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bayshore post

Posted by bayshore on 7/07/02 at 19:00 (089247)

Recovery time for ESWT patients varies from person to person. Generally, the recovery period is between 6 and 12 weeks post ESWT treatment. At **bayshore**, a telephone follow-up assessment is routinely done 6 weeks after treatment. Most patients achieve a substantial improvement in their pain level (3.0 or less on the VAS scale) at the 6 week level. For others it may take up to 12 weeks.

Yet there appears to be a correlation between length of pain history and treatment outcome. For all tendinopathies (with the exception of Achilles tendonitis) it can be said that the shorter the history of pain, the better the result with ESWT treatment.
(Ref.: 'Correlation between Length of History and Outcome' by Drs. V. Auersperg, G. Labek, N. Boehler, Linz, Austria, 2000)
Surprisingly, in this study, ESWT treatment for Achilles tendonitis showed better results for patients with a longer history of pain (36 months). All other tendinopathies achieved better results the shorter the history had been prior to ESWT treatment. Further studies are required to find the reason for the differing Achilles tendonitis result.

At **bayshore** clinics we achieve very good pain reduction with ESWT treatment at the early stages of pain, particularly for athletes and those involve in active sports.
Without elaborating further on this subject, I believe that there may be a socio economic or political reason for the originally established ‘six months chronic' acceptance criterion for ESWT treatment.

For out-of-country patients **bayshore** still requests that the patient had a chronic condition of approx. 6 months for the following reasons:
a) By that time most patients have visited their family doctor or specialist and have a proper diagnosis, including x-ray, MRI, etc.
b) Most patients have already received a full range of conventional treatment and perhaps have to make a decision whether to undergo surgery as a last resort, or have ESWT.

Low or High Energy ESWT?
The majority of **bayshore**'s patients with tendinopathies receive low energy, multiple session (usually 3) ESWT treatment, combined with low intensity laser.
However, for some patients (usually those who had previous surgery) we generally recommend high energy ESWT, which also can be done at **bayshore**.
In rare cases (less than 0.4% of our patients) success was achieved only after a second 3 session treatment 12 weeks after the first treatment series.
Out of all patients treated over the past two years we had three cases who did not get any pain relief. There is no explanation for this. We continue to follow up with them.

The ESWT equipment is only a tool, and all equipments on the market work comparatively well and are safe. As I have stated previously, HMT, Dornier, Siemens, etc., are very reputable manufacturers. All of their equipments have proven to be safe and effective. However, just as with successful surgery, it is the skill and experience of the operator and the quality of the treatment protocol that can determine the success of the treatment outcome.