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Extracorporeal Shock Wave Therapy

Discussion in 'General Issues and Discussion Forum' started by Dieter Fellner, Oct 20, 2004.

  1. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Shockwave Therapy for Pain Associated with Lower Extremity Orthopedic Disorders: A Review of the Clinical and Cost-Effectiveness
    Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2016 Sep.
    CADTH Rapid Response Reports.

     
  2. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Extracorporeal shockwave therapy for refractory heel pain: a prospective study
    J. Humphrey, L. Hussain, A. Latif, R. Walker, A. Abbasian, S. Singh
    Orthopaedic Proceedings 14 November 2016
     
  3. Dieter Fellner

    Dieter Fellner Well-Known Member

    I recently reviewed this item and have updates (to follow)
     
  4. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Efficacy of Extracorporeal Shock Wave Therapy for Lower Extremity Tendinopathy: A Meta-analysis of Randomised Controlled Trials
    Liao, Chun-De et al
    American Journal of Physical Medicine & Rehabilitation: March 19, 2018 - Volume Publish Ahead of Print - Issue - p
     
  5. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    What are patients’ knowledge, expectation and experience of radial extracorporeal shockwave therapy for the treatment of their tendinopathies? A qualitative study
    Raymond Leung, Nikolaos Malliaropoulos, Vasileios Korakakis and Nat Padhiar
    Journal of Foot and Ankle Research201811:11
     
  6. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Efficacy of extracorporeal shock wave therapy for lower limb tendinopathy: A systematic review and meta-analysis
    C.D.LiaoL.Tsan-HonC.Hung-Chou
    Annals of Physical and Rehabilitation Medicine; Volume 61, Supplement, July 2018, Page e503
     
  7. R.S.Steinberg

    R.S.Steinberg Active Member

    Any discussion of ECSWT, must first clearly define the device and the method. I used the Dornier EPOS Ultra -- which was designed, and then approved by the US FDA, as a HIGH ENERGY shockwave device. I followed the single treatment protocol. It required a local anesthetic. The device also has real time ultrasound imaging. Used as designed, concentrating on the plantar fascia at its insertion at the calcaneus, I had a near 90% complete cure rate at 6 months. Initially though , I had 2 patients who did not achieve a cure at 6 months. When I took them back for another treatment, I noticed abnormal plantar fascia thickening (6-7 mm), extending distal from the calcaneus, some 6-7 cm. I decided to increased the total number of pulses from 3800 to 4800, and treated the full length of the abnormal plantar fascia. Both have a 100% cure at 3 months. From that point on, I treated the full length of abnormal plantar fascia. I do not believe in the low energy devices.
     
  8. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Extracorporeal shockwave therapy for pain reduction of musculoskeletal diseases: Predictors and responders
    A.T.Sugawara et al
    Annals of Physical and Rehabilitation Medicine; Volume 61, Supplement, July 2018, Page e171
     
  9. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Effectiveness and Safety of Shockwave Therapy in Tendinopathies.
    Dedes V et al
    Mater Sociomed. 2018 Jun;30(2):131-146.
     
  10. R.S.Steinberg

    R.S.Steinberg Active Member

    Sorry, But you are incorrect. High Energy ESWT was never over used in the USA, because......... very few health insurance companies paid for it. My patients were fortunate in that one major health insurance company, BlueCross BlueShield of Illinois did pay for it for about 2 years, then. without cause, stopped. I sure wish we could compare our experiences, but because most posts do not state whether how ESWT was used, i.e., high or low energy, and then which technique, most posts do not give useful information.
     
  11. R.S.Steinberg

    R.S.Steinberg Active Member

    Rick, Why would I need to "look you up"? I have hands on experience using high energy ESWT on many patients. Maybe where you practice, doctors treat without a diagnosing, but that is not my experience. There was a strict protocol to follow, that started with six months of failed conservative treatments. Some did not use high energy shockwave in a manner not approved by the FDA. This caused failures. Maybe an Australian podiatrist still has access to a "faulty research" article published by an Australian radiologist who experimented with ESWT, by using it at low energy. His conclusion was, ESWT did not work. The article was published in the JAMA, and lead to insurance companies to stop coverage. His research was based on the MISUSE of a high energy ESWT device, by using it at low energy. Maybe he has some special training, that allowed him to do a thorough podiatric exam, but from what I remember reading in his article, he did not. The research that supported its use, and allowed it to be approved by the FDA, was its use as a HIGH ENERGY treatment.
     
  12. Dieter Fellner

    Dieter Fellner Well-Known Member

    Extraordinary this debate is still provoking emotional responses. Please, gentleman.

    I have to agree the research that was published lacks reliable veracity. Anecdotally, then, while obviously not a panacea-for-all, high energy ECSW is without doubt a useful addition to the practitioner's tool box. And, again without doubt, I 'would' incorporate this into the treatment plan for plantar fasciitis. The fact that insurance does not make this option available is the sole reason that I do not.

    My patient population cannot afford the out-of-pocket expense.
     
  13. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Effects of extracorporeal shock wave therapy on plantar
    pressure distribution of patients with epin calcanei

    Zehra Betül Karakoc, Zübeyir Sarı, Eren Timurtas and Mine Gülden Polat
    Physiother Res Rep, 2018 doi: 10.15761/PRR.1000112 Volume 1(3): 1-4
     
  14. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Piezoelectric focal waves application in the treatment of plantar fascitis.
    Vaamonde-Lorenzo L et al
    Rev Esp Cir Ortop Traumatol. 2018 Nov 19.
    CONCLUSION:
    Treatment with piezoelectric focal shock waves in PF may reduces pain from the first session and achieves a subjective perception of improvement, maintaining these results at 6 months post -treatment.
     
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