Extra Corporal Shock Wave Treatment (ESWT)
Extra Corporeal Sound Wave Treatment (ESWT) is commonly used for the treatment of soft tissue and bone disorders around the foot and ankle.
Originally known as Lithotripsy, sound wave technology is similar to a small sonic boom resulting from a super sonic jet breaking the sound barrier. Formerly used to break up kidney stones, in the early 1990's it was discovered that this high intensity sound wave had benefit on wound and fracture healing. Since 1993, ESWT has been used on a regular basis in Europe for the treatment of painful tendonitis (tennis elbow), plantar fasciitis (heel spur) and to treat fractured bones that did not heal normally.
Mechanism of Action
Sound wave utilizes a high intensity sonic pulse, which can be focused on a target area in and around the foot and ankle. Although the exact mechanisms for the technology is not fully known it is believed that micro-trauma will ultimately repair and increase in development of blood supply to the area. Some have linked the mechanism to tenderizing meat by pounding a tough piece of steak with a wooden mallet and making it more soft and pliable. Often chronic problems of tendons and ligament involve infiltration of scar tissue overlying these fibers. ESWT is thought to break up this scarring and allow the body to regenerate new and improved tissue to the area.
Equipment
The equipment used to deliver ESWT is highly advanced and has been evaluated by the FDA. These types of technologies are in common use throughout the world: Electrohydraulic, Electromagnetic and Pregoelectric. The equipment consists of a computerized device with a movable arm that allows the physician to position a water-filled rubber bladder targeting the precise point of pain.
Treatment
After confirmation of exact positioning, the computer is then set to deliver 1000-40000 high energy sonic pulses at a pre-determined intensity level. It is recommended the procedure be performed under local anesthesia in the office or twilight sleep in an ambulatory surgery setting or hospital.
Recovery
Following the procedure, patients are asked to take it easy the remainder of the day. The day after the procedure, almost all patients are able to resume normal activities. Significant pain relief was noted by 80% of the patients within a week following the procedure. No immobilization is required.
Results
Clincal studies have shown a 70% success rate while using ESWT to treat plantar fasciitis and other tendon problems involving the foot and ankle. 70% of patients treated have had a reduction on a 0-10 pain scale by at least 5 for their condition. No patients have gone on to invasive surgical procedures. No patients have been made worse and no patients have developed complications from the ESWT. Full clinical benefits are fully realized 2-3 months following the procedure.
Costsa
Costs are dependant upon the location of pain and the time required to treat the condition. Many insurance companies do not cover the cost of ESWT treatment. In the Washington DC area BCBS does cover ESWT.
Extra Corporal Shock Wave Treatment (ESWT)
Extra Corporeal Sound Wave Treatment (ESWT) is commonly used for the treatment of soft tissue and bone disorders around the foot and ankle.
Originally known as Lithotripsy, sound wave technology is similar to a small sonic boom resulting from a super sonic jet breaking the sound barrier. Formerly used to break up kidney stones, in the early 1990's it was discovered that this high intensity sound wave had benefit on wound and fracture healing. Since 1993, ESWT has been used on a regular basis in Europe for the treatment of painful tendonitis (tennis elbow), plantar fasciitis (heel spur) and to treat fractured bones that did not heal normally.
Mechanism of Action
Sound wave utilizes a high intensity sonic pulse, which can be focused on a target area in and around the foot and ankle. Although the exact mechanisms for the technology is not fully known it is believed that micro-trauma will ultimately repair and increase in development of blood supply to the area. Some have linked the mechanism to tenderizing meat by pounding a tough piece of steak with a wooden mallet and making it more soft and pliable. Often chronic problems of tendons and ligament involve infiltration of scar tissue overlying these fibers. ESWT is thought to break up this scarring and allow the body to regenerate new and improved tissue to the area.
Equipment
The equipment used to deliver ESWT is highly advanced and has been evaluated by the FDA. These types of technologies are in common use throughout the world: Electrohydraulic, Electromagnetic and Pregoelectric. The equipment consists of a computerized device with a movable arm that allows the physician to position a water-filled rubber bladder targeting the precise point of pain.
Treatment
After confirmation of exact positioning, the computer is then set to deliver 1000-40000 high energy sonic pulses at a pre-determined intensity level. It is recommended the procedure be performed under local anesthesia in the office or twilight sleep in an ambulatory surgery setting or hospital.
Recovery
Following the procedure, patients are asked to take it easy the remainder of the day. The day after the procedure, almost all patients are able to resume normal activities. Significant pain relief was noted by 80% of the patients within a week following the procedure. No immobilization is required.
Results
Clincal studies have shown a 70% success rate while using ESWT to treat plantar fasciitis and other tendon problems involving the foot and ankle. 70% of patients treated have had a reduction on a 0-10 pain scale by at least 5 for their condition. No patients have gone on to invasive surgical procedures. No patients have been made worse and no patients have developed complications from the ESWT. Full clinical benefits are fully realized 2-3 months following the procedure.
Costs
Costs are dependant upon the location of pain and the time required to treat the condition. Many insurance companies do not cover the cost of ESWT treatment. In the Washington DC area BCBS does cover ESWT.
