Home The Book Dr Articles Products Message Boards Journal Articles Search Our Surveys Surgery ESWT Dr Messages Find Good Drs video

Definition of high and low energy

Posted by Sunny Jacob - Bayshore on 7/07/02 at 21:25 (089264)

Throughout the literature, the experts distinguish between high and low energy ESWT as follows:
High energy: Energy flux density 0.2 to 0.4 mJ/mm2
Low energy: Energy flux density <0.1 mJ/mm2
(Ref.: International Journal of Technology Assessment in Healthcare 16:1 (200)

Note: Though each equipment may have energy level settings from 1 to 9, etc., one should not confuse this with the energy flux density in mJ/mm2
For successful results, low energy ESWT requires treatment with multiple sessions.

Re: Definition of high and low energy

Peter R on 7/09/02 at 08:46 (089343)

Can we have a layman's version of this please, the info provided means nothing to me.

Many thanks

Re: Definition of high and low energy

Sunny Jacob - Bayshore on 7/09/02 at 11:51 (089348)

Peter,
Unfortunately, I cannot help you too much with this.
Perhaps you can ask your clinic to show you their equipment's technical manual. If the manual states the energy flux density, than you can compare the numbers for high or low energy (as I have described in my previous message). Some equipment manufacturers may deliberately avoid to publish this data in the manual.
Sorry I am unable to explain this physics queston in a simple way or in a few sentences.

Re: Definition of high and low energy

David L on 7/17/02 at 10:55 (089869)

Whether the machine is high or low energy may not necessarily matter to the efficacy for the treatment of heel pain or other enthesiopathies. What does matter is the protocol which is used for the treatment. Generally speaking, lower energy ESWT is performed for heel pain in multiple sessions and may not require local anesthetics or conscious sedation with anesthesia. For some this may be an advantage due to certain patient fears of anesthesia. .(Often times treatment without anesthesia produce uncomfortable results during the procedure.)

However, in my experience, a one time treatment protocol with a moderate to high energy system like EPOS under a local anesthetic is preferable for most patients. The EPOS machine can be performed with a local anesthetic. The Ossatron really requires sedation added to it or else the patient feels a lot of discomfort during the treatment

For other indications such as non-union fractures sites a high energy machine is recommended.

Re: Definition of high and low energy

Peter R on 7/09/02 at 08:46 (089343)

Can we have a layman's version of this please, the info provided means nothing to me.

Many thanks

Re: Definition of high and low energy

Sunny Jacob - Bayshore on 7/09/02 at 11:51 (089348)

Peter,
Unfortunately, I cannot help you too much with this.
Perhaps you can ask your clinic to show you their equipment's technical manual. If the manual states the energy flux density, than you can compare the numbers for high or low energy (as I have described in my previous message). Some equipment manufacturers may deliberately avoid to publish this data in the manual.
Sorry I am unable to explain this physics queston in a simple way or in a few sentences.

Re: Definition of high and low energy

David L on 7/17/02 at 10:55 (089869)

Whether the machine is high or low energy may not necessarily matter to the efficacy for the treatment of heel pain or other enthesiopathies. What does matter is the protocol which is used for the treatment. Generally speaking, lower energy ESWT is performed for heel pain in multiple sessions and may not require local anesthetics or conscious sedation with anesthesia. For some this may be an advantage due to certain patient fears of anesthesia. .(Often times treatment without anesthesia produce uncomfortable results during the procedure.)

However, in my experience, a one time treatment protocol with a moderate to high energy system like EPOS under a local anesthetic is preferable for most patients. The EPOS machine can be performed with a local anesthetic. The Ossatron really requires sedation added to it or else the patient feels a lot of discomfort during the treatment

For other indications such as non-union fractures sites a high energy machine is recommended.