Shockwave therapy can be used to treat various diseases and complaints of the musculoskeletal system.
In my surgery in the Rudolfinerhaus Private Clinic, 1190 Vienna, I offer my patients both classic treatments and shockwave therapy. Shockwave therapy is carried out using an innovative shock wave therapy device with a constant energy flow density, which allows for lasting pain relief.
Shock waves are acoustic pressure waves with high peak energy. Shock waves are generated at supersonic speed. During treatment, they are directed from the outside directly onto the part of the body to be treated, with the help of a transducer.
Thus, shock waves act exactly at the pain’s center or where the cause of your pain is localized. They act in two ways:
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Shock waves were first used in urology in the 1980s to treat kidney and ureteral stones. Shortly thereafter, shock waves were, by chance, discovered to also be highly effective in the treatment of bone tissue.
Over the years, shockwave therapy has been intensively researched and developed – today, shockwave therapy is a popular and highly effective way to treat musculoskeletal pain and discomfort at its point of origin without surgery.
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During the treatment, the patient lies or sits. In the beginning, I apply a contact gel to the skin, this gel improves transmission of the impulses. The impulses’ number and strength are then adjusted to the individual patient.
Mild pain may occur – this may be the case when shock waves hit inflamed tissue. The pain usually subsides after a very short time and while the treatment is still in progress. The number of pulses delivered varies greatly between a few hundred and up to 2000 pulses, depending on the clinical picture.
One session lasts for about 20 minutes. The number of sessions needed varies from patient to patient, and can be defined more precisely after a diagnosis in my office (3-5).
Side effects of shockwave therapy are extremely rare. Harmless, local swelling and reddening of the skin may occur, which disappear after a short time.
If you have any questions about shockwave therapy, or when and how it may be applied, I will be happy to answer them personally.
Thanks to its outstanding effectiveness, shockwave therapy has been successfully established in recent years for the non-invasive treatment of various musculoskeletal complaints. The range of applications of shockwave therapy includes:
Heel spur
Heel spur refers to calcification in the area where the plantar fascia attaches to the heel bone. Pain occurs due to irritation and inflammation of this tendon attachment, and is localized very typically at the heel.
Causes are:
A typical symptom is severe pain on exertion in the morning, the pain often keeps the patient from stepping on the heel. Extracorporeal shockwave treatment precisely targets the inflammation of the plantar fascia. Daily stretching of the calf muscles is an important part of successful treatment.
Tennis elbow
The term “tennis elbow” stands for pain symptoms at the lateral edge of the elbow. In severe cases, patients may no longer be able to grip a glass or cup firmly or to unscrew bottles. This is due to excessive strain on the common tendon attachment of muscles on the forearm, which pulls the wrist upwards. Here, excessive stress or incorrect strain as well as a poor state of muscle stretching are responsible for the pain.
Bone marrow edema
Bone marrow edema is a bone reaction that deposits fluid in the bone, causing severe pain. Typical pain symptoms include pain at rest and pain on percussion of the affected area. The causes are varied, but can be roughly divided into 3 groups:
Patellar tendinitis syndrome
This refers to pain at the tip of the patella, a sign of prolonged overuse and inflammation of the patellar tendon where it attaches to the lower pole of the patella.
Unusually high tensile loads are often responsible, as they occur in many” stop and go” or “jump” sports, e.g. soccer, volleyball or squash, but also in athletics. In the early stage, the complaints are described mainly at the beginning of and after physical activity.
With increasing duration and progression of the disease, pain occurs throughout physical activity. Subsequently, continuous pain is also possible, e.g. during everyday activities such as while climbing stairs.
Shockwave therapy aims at fighting inflammation and regenerating the tissue. As mentioned at the beginning, healing along with consistent stretching exercises may be lengthy and take from 4 weeks up to 3 months.
After cruciate ligament surgery
The impressive effect of shock waves on a wide variety of tissues has been scientifically proven. Their effect on wound healing piqued curiosity as to whether patients may also benefit from shock waves following surgery.
Especially after arthroscopies of the knee joint, such as cruciate ligament operations or meniscus suturing, shock waves positively influenced the healing process. Sporting activities can be resumed after cruciate ligament surgery months earlier if shock wave treatment is performed.
