“Sonography”, also called “echography” or more colloquially “ultrasound”, uses ultrasound waves

• as an imaging technique
• to examine organic tissues for medicinal purposes

Sonography is the most commonly used imaging technique in medicine. One essential advantage of sonography over X-rays, which are also frequently used in medicine, is the harmlessness of the sound waves used. Even sensitive tissues are not damaged, and the examination is completely painless.
Ultrasound can be used to make initial assessments, for example of joint effusions, tendonitis and muscle injuries as well as for follow-up checks. Joint cannulation procedures can also be performed under ultrasound guidance.

We primarily use the SpineMED® treatment method to help patients who suffer from disc or spinal problems. As the first practice in the Saarland, we have been successfully offering SpineMED® treatments for some time now. Possible fields of application for so-called “spinal decompression” range from herniated discs to classic lumbago to sciatica and osteochondrosis. If you have any questions about this non-operative, painless procedure, please do not hesitate to contact us.

Further information can be found at: https://spine-med.de

rPMS is a completely new way to treat a multitude of painful states of the musculoskeletal system entirely without side effects. It is based on repetitive peripheral magnetic stimulation and highly effective, particularly for muscular problems.

Further information can be found at: http://www.inmetec.de/

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/

In our group practice, we treat all diseases of the musculoskeletal system. These include malformations, degenerative changes (osteoarthritis) and osteoporosis (a reduction in bone stability). Our field of expertise partly overlaps with those of internal medicine, rheumatology and paediatrics.

In addition to your medical history (consultation), our focus is predominantly on clinical examinations as well as the use of modern diagnostic techniques such as ultrasound, X-rays and laboratory tests, which all take place on site at our practice. Furthermore, to treat the different diseases, we use all recognised therapy methods, including physical methods, physiotherapy, acupuncture, ultrasound, shock wave and magnetic field treatments.

We treat work- and commute-related accidents within the framework of care provided by employers’ liability insurance associations, whereby the injured person can visit our practice without prior appointment. All types of acute accidents that occur in sports, leisure and domestic environments are also immediately treated.

For this purpose, we have at our disposal state-of-the-art medical technologies including digital X-rays and sonography. Surgical wound treatments can be performed immediately in our surgical operating room, while fracture treatments make use of the latest expertise in splints and bandages. If surgical care should be required, we can arrange it at a clinic that collaborates with us on a regular basis.

As part of the orthopaedic care we provide to the Olympic base Rhineland-Palatinate/Saarland and the Saarland Athletics Federation, as team doctors of SV 07 Elversberg and F91 Dudelange/LUX (football) as well as KSV Köllerbach (wrestling), we are familiar with the full range of professional sports and are able to always offer athletes the latest treatments in sports medicine.

Chirotherapy or manual medicine is a medical discipline that focuses on restoring joint mobility in cases where the joint’s structure and composition remain intact but there is a lack of correct function.

Methodology

In manual medicine, joints with limited mobility (hypomobile) can in principle be treated by mobilising or manipulating them. During the “mobilising” treatment, mobility is restored by using gentle and frequently repeated stretching movements. The “manipulative” treatment is based on the knowledge that rapid short movements performed with little force can often lead to an immediate and complete restoration of mobility. The manipulative techniques used are chosen by the appropriately trained physician.

Blockages as a functional disease

By treating a blockage with a rapid impulse, the therapist sets a targeted stimulus at so-called pain receptors, which are thereby switched off and the muscle blocking the joint becomes relaxed once more. To achieve this effect, neither a great force nor a great distance are required (gentle manipulation), so the “Three Ss” rule applies, i.e. small force, short distance, short time.

Prerequisites

Generally speaking, prior to this kind of manipulation, certain types of spinal column damage, for example metastases/tumours, must first be ruled out using X-rays.

Acupuncture is part of Traditional Chinese Medicine (TCM).
It is based on the Five Elements theory and performed by inserting a needle into acupuncture points.

It presumes the existence of 361 acupuncture points, which are arranged along the meridians. There are twelve main meridians, positioned as mirror image pairs on both sides of the body, plus eight extra meridians. In Traditional Chinese Medicine, the placement of the needles affects the flow of Qi (life energy).

Procedure
An acupuncture session lasts approximately 20 to 30 minutes. During the treatment, the patient is placed in a calm and relaxed position, typically lying down or sitting comfortably, while as few points as possible are needled. Some authors indicate a maximum number of 16 needles; however, this number can be exceeded in some instances. A full therapy cycle usually consists of 10 to 15 such sessions.

Trigger point therapy (dry needling)
Trigger point therapy aims to eliminate so-called myofascial trigger points.

The term refers to localised areas where the skeletal muscles are hardened, more sensitive to pressure and possibly act as sources of radiating pain.
A common example is the myofascial trigger point in the trapezius muscle of the shoulder joint, which can trigger pain in the temple area. In addition to preventative treatments on permanently shortened or incorrectly worked muscles, e.g. the elimination of unfavourable working postures, inadequate training conditions, etc., therapeutic treatment options specifically aim to deactivate permanently contracted (= tense) muscle fibres.
Depending on the muscles affected, the following specific manual treatment techniques may be suitable: stretching, possibly supported by cold application, needling of the trigger point using acupuncture needles or injections of local anaesthetics directly into the trigger point. Good results have also been achieved with trigger shock wave therapy (see ESWT).

Fields of application
Comparative studies on the effectiveness of acupuncture for chronic pain now exist, which prove its effectiveness in comparison to other forms of therapy.

Health insurance company policies
Since January 01, 2007 and in accordance with a decision of Germany’s Federal Joint Committee, all German statutory health insurance companies now cover acupuncture treatment costs for chronic pain in the lumbar spine or knee joints (gonarthrosis) as part of pain management therapy. The treatment of headaches using acupuncture has not been included in the service catalogue and therefore has to be paid for as an individual, so-called IGEL, service.

In an emergency, our practice is always able to provide competent emergency medical care.

EMTT is a state-of-the-art form of magnetic therapy and opens up completely new possibilities in the treatment of acute and chronic orthopaedic diseases.

https://www.emtt.info/de

PRP (platelet-rich plasma) is used in the treatment of (sports) injuries and degenerative diseases to promote tissue regeneration.
As a cellular matrix, PRP is combined with a hyaluronic acid as an important component of both cartilage and joint fluids.