The goal for patients is to increase movement and pain reduction.
Since ‘no one size fits all’ I offer several forms of treatment that may be helpful. Having the ability to use and combine multiple modalities is providing very positive results in terms of increased movement and pain reduction versus single modalities alone.
An advanced modality that is getting a lot of attention is shockwave. This provides peak pressures that are 1000 times greater than a biphasic ultrasound wave. Shockwave increases local blood flow, increases cellular activity, has an analgesic effect on nerves, and can breakdown calcific deposits (primarily, but not exclusively in tendons).
Laser is another treatment device that can target tissues to impact mitochondrial activity. Laser can be used on nerves, tendons, muscles, ligaments, joint capsules, bone, and wounds.
Pulsed Electromagnetic Field Therapy (PEMF) (MagnaWave) has had FDA approval for muscle stimulation since 1998. PEMF is just gaining popularity as ‘nutritional therapy’ to the cells. It increases nitric oxide levels (same thing Viagra does) and has microcirculation enhancement.
Summary: Combining these 3 modalities along with my hands-on therapy is allowing my patients to feel more supple and experience less pain.
I use two different types of shock wave devices for pain relief in my practice. One is a radial pulse wave (EnPuls) and the other is an acoustic wave (PiezoWave). Both carry energy that can be targeted and focused noninvasively to affect a selected region like the shoulder, hip or foot. When these devices are applied to the soft tissues, the impulses or shock waves interact with the targeted tissues and induce a cascade of biological reactions. This results in the release of growth factors, which in turn triggers new blood vessel formation (neovascularization) of the tissue with subsequent improvement of the blood supply and oxygen to the tissues. This helps healing.
Another effect of shock wave therapy is related to the stimulation of cell proliferation, tissue regeneration, and a process through which new blood vessels form from pre-existing vessels called angiogenesis.
The therapeutic effects of shock wave therapy can be used on patients who need pain relief and reduction of inflammation even in cases with diabetes, nerve pain, soft tissue injury, arthritic joint irritation, and healing of bone (2013, Qiu et al; 2013 Liu; 2013 Siegfried).
My practice is located in Brentwood, CA. I can be reached at 310-444-9393.
Chiropractic care or medication/shots?
Bone marrow stem cell injections vs non-surgical, non-invasive therapy?
DC’s, PT’s and MD’s know that chronic tendon pain is a challenge to treat. Chiropractors and Physical therapists use non-invasive procedures while medical doctors use cortisone shots and now some are using stem cell therapy injections. Research by doctors at the National University of Singapore suggest that bone-marrow derived stem cells accelerate tendon healing.1 Resolving ongoing inflammation is the key to management of these cases.
This is why the great excitement in stem cell therapy, it has the potential to reduce inflammation. BUT, so does TheraLase laser therapy and the use of PiezoWave and EnPuls. These are non-invasive therapies that the general public are not aware of yet.
Even the Center of Translational Regenerative Medicine researchers, in Torino, Italy say: “Tendon injuries represent even today a challenge as repair may be exceedingly slow and incomplete. Regenerative medicine (Tucker’s note – meaning laser and shockwave like the EnPuls & PiezoWave) and stem cell technology have shown to be of great promise.”2
I would much rather have patients try these non-invasive and less expensive therapies before getting a cortisone shot or going through expensive stem cell therapy first.