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second treatments

Posted by marcia on 12/09/00 at 10:35 (034531)

What is the percentage of patients who have had to have second and third treatments? Can there be continued improvement after 12 weeks of initial treatment? After 10 weeks, I'm not sure if it has worked...my feet still hurt!

Re: second treatments

Dr. Zuckerman on 12/09/00 at 16:49 (034549)

Hi,

There are no studies to confirm or disprove that ESWT is stilling helping the foot after 12 weeks. If you got improvement or no improvement from the first treatment you can have a second treatment. Additional ESWT treatments are benefical. This is a quote from the recent textbook on ESWT. This is also my personal experience. In my practice it is about thirty percent that will need or want a second treatment.

Re: second treatments

Jen Ross on 12/09/00 at 22:33 (034569)

Dr. Z.

Hi. You told me that there is evidence that accumulative shock wave therapy is beneficial. In order for the therapy to be 'accumulative' does the second treatment need to be given before the 12 week period from the 1st treatment is over? If so, today marks 6 weeks since my first ESWT and I don't feel any better...at what point do I start to seriously consider doing the second treatment? And...if I do not have any success with the first treatment, isn't it possible that a second treatment will also fail? (I know...that's the pessimistic attitude, but at this point it's difficult to be overly optimistic. Even Christmas shopping, something I normally love to do, is pure torture.)

Jen Ross

Re: second treatments

Dr. Zuckerman on 12/10/00 at 19:54 (034623)

It is possible that the second treatment could do the trick. If you are in alot of pain and no improvement then this would be the time to do another treatment. I have had cases where no relief 2nd. and then the third cured the foot I have had cases where no relief first and then second did it.. So any time before 12 weeks is good. I would want you to have the 2nd treatment within the twelve period. So lets set up a time as soon as you can do this. Just e-mail katie at cheerkat24@hotmail.com or call at 1-856-848-3338 and tell the office when you want to come in. If want my office to call you just let me know and I will have them call you.

Re: second treatments

Jen Ross on 12/11/00 at 12:40 (034690)

OK. I should be able to make it out to NJ either the 1st or 2nd Saturday in January (either Jan. 6 or 13) and I will e-mail Kate about putting me on the schedule. My basic concern with having a second treatment is the tingling sensation I get when you tap on the inner side of my foot, just below the ankle bone. I don't think I had this before the EWST. My local doc is concerned that it could be TTS. Do you think this is a temporary condition brought on by the ESWT? Could a second treatment make it worse?

Re: second treatments

Dr. Zuckerman on 12/11/00 at 21:48 (034707)

I don't see how ESWT could bring on TTS unless the treatment was directly into the area of the Tarsal Tunnel, which your treatment wasn't . The literature does talk about a temporary neuritis but I don't believe it is in the area that you are talking about. So let me check this information at.
There is mention in the ossatron FDA reports I believe, about a temporary tingling but I have to take a look to see where in the foot this occurred.

Re: second treatments

Dr. Zuckerman on 12/09/00 at 16:49 (034549)

Hi,

There are no studies to confirm or disprove that ESWT is stilling helping the foot after 12 weeks. If you got improvement or no improvement from the first treatment you can have a second treatment. Additional ESWT treatments are benefical. This is a quote from the recent textbook on ESWT. This is also my personal experience. In my practice it is about thirty percent that will need or want a second treatment.

Re: second treatments

Jen Ross on 12/09/00 at 22:33 (034569)

Dr. Z.

Hi. You told me that there is evidence that accumulative shock wave therapy is beneficial. In order for the therapy to be 'accumulative' does the second treatment need to be given before the 12 week period from the 1st treatment is over? If so, today marks 6 weeks since my first ESWT and I don't feel any better...at what point do I start to seriously consider doing the second treatment? And...if I do not have any success with the first treatment, isn't it possible that a second treatment will also fail? (I know...that's the pessimistic attitude, but at this point it's difficult to be overly optimistic. Even Christmas shopping, something I normally love to do, is pure torture.)

Jen Ross

Re: second treatments

Dr. Zuckerman on 12/10/00 at 19:54 (034623)

It is possible that the second treatment could do the trick. If you are in alot of pain and no improvement then this would be the time to do another treatment. I have had cases where no relief 2nd. and then the third cured the foot I have had cases where no relief first and then second did it.. So any time before 12 weeks is good. I would want you to have the 2nd treatment within the twelve period. So lets set up a time as soon as you can do this. Just e-mail katie at cheerkat24@hotmail.com or call at 1-856-848-3338 and tell the office when you want to come in. If want my office to call you just let me know and I will have them call you.

Re: second treatments

Jen Ross on 12/11/00 at 12:40 (034690)

OK. I should be able to make it out to NJ either the 1st or 2nd Saturday in January (either Jan. 6 or 13) and I will e-mail Kate about putting me on the schedule. My basic concern with having a second treatment is the tingling sensation I get when you tap on the inner side of my foot, just below the ankle bone. I don't think I had this before the EWST. My local doc is concerned that it could be TTS. Do you think this is a temporary condition brought on by the ESWT? Could a second treatment make it worse?

Re: second treatments

Dr. Zuckerman on 12/11/00 at 21:48 (034707)

I don't see how ESWT could bring on TTS unless the treatment was directly into the area of the Tarsal Tunnel, which your treatment wasn't . The literature does talk about a temporary neuritis but I don't believe it is in the area that you are talking about. So let me check this information at.
There is mention in the ossatron FDA reports I believe, about a temporary tingling but I have to take a look to see where in the foot this occurred.