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Ossatron treatment

Posted by Pauline on 4/23/03 at 15:07 (116941)

I think I recall there was someone that had ESWT treatments done using the Ossatron machine to BOTH feet at the same time?

Does anyone recall this? Did they post any follow up on their double treatments?

Re: Ossatron treatment

Pauline on 4/23/03 at 19:01 (116958)

A search showed at least two people had both feet treated with the Ossatron at the same time. John M who's last post was 1/30/02 and Cindy K. from 1/07/01.

If these posters are still around would you mind up dating us on your experience and outcome thus far? Would you recommend to readers that have bilateral PF to have both feet done at the same time?

Please give us feed back now that your treatment is over a year old.

Re: Ossatron treatment

Ed Davis, DPM on 4/24/03 at 18:45 (117020)

Every patient I know who has bilateral PF treated via ESWT has opted for doing both feet at the same time.

Re: Ossatron treatment

Pauline on 4/24/03 at 19:47 (117028)

Dr. Ed,
The Ossatron people claim that patients are treated and return to work the next day like they are pain free, yet our posters report after having ESWT they are in considerable pain from the treatment that hammered their feet.
How do the Ossatron patients walk when they have both feet done at the same time?

Surely they are telling us the truth. How much pain have your patients experienced following ESWT treatment when you use the high power machines?

I used to feel comfortable reading that patients were haveing ESWT and hoping that they would become pain free from their PF, but I'm not so sure any more, and not sure the additional pain that they go through following the treatment and money spent is worth it.

We're not seeing that many cured postings, but we see failed cases, and people posting that they are in more pain following the treatment than before the treatment.

Is the JAMA article coming back to haunt us? Why all the swelling, pain and repeat treatments and so few happy endings to these stories.

Re: Ossatron treatment

Cherie on 4/24/03 at 21:51 (117042)

I had Ossatron treatments on both feet on Nov 7, 2002. I think my case is the exception to the rule because the podiatrist accidentally hit my nerve when he was numbing my foot. It is almost 6 months later and I have had no pain in my heels since the surgery. There is no way that you could return to work the next day, my feet were swollen, red and tender to the touch. I had intended on going to work on Mon after my treatment on Fri, but because of the nerve injury I was out of work for 2 months and am still suffering from numbness, pain, and lots of other side effects from this little mishap. On my foot that was not injured with the injection, I did not have much pain after. I think that 'normally' you would have very little pain after a couple of days and the pain related to the ESWT was not very bad after the first night in my case. I've been to several doctors since my surgery and my orthopedic surgeon also does the Ossatron and he says it appears that my PF is gone, if I could just get over this injury caused by the doctor I'd be in great shape. If you have any questions, e-mail me and I'll be glad to answer...Good Luck

Re: Ossatron treatment

john h on 4/25/03 at 10:13 (117076)

Cherie: Your comments pose a question I have for some of the experts. I have seen a number of post from people who have had the Ossatron treatment. A number have posted with results similar to yours in that there feet were sore, red, swollen,etc. In most cases this subsided with time. I have not heard of any such results with the EPOS. I still want to know if the Ossatron is a more powerful machine than the EPOS as Dr. Gordon advised me to go with the Ossatron on a foot that had previous surgery (scar tissue). Perhaps this swelling,soreness,etc is because of the wider beam of the Ossatron. I just do not know but it would seem to have some indication that more power is being applied in one way or the other. I have seen the numbers about the power reaching the focal point being very similar with the two machines but real world reports from patients show more after effects from the Ossatron.

Re: Ossatron treatment

john h on 4/25/03 at 10:21 (117077)

For what it is worth Pauline I had three ESWT treatments with the Orby on both feet at the same time without any ankle blocks. Supposedly it is a high power machine and I know the setting to be around 18KV. I walked out of Dr. Z'S. Office, drove to D.C., walked through the airport, on to St Louis and walked through the airport for a few hours, and then on to Little Rock and through the airport. I really did not notice much with my feet at all. From most of the reports I read from Ossatron patients it seems they have a much different experience which leads one to believe that it is either a more powerful machine or for what ever reason is doing more damage. I noticed no effect from the EPOS and walked out and caught a plane immediately out of St Louis to Little Rock.

