Xie Y, Zhang C, Liang B, Wang J, Wang L, Wan T, Xu F, Lei L. Effects of shock wave therapy in patients with carpal tunnel syndrome: a systematic review and meta-analysis. Disability and Rehabilitation. 2020 May 14:1-2.
Purpose: To determine whether shock wave therapy could improve symptoms and hand function in patients with carpal tunnel syndrome.
Results: Ten trials involving 433 patients (501 wrists) were included in this systematic review. The shock wave therapy was observed to have a significant effect on pain relief (MD: ?0.60, 95% CI: ?1.16 to ?0.05, p?=?0.03), syndrome alleviation (MD: ?2.26, 95% CI: ?3.24 to ?1.27, p?<?0.00001) and functional recovery (MD: ?1.25 95% CI: ?2.08 to ?0.43, p?=?0.003) among the carpal tunnel syndrome patients. As revealed by the subgroup analysis, radial shock wave therapy made a significant difference in pain relief, syndrome alleviation, and functional recovery (p?<?0.05). Focused shock wave had no significant effect on pain relief, syndrome alleviation, and functional recovery (p?>?0.05).
Conclusion: Shock wave therapy could be conductive to improve syndrome and hand function for carpal tunnel syndrome patients.
- Implications for rehabilitation
- Shock wave therapy is beneficial for alleviating syndrome and improving hand function of carpal tunnel syndrome patients.
- Radial shock wave therapy seems superior to focused shock wave therapy on syndrome alleviation and functional recovery of hand in carpal tunnel syndrome patients.
Dr. Jeffrey Tucker is the only Los Angeles practitioner with 3 different shockwave (radial & focused) devices. This allows for the most customized and personalized treatment therapy that is non-invasive for CTS.
Safe, effective and natural approaches for reducing blood pressure and men’s health.
Nitric oxide or NO, is
an important signaling molecule in the human body.
One of the best ways
to increase NO is by using Shock Wave Therapy and eating sources of nitrates such
as beetroot, arugula and spinach.1 After eating
these foods, the dietary nitrate molecules are metabolized by
oral bacteria into nitrites which are then endogenously
transformed into the cardioprotective NO molecule.2-3
NO plays a critical
role in cardiovascular health and men’s health. For example, low levels of NO
in the body can lead to various pathologies, most notably endothelial
dysfunction which contributes to hypertension and atherosclerosis; low NO has
also been found to play a role in diabetes, hypercholesterolemia and Erectile Dysfunction.1
Healthy levels of NO
in the body support vascular tone, healthy blood flow, leukocyte adhesion, and
platelet aggregation.1 Consuming food-based nitrates on a routine
basis, and getting treatment with Shock Wave is a logical next step for those
desiring to prevent or treat NO deficiency-related disease processes. The
science backs it up.
A study published
in Nutrition Reviews looked
at 23 studies that measured blood pressure, endothelial function,
arterial stiffness, platelet aggregation, and/or blood lipid outcomes in
response to oral inorganic nitrate/nitrite intake.4 The analyses demonstrated that inorganic nitrate intake
significantly reduced resting blood pressure, improved endothelial function
(measured as flow-mediated dilatation), arterial stiffness, and platelet
Put it all together –
Shock Wave therapy, beets, beetroot juice, quinoa, spinach, and lamb’s quarters
(AKA wild spinach) to increase NO.
One of the beetroot
studies found that daily supplementation with dietary nitrate from beetroot
juice was associated with a reduction in blood pressure: systolic ?7.7-8.1mmHg;
diastolic ?2.4-5.2mmHg.6Additionally, endothelial function improved by
approximately 20% and there was a reduction in arterial stiffness by 0.59m/s.6
Overall reduction in
systolic and diastolic blood pressure of 3.55 mmHg and 1.32 mmHg, respectively,
and these reductions were significantly greater in the beetroot juice
supplemented groups vs. control groups.7 This same
publication also noted greater improvements in blood pressure with higher (500
mL/day) vs. lower (70-140 mL/day) beetroot juice doses or with longer periods
of consumption (?2 weeks vs. <2 weeks).7
So, eat your vegetables and do Shock Wave for ED and/or hypertension.
- Luiking YC et al. Regulation of nitric oxide production in health and disease. Curr Opin Clin Nutr Metab Care. 2010; 13(1): 97–104.
- Hobbs DA et al. Blood pressure lowering effects of beetroot juice and novel beetroot-enriched bread products in normotensive male subjects. Br J Nutr. 2012;108(11):2066-74.
