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possibly free ESWT!!!!

Posted by elliott on 7/26/02 at 16:55 (090703)

Here's an article from the July 21 Chicago Tribune:

http://www.chicagotribune.com/features/health/chi-0207210376jul21.story

Sonic tonic
Sounds waves offer hope for alternative to foot surgery

By Mel Novit
Special to the Tribune
Published July 21, 2002

People with foot problems no longer need to fear being sidelined for several weeks by surgeries. A non-invasive technique can have them back on their feet and back to work as soon as the next day, according to Dr. Lowell Weil Jr. of the Weil Foot and Ankle Institute in Des Plaines.

Weil should know. As foot doctor to the Chicago White Sox and the Chicago Bears, he has performed extracorporeal shock wave therapy on scores of professional athletes and has watched some go out on the playing field the next day.

Known as ESWT, the equipment delivers controlled blasts of sound waves, which have been used since the 1980s to break up kidney stones. Now it is being used to treat heel problems such as plantar fasciitis, Achilles' heel pain, tendonitis, bone bruises and some arthritic conditions.

Weil also is the only physician using ESWT on Morton's neuroma, an excruciating nerve condition between the third and fourth toes.

ESWT proved successful in European studies as far back as 1990 for musculoskeletal and tendon problems but did not make its way to the United States until 1997.

Weil has helped certify about 150 doctors to perform the procedure in the Midwest, but he added that so far his is the only clinic in the Chicago area that owns the equipment and has it on site.

The first FDA trial in this country was performed on the heels of 314 patients at random sites by Healthtronics Surgical Services Inc., of Marietta, Ga. As a result of that trial, the Ossa Tron ESWT system was approved by the FDA in October 2000.

The most common problem

The most common heel problem treated, plantar fasciitis, is a condition that causes heel pain with each step. The plantar fascia is a broad, thick ligament that starts at the heel bone and attaches to the tips of all the toes. Its function is to support the arch.

Once the plantar fascia becomes irritated due to excessive walking, ill-fitting shoes or exercise, it becomes thickened and can actually pull the lining of the bone off the heel. Weil estimated that hundreds of thousands of people suffer from this condition in the United States.

The Weil Foot & Ankle Institute since has treated 300 patients with ESWT. In his study, presented in the Journal of Foot & Ankle Surgery on June 10, Weil reported that 82 percent of the patients treated for heel problems ranged from satisfied to very satisfied, and more than 50 percent of them were at least 50 percent improved.

Patients used a scale of pain ranging from 1 to 10 and recorded their levels of pain, he said, such as when they got out of bed in the morning, the most painful time, and at various other times throughout the day.

Sox trainer Herm Schneider said ESWT was used on six players in the last year with 'good results.'

'By using low-intensity ESWT [that allows for repeated treatments], I was able to . . . get my players out on the field the next day,' said Schneider, adding that he had the therapy on his own ankle.

'I have no doubt it's the way of the future. It's unbelievable for chronic problems,' he said.

When ESWT is used on tendons and ligaments, the deep sound waves are aimed at the damaged, thickened and poorly nourished areas of the soft tissue in the heel. ESWT breaks up the damaged tissue so it can heal from within. Animal studies have shown that this process promotes new blood vessel formation in the damaged tissue, allowing one to walk in comfort again, said Dr. Thomas S. Roukis, a surgeon at the Weil Institute.

For this and all other ESWT procedures, patients are put into a twilight sleep while the energy is focused on areas as precise as a centimeter by half a centimeter to avoid injuring surrounding tissue, Roukis said.

'I believe that this process will eventually replace [all] foot surgery, and in my practice it has replaced surgery already,' Weil said. But he is quick to point out that ESWT is the last of several steps that would precede surgery. 'Although ESWT is considered low risk because there is no cutting, it is not a procedure that can be undertaken in unskilled hands,' he said.

Dr. Jan D. Rompe, 'the father of ESWT' and renowned orthopedic surgeon at Johannes Gutenberg University School of Medicine in Mainz, Germany, agreed.