Re: Ossatron treatment

Pauline on 4/25/03 at 11:06 (117085)

Although Cherie thinks that her case may be an exception which may well be true about her additional injection, I don't think her response to the Ossatron is too far off.

I've been going back and reading posts from Ossatron patients and many report similar after affects. Definately not the comfort levels that we read about with the Dornier.

The do mention swelling, lots of soreness which seems to take days if not months to go away and some even go as far to say they are in worse pain after the treatment than before.

That's why I wish Sunny would post their patients responses to the Ossatron treatment. Being shot through the base of the foot, just like getting a steroid injection in the bottom, has to have an added kick.

Perhaps it's a combination of it's strength, how it's delivered, and it's focal area, but it seems to definately pack a larger punch than the Orbie,
or Dornier machines.

Regardless of what your experience was with the Orbie, I doubt you'd be able to withstand the Ossatron treatment without anesthesia. There talking in most centers general anesthesia, that's got to mean big, bad pain that doesn't numb the foot as the progress through the treatment.

I'd like to know how they adjust it for atypical cases located only in the arch area. That really sounds like big time ouch to me.

Re: Ossatron treatment

dave r on 4/25/03 at 13:30 (117106)

I had eswt with the dornier epos twice and i had alot of swelling and alot more pain for the better part of three months. To me the procedure was very painful and it took alot of time to get back to wear i was before i had the treatment. I take daily notes on my foot pain so it is easy for me to say this. I will also say that haveing the plantar fasciotomy was much less painfull than having the eswt done. I know that it hard for some to believe but it is true. that maybe because i sat on my but for 6 weeks but all the same it really wasnt bad........

Re: Ossatron treatment

rekha s on 4/25/03 at 13:58 (117114)

I am one that has had both the orby and ossatron....with the orby I just walked out of the office...no anesthesia or block....was only mildly uncomfortable.....

however the ossatron was a different ballgame altogether...needed an ankle block...and even with the block, the pain on right side of ankle was unbearable, so the dr had to stop and administer more block....foot was swollen, and painful....for a good 2 weeks...it is now starting to subside....and am noticing my feet are close to what they weree prior to treatment...

two very different approaches...I liked the orby better.....

Re: Ossatron treatment

paula a on 4/26/03 at 10:42 (117181)

I had bilateral ossatron treatments in December.It was done under IV sedation no local or block. I only had mild heel pad soreness for about three days. Compared to my PF pain the post ossatron pain was minimal.
For 10 days both feet were 100% pain free but then the symptoms returned to my right foot. It was my worse foot. Today I am still dealing with the
severe pain to my right foot. Soon I hope to have a dornier treatment.
The ossatron is a high intensity shock wave where as the dornier ia a variable intensity but ultra sound guided. You have visualization of the
PF with the dornier unlike the blind sweep with the ossatron. I had 2000
shocks per foot with the ossatron from what I've read the average with dornier is 3500. I hope the retreat with my right foot is successful this time. I realy dread having a EPF done. I would like to hear from people
that had EPF's done.

Re: Ossatron treatment

Pauline on 4/26/03 at 13:31 (117187)

Hope the Dornier does the trick for you. It's disappointing for us as readers and patients to have our bubbles burst and hope begin to deminish about the ESWT treatments.

Re: Ossatron treatment

Sunny Jacob, Bayshore on 4/26/03 at 16:13 (117197)

