We offer the following therapies:
1. Extracorporeal Shock Wave Therapy (ESWT)
Extracorporeal shock waves are high-energy sound waves generated by a medical device, which enter the body while causing only minimal pain. In internal medicine, for example, they are used to eliminate kidney or urinary stones without the need for surgery.
In orthopaedics and pain therapy, extracorporeal shock wave therapy (ESWT) is used to treat diseases of the muscles, tendons, joints and bones.
While internal medicine uses high doses of energy to break up stones, orthopaedic shock wave therapy uses significantly lower doses. Only a tenth of the dose needed to break up kidney stones is required for example.
The shock wave therapy methods used in orthopaedics aim to positively influence tendons, joint capsule parts, the periosteum and nerves. Treatment with extracorporeal shock waves can relieve or even eliminate pain.
The most common conditions treated with ESWT are:
- Tennis and golfer’s elbow
- Chronic shoulder pain
- Plantar heel spurs
- Joint wear (arthrosis)
- Pseudoarthroses (non-healing fractures or cuts
- Dupuytren’s disease
In addition to the diseases listed above, there are many other diseases where extracorporeal shock wave therapy can be helpful. We are always happy to discuss your ESWT treatment options with you.
The treatment process is as follows:
An ultrasound gel is applied to the affected joint. The shock wave device’s ultrasonic probe is then placed on the joint and positioned precisely. The ultrasound monitor shows the position of the incoming shock wave. The patient takes hold of the trigger for the shock wave generator and by pressing it continuously triggers a series of pulses. The patient can instantly stop the therapy at any time, simply by letting go of the generator. For the treatment to be successful, it is very important that the impulses hit the pain site precisely and thus also trigger the associated pain that would otherwise be caused by everyday movement sequences. As a rule, the pain caused during therapy decreases after approximately 500 pulses, so that the patient may have to find and set the location with the greatest pain sensitivity. Continuous monitoring by the attending physician is ensured.
Depending on the medical indications, the therapy is carried out at weekly intervals with 1,500–3,000 pulses administered per treatment session. The number of treatments required depends on how the individual patient responds to shock wave therapy and for how long the pain has been felt.
After the first few therapy sessions, the treated joint may temporarily feel more sensitive, i.e. the amount of pain perceived by the patient increases. However, this increased pain sensitivity will soon diminish once more. In general, this results in a change in the nature of the pain: the pain is no longer perceived as stabbing and shooting but rather as dull, radiating and pulling. In most cases, this change is followed by a significant reduction in pain.
As a rule, a decrease in the amount of pain felt is noticed after three to five treatments. Therapeutic success, in the sense of becoming pain free, cannot be guaranteed. However, a decrease in pain is regarded as a therapeutic success.
In orthopaedic use, the only known risk of ESWT for the patient is that the therapeutic effect is insufficient and that the pain may persist. A temporary increase in pain has been observed in a small number of cases.
In some patients, a temporary localised reddening of the skin occurs. In rare cases, sensitive skin can develop small punctiform bruises, which regress within a few days. No long-term damage is known.
2. Trigger Point Shock Wave Therapy (TPST)
A few years ago, a chance discovery was made that short and intense increases in pressure within muscle tissues, like those that arise due to the use of extracorporeal shock waves, which had actually been developed to break up kidney stones, are very well suited for the diagnosis and therapy of trigger points found in muscles.
A healthy muscle’s response to shock waves is hardly noticeably – even when high shock wave energy, which could easily cause kidney stones to break up, is directed at a healthy muscle, it is perceived as only a slight knocking sensation within the muscle, without being really noticeable.
However, if the same short and intense pressure increase in the tissue, which is caused by the shock wave, acts on a trigger point, pain is triggered instantly, and this also often happens even at much lower levels of shock wave energy. This pain can be perceived at the site of the trigger point as well as at a completely different location (known as referred pain).
As a result, that trigger point will then have been identified to be the cause of pain felt elsewhere.
Once, by virtue of the pain triggered, the trigger point (TP) has been identified as the source of the pain, it is treated with a few hundred (in the case of stubborn TPs even a few thousand) shots of shock wave therapy (the intensity of which will have been reduced to a level where unbearable pain is no longer triggered) and the patient will then immediately sense a decrease in the intensity of the triggered pain. However, the TP does not shatter like a kidney stone! The short-term increases in pressure within the tissues cause the cells to release substances that promote the healing process. The TP may recover after the first session; however, after a few therapy sessions, it is usually permanently eliminated, so that even pain that has persisted for years can often be reduced or eliminated for good.
Further information can be found at: https://www.eswt.info/de/