'Shock wave therapy can do a lot of harm in the hands of an unskilled practitioner. The users of this equipment have to be acutely aware of the topographical anatomy of the area intended to be treated,' he said.

He emphasized that no treatment can be carried out safely by a technician; 'a trained surgeon is a must. This is especially important when applying high-energy shock waves for a non-union [broken bone that won't heel] or calcifying tendonitis.'

The range of future applications of ESWT is enormous. 'We have only chipped away at one-eighth of the iceberg [of possibilities], with seven-eighths unexplored,' said Dr. John Ogden, an orthopedic surgeon in Atlanta and president of the International Society of Musculoskeletal Disorders. Ogden is going to be conducting special studies using ESWT on tennis elbow and knee problems in the near future.

Needs more study

Weil said he is not yet convinced of the 'curative effects' long term because his study was only nine months long. And despite long-range European studies and a five-year study by Ogden showing 'few recurrences,' the procedure is not yet perfect.

Linda Gribus, a 52-year-old hairdresser in the Chicago area, experienced recurrence of her heel pain about a month after she was treated but then started using an orthotic device.

'I'm on my feet all the time and walk five miles several times a week. The pain got so bad I couldn't walk, and I wondered how long I'd last in the business, when I heard about shock wave treatment,' she said.

'I was about 80 percent better immediately after the treatment, but a month later it [the pain] came back,' she said.

At that time, Gribus was fitted with an orthotic, and she now is about 90 percent better overall.

'I am very happy with the procedure, and as long as I wear my shoes, I am almost back to normal,' she said.

James F. Haworth, 67, of Orland Park said he was in terrible heel pain for two years. He tried numerous treatments, including acupuncture.

'I couldn't walk a block; now I can walk the mall two times. That's about two miles,' he said. 'I was 100 percent better right after the procedure, and now I'm about 90 percent a year afterward. It was like a miracle, and it even got rid of my spider veins,' he said.

All surgeons agree that ESWT should be used only after more conservative measures have been exhausted over a period of six months. When all other avenues of treatment have been tried, most health-care plans will cover the procedure, which costs about $5,000.

Put to the test

In early August, the Weil Foot & Ankle Institute in Des Plaines will begin FDA trials to evaluate the safety and effectiveness of three shock wave machines.

People with chronic heel pain of greater than six months' duration and those who have unsuccessfully undergone non-operative treatment may be eligible to enter the studies.

If eligible, there will be no direct cost to the patient. For more information, call 847-390-7666, ext. 200.

Copyright 2002, Chicago Tribune

Re: possibly free ESWT!!!!

Dr. Zuckerman on 7/26/02 at 17:02 (090704)

Its the Big O machine from Norland Medical that is now called Orthometrix

Re: possibly free ESWT!!!!

Elizabeth B. on 7/28/02 at 01:24 (090784)

I would like to know what I need to do to become eligible for the study. I am a nurse and mom of a six year old and have been having bilateral heel pain for at least seven months now and the pain is getting worse. Although I have not seen a physician I know that the problem is plantar fasciitis. Both my mother and brother have been diagnosed by physicians, and I am having the same type of problems. I have tried various shoes, taping, icing, NSAIDS, exercises, shoe inserts, and I am looking for another option. I am 42 years old and do not want to give up my life to pain. Please respond ASAP.

Re: possibly free ESWT!!!!

Dr. Zuckerman on 7/28/02 at 08:59 (090787)

You have to contact Dr. Weil in Chicago. I believe that you need to have conservative therapy by a doctor to qualify for the study. The typical study is that you had at least three treatments by a doctor to qualify for the study but I would call Dr. Weil and ask exactly what the criteria is for the orbasone study

Re: possibly free ESWT!!!!

Elizabeth B. on 7/30/02 at 00:26 (090959)

Could you provide me with the phone number to Dr. Weil in Chicago? Your prompt response is greatly appreciated.