I shall try my best to answer your question regarding our direct experience with Ossatron and the outcome of the patients who received PF treatment (unilateral or bilateral). This requires some explanation and background of the proprietary ESWT combination therapy we do routinely for all tendonitis using Sonocur with in-line ultrasound imaging without anesthesia.
Patients who seek our service receive detailed explanations about our treatment protocol prior to their arrival, including our recommended 3-session combination therapy, i.e. low intensity ESWT and low intensity laser. This therapy requires approx. 4 hours of total treatment time allocation over a period of 4 days.
However, if the patient insists to receive single session high energy ESWT with Ossatron then they will be booked for that. This is performed by Dr. Gordon and an anesthetist and is done under I.V. sedation. For bilateral PF with Ossatron it is recommended to receive treatment in separate sessions, several weeks apart.
I occasionally attend Ossatron treatment sessions. My main interest, however, is in the above mentioned low intensity ESWT/Laser combination therapy developed in our clinic and research in that field. Please refer to my paper presented at the ESWT symposium in Germany on our website, first page, under NEWS.
There is a noticeable difference in post treatment between patients who received high energy ESWT with Ossatron and those who received the low energy combination therapy. The most noticeable difference is the post treatment pain, swelling and the recovery period after high energy Ossatron treatment.
As far as the outcome is concerned, to date we do not have sufficient data to compare the long tem results of high energy Ossatron vs. low energy Sonocur, although it was our intention (Dr. Gordon and I) to do a comparative study.
It is my observation that the lack of an in-line ultrasound and larger focal area of Ossatron is not ideal to treat tendonitis (in comparison to other equipment available on the market).
I do recommend Ossatron for non-union or delayed union of fracture treatment where it has a high success rate. Dr. Gordon is well experienced in this area and gives lectures to teaching institutions in the U.S.
My further interest is low intensity ESWT combination therapy for the treatment of Peyronie's Disease. We hope to start treating patients on a trial basis soon. This will be the first such clinic in North America. For those who are interested, information on Peyronie's is available on the following websites: http://www.peyronies.org , http://www.peyroniesassoc.org , http://www.impotence.org.uk/peyronies/

Re: Ossatron treatment

Pauline on 4/26/03 at 22:52 (117208)

Thank you so much for your response. I like all aspects of Bayshore. Your expertise, willingness to answer all questions and the fact that you have two type of ESWT available.

After reading so much about the various treatments on this site and that last paper by Dr. Rompe if I needed ESWT because my PF kicks in again I think I'd try Bayshore and begin with the lower power machine because I like what you've told us about it. I like the fact that you don't need anesthesia and that the treatment builds up over time.

If I didn't get any improvement then I'd look into the Espos and Ossatron. Everyone responses differently, but why not try lower power first before bringing on the big gun.

I remember in 2000 before our trip to Spain, I spoke to Dr. Galea about the Ossatron. He said he would treat me before the trip, but I'm glad I didn't have the treatment. I don't know how I would have made it through the short time I was there. As it turned out, I left my husband and family in Spain a few days after we arrived and flew home because of the PF. My feet were sore enough. I can only imagine the additional pain that would have been caused by the Ossatron given just days before we left.

Spain certainly isn't as handicap accessible as Canada. If my PF kicks in again I hope you'll treat me.

Re: Ossatron treatment

Dr. Z on 4/27/03 at 18:24 (117232)

This is an interesting topic. One thing to add. The ossatron TECHNIQUE is to move the shockhhead around in a circular path wich does deliver shockwaves to a much wider area. This is done routinely with the ossatron.
Long term comparative results comparing low vs high will be interesting to review. Have any FDA low energy double blind randonized pf studies started yet?

Re: Ossatron treatment

Ed Davis, DPM on 4/28/03 at 14:29 (117268)

I cannot speak for the 'Ossatron people' but I would never promise someone the ability to return to work the next day unless, perhaps, they had a desk job.

Re: Ossatron treatment vs. Sonocur

Ed Davis, DPM on 4/28/03 at 14:35 (117270)

I have used the Ossatron, Dornier EPOS and the Sonocur. As you know, my preferred machine is the Sonocur, although the Dornier can be used in a similar fashion but is not for insurance purposes. It appears that the important factor is the total amount of energy provided to the tissues and the safest, most comfortable and cost effective way is to do that with low energy.

Re: Ossatron treatment vs. Sonocur

Pauline on 4/28/03 at 17:46 (117285)

Dr. Davis,
You and Sunny have begun to sway my thinking and vote toward the Sonocur machine. I certainly didn't think this way before, but not seeing people posting the great results expected out of the Dornier machine frankly I'm dissappointed.

I'm thinking why bring on the big guns if the Sonocur will do the trick. If Sonocur doesn't work then add one of the other higher power machines. This would sure seem to save on useless beating up of foot tissue and achieving no results.

Re: Ossatron treatment vs. Sonocur

Dr. Z on 4/28/03 at 18:20 (117289)

Hi Dr. Ed,

Is the dornier High energy protocol used for insurance purposes only? Do you know if Soncur is going to apply for FDA approval for Pf?