- Khatri J et al. It is rocket science – why dietary nitrate is hard to “beet”! Part I: twists and turns in the realization of the nitrate-nitrite-NO pathway. Br J Clin Pharmacol. 2017;83(1):129–139.
- Jackson JK et al. The role of inorganic nitrate and nitrite in cardiovascular disease risk factors: a systematic review and meta-analysis of human evidence. Nutr Rev. 2018;76(5):348-371.
- Encyclopedia Brittanica. Amaranthaceae. https://www.britannica.com/plant/Amaranthaceae. Accessed July 26, 2018.
- Vikas K et al. Dietary nitrate provides sustained blood pressure lowering in hypertensive patients: a randomized, phase 2, double-blind, placebo-controlled study. Hypertension. 2015;65(2):320–327.
- Bahadoran Z et al. The nitrate-independent blood pressure-lowering effect of beetroot juice: a systematic review and meta-analysis. Adv Nutr. 2017;8(6):830-838.
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.
Painkillers, anti-inflammatory drugs, surgery, physical therapy, glucosamine, chondroitin, stem cell injections etc. I think there is a better way to repair damaged joints, injured ligaments, and painful muscles.
Regenerative medicine is here and IT DOES NOT HAVE TO BE EXPENSIVE AND INVASIVE. My tools include soothing laser light therapy, pulse sound wave or shockwave therapy, pulsed EMF, Vibragenix vibration/sound therapy, lymphatic system therapy, ELDOA training, and peptide therapy. These therapies don’t just mask symptoms; it fixes the problem for good.
Sound & light therapy is a combination of therapies that
speed up your body’s own healing mechanisms.
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.
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.
The bottom of your foot hurts. Maybe one side, or worse both feet hurt! The cause of the pain is probably something related to a change in your walking or running habits. People say to me “I haven’t changed anything so how does it happen?” There has to be something that you are doing wrong that you don’t even know you are doing wrong. It’s often in your gait or posture causing an excessive strain that is creating repetitive irritation of the arch of the foot.
Plantar fasciitis starts with some inflammation of the fascia on the bottom of the foot and eventual thickening of the plantar fascia. I don’t have to tell you that it can be a severe irritation. In order for me to evaluate and correct plantar fasciitis I examine the whole Superficial Back Line of fascia, which starts at the bottom of the foot and goes all the way up to your head. We might find this fascial band tight anywhere along its entire length. Fascia is the primary force transmission system in your body. If it cannot transmit force efficiently, there is too much strain in certain places: the bottom of the foot is often one of the spots that takes the burden of the excess stress (resulting in too much strain).
The examination includes checking for tightness in the muscles around the calf, especially the soleus and toe flexors. I also check stability and force generation in your glutes, psoas, quads, and abdominals. If they are inhibited or weak the lower leg and foot have to do more work. More work leads to pain and discomfort. A common movement pattern dysfunction of plantar fasciitis is lack of strength and timing of the Gluteus Maximus. Weak glutes contribute to foot dysfunction.
Key non-invasive treatments:
EnPuls (radial pulse therapy or shock wave therapy) and Piezowave Therapy (Acoustic pulse therapy)
These therapies significantly reduce pain and inflammation while stimulating the formation of new collagen matrix in damaged foot tissues. Properly applied shock wave therapy with optimal dosage is one of the best modalities available for effective treatment of Plantar Fasciitis. Often you will feel significant changes and improvements within several sessions.
Taping is an effective tool for alleviating symptoms and helping to form new movement habits. Sensory input from the tape on skin ignites the brain maps in discovering new options for movement. Tape adds stability. More stability leads to increased movement variability. Being stability is a good thing.
I am the only Chiropractor in Los Angeles with these combinations of modalities to target treatment to the site of pain and I teach patients the use of corrective exercises. This approach leads to more positive outcomes. The body will tell you very quickly what it likes and what it doesn’t like. If you feel better and it lasts you are on the right track. If you don’t, that’s a sign you need to change approaches. I can combine radial pulse waves, acoustic pulse waves, laser therapy, taping, and strength work to help you heal better and faster.
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:
The Radial Pulse Therapy (RPT) also known as Shockwave Therapy does not apply electric shocks. The RPT I use in my practice is applied by holding a lightweight hand-piece against the skin that (houses electromagnets, instead of a compressor, to accelerate a projectile inside the hand-piece that hits an applicator tip) creates a unique radial wave that penetrates into the surrounding target tissue.