Thank you,

Elizabeth Bowler

Re: possibly free ESWT!!!!

john h on 7/30/02 at 09:16 (090978)

Elizabeth: A few years ago Dr. Weil returned my call and I live in Little Rock so he will take the time to visit with you. Also, Dr. Gordon a well known Orthopedic Surgeon in Vancouver who is a Guru when it comess to PF will call you. He called me and talked to me for 20 minutes about ESWT. He uses several machines including the Ossatron and Sonoccur depending on your condition. He has presented lectures on ESWT in Europe at the International ESWT Conventions. You can get his number probably from Sunny or through Bayshore (www.bayshore.com) where he is a consultant since he has his own private practice. Dr. Zuckerman will also gladly talk with you on the phone.

Re: And the number is.....

BrianG on 7/30/02 at 22:00 (091059)

Hi Elizabeth,

If you look at the bottom of Eliott's post, you'll find the telephone number for Dr. Weil's trials, It is (847) 390-7666, ext 2000. Since this machine (The 0rbasone) has been banned by the FDA, you might want to see something official from them, that they are now allowing him to begin the trials. Good luck, and make that call, if you are still interested. These trials tend to fill up quickly.

BrianG

PS Part of the trials, requires going back to his office for numerous visits, to see how your progressing. Do you live near Chicago?

Re: possibly free ESWT!!!!

Dr. Zuckerman on 7/26/02 at 17:02 (090704)

Its the Big O machine from Norland Medical that is now called Orthometrix

Re: possibly free ESWT!!!!

Elizabeth B. on 7/28/02 at 01:24 (090784)

I would like to know what I need to do to become eligible for the study. I am a nurse and mom of a six year old and have been having bilateral heel pain for at least seven months now and the pain is getting worse. Although I have not seen a physician I know that the problem is plantar fasciitis. Both my mother and brother have been diagnosed by physicians, and I am having the same type of problems. I have tried various shoes, taping, icing, NSAIDS, exercises, shoe inserts, and I am looking for another option. I am 42 years old and do not want to give up my life to pain. Please respond ASAP.

Re: possibly free ESWT!!!!

Dr. Zuckerman on 7/28/02 at 08:59 (090787)

You have to contact Dr. Weil in Chicago. I believe that you need to have conservative therapy by a doctor to qualify for the study. The typical study is that you had at least three treatments by a doctor to qualify for the study but I would call Dr. Weil and ask exactly what the criteria is for the orbasone study

Re: possibly free ESWT!!!!

Elizabeth B. on 7/30/02 at 00:26 (090959)

Could you provide me with the phone number to Dr. Weil in Chicago? Your prompt response is greatly appreciated.

Thank you,

Elizabeth Bowler

Re: possibly free ESWT!!!!

john h on 7/30/02 at 09:16 (090978)

Elizabeth: A few years ago Dr. Weil returned my call and I live in Little Rock so he will take the time to visit with you. Also, Dr. Gordon a well known Orthopedic Surgeon in Vancouver who is a Guru when it comess to PF will call you. He called me and talked to me for 20 minutes about ESWT. He uses several machines including the Ossatron and Sonoccur depending on your condition. He has presented lectures on ESWT in Europe at the International ESWT Conventions. You can get his number probably from Sunny or through Bayshore (www.bayshore.com) where he is a consultant since he has his own private practice. Dr. Zuckerman will also gladly talk with you on the phone.

Re: And the number is.....

BrianG on 7/30/02 at 22:00 (091059)

Hi Elizabeth,

If you look at the bottom of Eliott's post, you'll find the telephone number for Dr. Weil's trials, It is (847) 390-7666, ext 2000. Since this machine (The 0rbasone) has been banned by the FDA, you might want to see something official from them, that they are now allowing him to begin the trials. Good luck, and make that call, if you are still interested. These trials tend to fill up quickly.

BrianG

PS Part of the trials, requires going back to his office for numerous visits, to see how your progressing. Do you live near Chicago?