Re: Ossatron treatment vs. Sonocur

Ed Davis, DPM on 4/28/03 at 18:23 (117290)

The neat thing about the EPOS is that it can be used at low energy levels although third parties in the US could challenge that for now.

Re: Ossatron treatment vs. Sonocur

Ed Davis, DPM on 4/28/03 at 18:29 (117291)

Dr. Z:
I cannot say for sure but have run into some insurers insisting on 'high energy' for one treatment since there is not an officially approved low energy protocol by the FDA yet for PF. My situation is that it would be hard, logistically, to get the people from United Shockwave to allow use of their machine times three since it is a mobile unit for now. (PS I met with one of the United execs from Chicago last weekend and encouraged him to contact you per our prior discussion).

I believe that Sonocur is going to apply for FDA approval for PF and hopes to have it in place by the end of the year but do not have specifics yet. They need to move on this issue due to third party considerations.

Re: PS Orthometrix

Ed Davis, DPM on 4/28/03 at 18:32 (117292)

PS Orthometrix is due to re-introduce the Big-O. I don't know what their timetable is. I have been dealing with them concerning another one of their procducts, the Galileo 2000 which I will use to help rehab lateral ankle instability.

Re: Ossatron treatment vs. Sonocur

Dr. Z on 4/28/03 at 18:32 (117293)

What I have found is all three machines can cause pain after the procedure.
There are some Sonocur postings where patients had pain that they considered very high post treatment pain levels. I sure wish there was a way to predict post-eswt pain levels . We can only estimate from experience. I find that most patients have very little pain from ESWT treatments whether high or low energy. The THEORY behind low energy multiple treatments is that when you add up the total energy levels it produces the same amount of trauma to the area. So in theory both machines should give you the same amount of trauma to the area. I am not sure if this has been proven so this why I am using THEORY in caps. What we do know is that trauma stimulates inflamatory response and thus healing cycle. The question is how much trauma and should you stage it . My opinion is that multiple low energy is repeated local trauma where high energy is one local trauma. Which is better ? With low energy FDA studies we can begin to have comparisons

Re: Ossatron treatment vs. Sonocur

Dr. Z on 4/28/03 at 18:57 (117295)

I had an interesting conversation with an insurance company. They were paying a very low rate in my opinion for ESWT but I then later found out that they were using a low energy model so the rate turned out to be more then the high energy ossatron treatment package. At this point in the insurance world in my area they don't know the difference between the two protocols and some are paying using a three treatment protocol in some cases. Until Medicare makes a move there will be no uniform payment schedule

Re: PS Orthometrix

Dr. Z on 4/28/03 at 22:18 (117314)

If you want a used Big O . I have one. Great price to own

Re: Ossatron treatment vs. Sonocur

Sunny Jacob on 4/29/03 at 06:52 (117321)

There is a general thinking that the ‘big bang' with Ossatron is a good buy for the bucks. This reminds me of Tim Taylor's ‘Home Improvement Show'.
Both, Epos and Sonocur are equally good to treat PF. You are absolutely right.
If I were a patient, safety, comfort, outcome and cost effectiveness would be the most important considerations.
Everything being equal, I would choose Sonocur for two reasons:
1) no need for local anesthesia
2) in-line ultrasound (This feature is not available in U.S.A. and I admit that I may be somewhat partial about its advantages.)
However, 3 sessions is a must when Sonocur is used. Dornier (Epos), in most cases, also may require more than the usually recommended single treatment. This is evident from the experience of many patients reported on this message board.

Re: Ossatron treatment vs. Sonocur

Dr. Z on 4/29/03 at 18:56 (117390)


What is the repeat soncur experience? How many patients go for a second series of three treatments in your experience.?

Re: Ossatron treatment vs. Sonocur

Sunny Jacob on 4/29/03 at 19:24 (117391)

Dr. Z,
From several hundred patients treated during the last 2 years (using our combination therapy) we had two repeat treatments, i.e. a second 3-session treatment. One of them fully recovered and the second person had other complications that were not treatable with ESWT.

Re: PS Orthometrix

Ed Davis, DPM on 4/30/03 at 15:17 (117443)

Dr. Z:
Can you use it 'off label' particularly if the procedure is being done on a patient pay basis or is it currently unusable?