The effect is again based on the principle of the shock wave: tissue processes are set in motion, and the body’s messenger substances become enriched in the treated area. This attracts new cells, and tissue develops. New blood vessels are also created and healing can occur more quickly.
Cartilage damage
Cartilage damage often causes pain in the knee joint – either acute due to an accident or, more frequently, chronic due to wear and tear, aging, excessive stress.
Unfortunately, shockwave therapy is also not a method to sprout new cartilage. But: Current studies show that in cases of precursors to osteoarthritis and incipient osteoarthritis, discomfort can be significantly reduced through shockwave therapy.
Furthermore, shockwave therapy has a positive influence on the tendon insertions near the knee and overuse-related complaints.
Calcific tendonitis of the shoulder
The shoulder joint is protected by a strong muscular cuff consisting of several muscles (= rotator cuff).
The term “calcific tendonitis of the shoulder” describes a calcification of one or more tendon insertions of these muscles at the shoulder joint. Experts still disagree about the main mechanism behind its development.
Often, a certain tightness exists in the shoulder joint (= impingement), which, together with poor blood supply to these tendon insertions, leads to overload and chronic irritation. This constant inflammatory process results in calcification, which then causes severe pain and a massive restriction of movement in the shoulder joint.
Achilles tendon pain
Numerous causes can trigger complaints in the Achilles tendon. As is often the case with complaints in the tendon or tendon attachment area, incorrect and excessive strain, poor stretching and training errors (shoe choice, training volume or intensity, etc.) are responsible.
But also gout, high cholesterol and certain medications, especially specific groups of antibiotics, can trigger the development of Achilles tendon pain. A spindle-shaped and painful thickening of the Achilles tendon is typical.
Morbus osgood schlatter
Athletically active children between the ages of 10 and 16 often suffer from pain just below the knee joint.
This is often a case of excessive strain. Thus, pain occurs on the part of the tibia near the knee.
In this area, the patellar tendon attaches to the lower leg. A growth plate (apophysis) is also located at this angle between tendon and bone.
Typical symptoms include pressure pain and increased pain when the knee is stretched against resistance. Frequently, the complaints are seen in the context of a growth spurt or as a sign of muscular imbalances or are only a consequence of poorly stretched muscles.
Localized reduced blood flow in the area of the tendon insertion is also assumed to be causative for the clinical picture.
Sports abstinence, rest and relieving strain usually only improve the symptoms temporarily, until sports can be resumed. The complaints subside when growth is complete.
Shockwave therapy is aimed at healing inflammation, improving blood circulation and regenerating the tissue.
Together with consistently performed stretching exercises, healing can be achieved. However, it is also necessary to relieve strain on the knee for up to 6 weeks, as an accompanying measure.
Greater trochanteric pain syndrome - Trochanteric bursitis/lateral hip pain
This is a typical discomfort on the outside of the thigh: at the point where the ball of your hand touches your thigh, when you let your arms hang loosely.
The so-called greater trochanter is located in this area, it serves as the insertion point for many muscles. The root cause of the complaints is probably buried in the area of these muscle attachments.
The tendon insertion problems also make them treatable through shockwave therapy. Muscle shortening, overuse, unaccustomed strain and reduced blood flow at these tendon attachments lead to complaints.
Medial Tibial Stress Syndrom
Do you have pain on the front or inner side of the lower leg? This is a typical symptom of medial tibial stress syndrome (MTSS), also called shin splints.
Runners are often affected, complaints typically start when training begins and may improve during the training session. This is caused by excessive stress and/or incorrect strain of the muscles on the lower leg, which can also extend to the periosteum via muscle attachments.
In the early stages, a mandatory break from running and also home remedies such as curd compresses can help.
C-section scar
What does shockwave therapy do?
Further information: Shockwave therapy for C-section scars
Also: bone healing disorders (pseudarthrosis in accessible localities), gonarthrosis (osteoarthritis of the knee joint), adductor syndrome, rotator cuff complaints (subacromial bursitis), targeted treatment of trigger points.
Shock waves have no damaging effect on the skin, fat tissue, muscles or other structures. Shockwave therapy’s effectiveness is evident from numerous clinical studies – up to 80 percent of all patients report a significant improvement in their symptoms or freedom from pain after just a few sessions.
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oskar2020-02-25 15:28:432021-05-05 13:21:18Shockwave therapy for C-section scars
