All Posts tagged acoustic shock wave therapy

Calcific Tendonitis of the Shoulder (Rotator Cuff)

My experience using shockwave for shoulder problems are good outcomes. My patients see pain levels go down, range of motion improves, and activities of daily living (arm reaches, lifting, carrying, and sleeping) gets better. This suggests the treatment is helping and decreases inflammation associated with calcific deposits. I think the individualized protocols I use for treatment such as number of pulses, the variety of applicators I use, frequency of treatment, as well as having the use of 3 different types of pulse therapy machines makes a difference. I can also use Pulse EMF and laser light approaches to help difficult shoulder cases along.

Bannuru et al. (2014) conducted a systematic review (n=28 RCTs/1307 subjects) of the evidence to assess the efficacy of Extracorporeal Shock Wave Therapy (ESWT) in patients with calcific and non-calcific tendinitis. The outcome measures included pain, function and calcification resolution which was evaluated only in calcific tendinitis trials. High-energy Shock Wave Therapy was found to be statistically significantly better than placebo for both pain and function.

In a 2013 systematic review and meta-analysis, Loppolo et al. looked at ESWT compared to sham treatment or placebo for calcific shoulder tendinopathy.  Greater shoulder function and pain improvements were found at 6 months with ESWT over placebo.

Lee et al. (2011) performed a systematic review of RCTs examining the midterm effectiveness of ESWT for calcified rotator cuff tendinitis. The review found consistent evidence of midterm effectiveness of ESWT in reducing pain and improving shoulder function.

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Shockwave Therapy

What are the benefits of the Shockwave Treatment?

Radial shockwave therapy is used to stimulate the body’s natural self-healing process. Most patients experience immediate reduction of pain and improved ease of movement. Shockwave therapy should be tried before costly surgery procedures because it may eliminate your need for surgery. The use of drugs are not needed with this procedure.

How long does the treatment session take?

2000 – 3000 acoustic radial waves are administered per session, which takes approximately 5-10 minutes to apply. After the initial session with Dr. Tucker which includes the evaluation and typically lasts 60 minutes, he will schedule  30 minutes sessions. This allows enough time for questions/answers, and any home therapy recommendations. 

How many treatments will I need?

Normally a series of five treatments are scheduled at 4-5 day intervals; there is a small possibility that an additional 3-5 treatments may be necessary if your condition is very chronic.

Does the treatment hurt?

It is a 5-10 minute treatment that may be uncomfortable to some. Others only feel the sensation of deep percussion and do not express discomfort. Dr. Tucker will do everything possible to make you comfortable and able to tolerate your treatment. However, if you cannot tolerate it, the Dr. Tucker can make adjustments on the machine that can decrease the pressure you feel.

Will it hurt after the treatment?

There may be no immediate pain at all, but some discomfort may be experienced 6 – 12 hours after the treatment. In some cases it can last up to 48 hours and in very rare cases, the pain lasted up to 3 days. Dr. Tucker is using other cutting edge technology (i.e. laser, Deep Muscle Stimulator, lymph drainage) to enhance the effects of the Radial Shock Wave Therapy as well as researching the best methods to decrease post treatment soreness.

What should I do if I am in pain after the treatment?

The shockwave therapy is used to trigger an inflammatory response, which is the body’s natural process of healing. For this reason, do not use anti-inflammatory medications. Do not use ice. The pain should subside within 24 hours.

What if it feels good after the treatment?

Even if it feels good, we recommend decreased activity for 48 hours following the treatment.

Is Shockwave Therapy covered by my insurance?

If you have insurance you will want to ask your provider about the requirements of your coverage. Please call the office at 310-444-9393 with specific questions.

What is the success rate of this kind of treatment?

A successful treatment is considered as a patient having at least 75% reduction in pain within 3 months. The current literature worldwide, suggests success rates are around 80 to 90%.

What if it doesn’t work for me?

Although the short-term effects alone are exceptional, the long-term benefits of this treatment may take up to 3-4 months. If after this time there has not been any marked improvement, we will discuss further treatment options.

Are there contraindications and/or precautions?

Yes! Contraindications

  •          Coagulation disorders, thrombosis, heart or circulatory patients
    • Use of anticoagulants, especially Marcumar, Heparin, Coumadin
    • Tumour diseases, carcinoma, cancer patients
    • Pregnancy
    • Polyneuropathy in case of diabetes mellitus
    • Acute inflammations / pus focus in the target area
    • Children in growth
    • Cortisone therapy up to 6 weeks before first treatment
    • Blood or nerves supplies too close to the affected area

Side effects

  •           Swelling, reddening, haematomas
    • Petechiae
    • Pain
    • Skin lesions after previous cortisone therapy

These side effects generally abate after 5 to 10 days.

We are happy to discuss your case with you. Please call the office at 310-444-9393

 

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