does shockwave therapy work?
Shockwave therapy is an
in-office procedure that focuses low intensity pulses (waves) at the soft
tissues to treat injured tendons, scar tissue formation, ligament and cartilage
damage, and tight- stiff joints and muscle tissue. Shockwave treatments are
performed by Dr. Jeffrey Tucker, and the course of therapy usually requires a
trial of 3 sessions and up to 6-12 office visits. Shockwave therapy treatments create
stresses to the soft tissues (muscles, tendons, ligaments, lymph, and blood vessels)
and bone that promote physiological processes meant to regenerate blood vessels
and improve circulation – a process known as neovascularization. Increased
circulation (blood and oxygen) allows for the natural exchange of blood flow
with new cell formation.
expect at your visit.
Dr. Jeffrey Tucker is the
only Los Angeles practitioner with 3 different (Piezo-wave, Storz, Zimmer) pulse
wave machines using this technology. Some machines are better than others
because of the hand held applicator sizes and choices it provides me and my
patients to deliver the shock wave. I can better target the areas that bother
you. Prior to commencing treatment, an ultrasound gel is applied to the
treatment area. During treatment, shockwaves will be directed to various areas
around the target site of pain or dysfunction as well as near-by fascial
connections. While patients may experience a slight tingling, they should not
be uncomfortable or experience pain. Typically, the entire treatment session
will last about 25-30 minutes. Understanding your chief complaint and
performing a proper history and examination helps determine the number of
recommended treatments you would need. This number may be adjusted based on
results. Because this is a non-invasive procedure, patients will not require
anesthesia. You may return to normal activities such as going right back to
work, to the gym, walking, etc. right after a pulse wave treatment.
shockwave therapy right for me?
Pulse wave (Shockwave)
therapy is one of the best treatment options used for treating tendons,
decreased blood flow, and fascia (scar tissue) dysfunction. A thorough
assessment of the your overall health, past history related to sports injuries,
car accidents, falls, diet, and lifestyle will be considered prior to
treatment. Discussion will also cover treatment options that you have tried and
what worked and did not work.
If you would like to learn
more about the benefits of pulse wave therapy (shockwave therapy), contact Dr.
Jeffrey Tucker at 310-444-9393 to schedule a consultation. I am located in the
west Los Angeles, Brentwood area.
Almost 50% of women suffer from chronic pelvic floor
disorders. Men can experience this too but the percentage is lower. Symptoms
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.
free to call my office at 310-444-9393 if you would like to meet and talk 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.
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.
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.
Radial Pulse Therapy also known as Radial Shockwave Therapy has and is gaining popularity for the adjunct treatment of superficial orthopedic conditions especially myofascial conditions and tendinopathy. This is do to: some clients need overly dense fascia, scar tissue, soft tissue and joint adhesions broken up; doctors like using new technology; and some clients need a device with specific magnitude of forces (Joules) and a controlled speed (Hertz) applied to the muscle/tendon/bone unit in order to achieve the goals of restimulating the healing process.
As practitioners, it is important to correctly identify the patient’s biggest dysfunction. I often ask myself, “What’s the biggest issue?” Is it pain related to repetitive trauma, microtrauma, macrotrauma, obesity, poor nutrition, lack of motor control, poor strength, poor mobility, etc. Once the treatment plan is initiated, we must have positive short term responses from our treatment decision to obtain long term adaptation. In this regard, I have the experience of working with Radial Pulse Therapy for rotator cuff tendinopathy, achilles tendinopathy, plantar fasciitis, patellar tendinopathy, tennis elbow, iliolumbar and thoracolumbar fascial dysfunctions. I like being able to offer treatment options especially after patients have tried medications and glucocorticoid injection therapy for tendinopathy, trigger points and fascial adhesions.
To read the full article:
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?
- Coagulation disorders, thrombosis, heart or circulatory patients
- Use of anticoagulants, especially Marcumar, Heparin, Coumadin
- Tumour diseases, carcinoma, cancer patients
- 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
- Swelling, reddening, haematomas
- 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
Shockwave Therapy is a non-invasive treatment involving the delivery of acoustic shockwaves to affected areas of the body to trigger natural repair mechanisms and stimulate healing. I am now using this in my practice for Achilles tendonopathy, plantar fasciitis, shoulder tendonopathy, calcific tendinitis, patellar tendonosis.