissipated over approximately three days.

eswt

Re: Sonorex

Dr. Zuckerman on 2/23/00 at 00:00 (016236)

I have found that patients will go a tired feeling in the arch after the high energy ESWT orbasone treatment at times. You need to rest the foot. Apply ice never go without shoes. Wear some kind of arch support. This does go away. The ESWT treatments do create trauma to the foot and you need to rest the foot. Most people get sorness, some get alot of pain. In my practice the pain goes away within a few days, but still don't go out and run the 100 yard dash. REST REST
eswt

Re: Sonorex

Trish on 2/23/00 at 00:00 (016248)

Thanks for your comments. I always wear orthotics or birks, never go without shoes and ice 2 or 3 times a day. At the Sonorex clinic, I was told to continue my activities as usual.....this I have been doing which includes teaching dance (tap and jazz) 3 times a week. On the weekend, when it was really sore I rested a lot; I definitely listen to my body. I am still worried about this new arch pain I have though, and will ask about it when I go for the treatment on Thurs. By the way, Sonorex is supposed to be low-energy shock waves, with 4 levels of intensity....I didn't make it past level 1...that was plenty PAINFUL for me!!! Also, there is no anasthetic or injection to freeze the area. I am still very hopeful!
eswt

Re: Sonorex

David L on 2/23/00 at 00:00 (016270)

Trish,
It's good that you are feeling pain after treatment, believe it or not. That means things have been 'stirred up' and blood flow is getting to the areas that it hasn't for awhile. When I had it done on my foot, I felt pain through the arch as well, but it subsided quickly.
You can continue with activities as normal with Sonocur, however, rest is better, as well as stretching.
On the topic of anasthetic, it is much more advantageous without it. You'll note how specific the shock waves are and if you are not right on the painful spot, it is not as successful. If you have to numb the area, your only guide is ultrasound or fluoroscopy. As you cannot 'see' pain, the chances are greater that the shock waves can miss the painful spot.
Regards
eswt

Re: Sonorex

Dr. Zuckerman on 2/23/00 at 00:00 (016271)

I have fluroscopy in my office. I find that palpation and knowing the anatomy of the foot and with attention to the medial tubercle is very important. I actually am doing in some bad cases the entire medial tubercle which is where all of the tendons and medial band PF attach to the heel. I will even do the lateral band insertion and the posterior aspect of the heel on the plantar surface where the achilles tendon attaches. This does take alot longer then twenty minutes, but the goal is rid the pateint of the patient with only one session if possible
eswt

Re: Sonorex

Trish on 2/23/00 at 00:00 (016273)

Thanks for your response. It seemed that EVERY spot was very painful, so what does that mean? Also, just because it hurt, I'm not about to give up. I'm still very hopeful, but not sure how to know where the 'right' spot is when every spot was really painful...Any thoughts on this?
eswt

Re: Sonorex

David L on 2/23/00 at 00:00 (016276)

Trish,
I understand about the painful spots. Glad to hear that you are going to stick with it. Essentially, the most tender spot is what you want to treat. I had 2 spots.....the inside front end of the heel and the outside of the ball of the foot. It resolved itself within a few days. It sounds like you've had it for a lot longer than me and it might take a while to heal. I stayed on 'level 1' for my first 2 treatments, then was able to go to level 2 for my last.
Regards,
David
eswt