by dr.g

Have you been experiencing pain at the outside of your elbow that hurts with wrist or hand movements or picking up objects. Have you noticed weakness or even dropping items at times. If so you probably have tennis elbow or an inflammation of the tendons of the lower arm that attache to the lateral epicondlye(bone on the outside of the elbow. Typically rest (avoidance of tennis, golf throwing or other activities that aggravate the elbow), ice, wearing a compression wrap/tennis elbow support work to reduce the symptoms. Medications sometimes help but NSAID’s can often delay healing of tendonous injuries so I prefer to use proteolytic enzymes like Wobenzyme or Acute by Optimal health systems. If these things fail to relieve the symptoms sometimes cortisone injections are performed and in resistant cases surgery. Before resorting to these more invasive procedures you might want to consider extracorporeal shockwave therapy or ESWT.

What is Extracorporeal Shockwave Treatment?

Extracorporeal Shockwave Treatment is a non-invasive (no incisions) treatment that involves the delivery of high energy sound waves, or acoustical energy, to affected areas of the body to trigger the body’s own natural repair mechanisms and stimulate healing. Shockwave Treatment (‘extracorporeal’ meaning ‘outside the body’) is a safe and effective treatment option. The recovery period is shorter than traditional invasive surgery and the procedure eliminates many of the risks associated with traditional surgery. Extracorporeal Shockwave Treatment (ESWT) has been used effectively for many years around the world. It was first approved in the United States by the FDA in October 2000 for the treatment of Plantar Fascitis, a type of heel pain. The FDA subsequently approved ESWT for Lateral Epicondylitis, commonly referred to as Tennis Elbow, in March 2003.

Shockwave therapy benefits include non-surgical/non-invasive treatment, fast healing and recovery time and supported by research!

What Is ESWT Used For?

ESWT has been used effectively worldwide to treat “insertional tendinopathies,” such as:
• Heel Pain (Plantar Fasciitis)
• Tennis Elbow (Lateral Epicondylitis)
• Shoulder Calcifications (Calcific Tendonitis)
• Achilles Tendonitis
• Knees (Patellar Tendonitis)
Millions of people suffer from pain caused by inflammation of tendons and other soft tissues attached to bones, commonly referred to as “insertional tendinopathies.”

How Does Extracorporeal Shockwave Treatment Work?

The widely accepted theory is that Extracorporeal Shockwave Treatment (ESWT) causes micro-trauma and controlled injury at the affected area, thereby leading to the formation of blood vessels (revascularization) which triggers the body’s natural healing process and repair mechanisms. The sound waves are also thought to release adhesions and scarring to help increase mobility an doptimize healing. Studies have shown a 60-80% success rate in significantly reducing or eliminating pain.

What Happens Before, During and After ESWT Treatment? 


BEFORE: Patients will be evaluated to determine if their condition might respond to ESWT and what other treatments may help them restore function and reduce pain. 


DURING: Treatment typically lasts 10-15 minutes and is performed in the office. The treatment begins by placing the Myact head over the sensitive area and applying shocks until the patient gets a slightly painful sensation (“patients report saying yeah that is the area or feeling tingling over the area and surrounding areas)  Once the most sensitive area is determined approximately 1000-1500 compressions are delivered to the area to help stimulate blood flow and improve healing. The goal is to deliver the highest tolerable intensity of compressions during treatment.  Treatment is always delivered to patient tolerance. 


AFTER: Patients may experience discomfort in the treated area after the treatment but many feel decreased pain or increased range of motion immediately following treatment.   Some bruising, swelling, and temporary numbness is normal and expected. In the immediate days following treatment, many doctors will recommend RICE – Rest, Ice, Compression, Elevation. In some instances they will recommend heat. Movement and stretching will also be recommended. Weekly follow-up visits with your doctor allow the physiotherapy needed for optional healing. 


For three to four weeks following treatment, patients are advised to not participate in stressful activities or to limit those (e.g. jogging, heavy housework, yard work, participating in sports) involving the affected area. Patients can then typically resume normal activity. Heel pain patients are typically instructed to avoid flat shoes such as sandals and slippers; continued use of orthotics may be encouraged. Healing is generally complete at about twelve weeks, although patients may continue to experience additional reduction in pain thereafter.

If you  are in pain or just don’t feel your best most days, call us to make an appointment or to see how we may be able to help.

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