All Posts tagged Pulse therapy

Shock wave therapy Plantar fasciitis

Here’s one research article behind the treatment for patients with heel pain due to chronic plantar fasciitis.
*Gollwitzer, H. et al. Clinically relevant effectiveness of focused Extracorporeal shock wave therapy in the treatment of chronic plantar fasciitis: a randomized, controlled multicenter study. J Bone Joint Surg Am. 2015 May 6;97(9):701-8. doi: 10.2106/JBJS.M.01331.

The objective of the present study was to test whether focused Extracorporeal shock wave therapy is effective in relieving chronic heel pain diagnosed as plantar fasciitis. Two hundred and forty-six patients (98.4%) were available for intention-to-treat analysis at the twelve-week follow-up. There was a significant difference (p = 0.0027, one-sided) in the reduction of heel pain in the Extracorporeal shock wave therapy group (69.2%) compared with the placebo therapy group (34.5%). Extracorporeal shock wave therapy was also significantly superior to the placebo therapy for the Roles and Maudsley score (p = 0.0006, one-sided).

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Pulsed EMF also known as Magnet Therapy for Pelvic Floor Disorders & Chronic Pelvic Pain (CPP)

Almost 50% of women suffer from chronic pelvic floor disorders. Men can experience this too but the percentage is lower. Symptoms include uncontrollable bowel movements, frequent urination, urinary incontinence, pain during sex, low to no orgasms, and loss of pelvic mobility. Mainstream medicine treats this as “normal” aging because it is so common, especially in the 45 year old plus ranges.

If you feel like you need to brace yourself once a sneeze is coming on to avoid embarrassing “accidents” then you probable have weak pelvic floor muscles that can be reawakened. I am all about Biohacking and upgrading one’s quality of living and healthy aging.

Biohacks are things we can do that supports optimal inflammatory response, enhance relaxation, improve sleep quality, improve brain function and improve body structure (fat to lean muscle mass ratios, strength, etc.), increase resiliency, longevity, and decrease chronic pain.

My top biohacks for pelvic pain include:

Laser Therapy. Stem cells are becoming a mainstay treatment for chronic pain and athletic injuries. Laser therapy can be used as a biologic agent to increase stem cells and blood platelets to help manage bony and soft tissue conditions. I especially like laser therapy for those who experience coccyx pain or sacroiliac area pain.

Pulsed EMF (Magnet therapy). Clinical evidence lends support for PEMF. The benefits of ‘Magawaving’ include: it stimulates electrical changes — around and within the cell; Activates and promotes cell regeneration; can alleviate the symptoms of arthritis; improves circulation; can help relieve the symptoms of depression, pelvic floor issues, and it promotes bone healing.

Pulse wave Therapy also known as Shockwave Therapy. Research investigating the role of shockwave therapy for chronic tendon injuries such as Achilles tendon and plantar fasciitis is ongoing and positive. I like seeing the results I get helping break up scar tissue and improve range of motion with my 3 different types of shockwave machines. There is evidence that this is helpful for CPP because of scar tissue build up. I currently use it on patients for this condition.

Diet & Nutrition. We discuss foods that support and nourish your body so that it does its job properly – helping you increase energy, lose weight, reduce nagging and unpleasant symptoms, improve your mood, and have more vitality.

I use ELDOA exercises. This is way beyond Kegel stuff you’ve already learned. These poses will create space in the spine and help you improve your posture and feel better.

Feel free to call my office at 310-444-9393 if you would like to meet and talk face to face.

Please don’t feel like you need to suffer in silence. Let’s try do something about it without risky surgery, effects of medication, and let’s keep it less costly.

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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.

Call 310-444-9393 for an appointment. 

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Achilles Tendonitis

I have treated many cases of Achilles tendinopathy (tendonitis) using pulse wave therapy also known as shock wave therapy or extracorporeal shock wave therapy (ESWT).

In 2015, Mani-Babu et al. reported results that there is evidence for short-term improvements in Achilles problems with ESWT.

A 2017 Health Technology Assessment (HTA) review showed efficacy of ESWT for treating Achilles tendinopathy. They showed significant pain improvement while running or playing sports.

For patients with Achilles tendon pain or dysfunction I recommend a trial of therapy. This may involve the use of sound therapy (shock wave, pulse therapy, pulsed EMF, radial therapy) along with light therapy (laser). This is why I call my specialty sound & light therapy. I teach my patients stretches and strengthening exercises for this condition. I also use nutrition and topicals to help patients get out of pain as quickly as possible.  

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Shock wave therapy, Extracorporeal shock wave therapy (ESWT), also referred to as Pulse wave therapy.

Extracorporeal shock wave therapy (ESWT) is also referred to as Pulse wave therapy.

Pulse wave therapy is a noninvasive treatment that that uses the force of a sound wave with the goal of reducing pain and promoting healing of the affected area. The mechanism by which pulse wave therapy achieves a therapeutic intervention is that it may disrupt fibrous tissue allowing for the subsequent promotion of revascularization and healing of tissue. Controlled shock wave therapy may damage cell membranes so that nerve messengers (nociceptors pain receptors) cannot build up a potential to transmit pain signals. It is also thought that the shock waves (pulse waves) will break up fascial adhesions, scar or calcium deposits, loosen tight tissue structures, promote resorption of calcium, thereby decreasing pain and improving function. (Hayes 2016a)

I am the only doctor in Los Angeles with 3 different types of pulse wave therapy machines. This allows me to use the best evidence from each of the devices, plus my 7 years of experience using pulse wave therapy, and patient preferences to provide you with the best care.  

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