ESWT FAQ

ESWT Frequently Asked Questions

When you have chronic pain everything you do in your life is affected. Having daily pain is no way to live, especially when the pain is avoidable.

It is a pleasure to share this information about a state of the art solution to a common painful problem. ESWT or Extracorporeal Shock Wave Therapy will make your life more enjoyable with one simple 18 minute procedure.

If after looking through this page of frequently asked questions and answers, you still have any other questions, click here to contact us and we will get back to you with an answer as soon as possible.

The information in the FAQ links below will answer several other questions you may have:.

What is ESWT?

Shock wave therapy was originally developed by Dornier MedTech to break up kidney stones in the body. Shock Wave therapy was discovered to be beneficial for orthopedic use in the treatment of soft tissue and some bone injuries. The orthopedic treatment is called Extracorporeal Shock Wave therapy or ESWT. ESWT benefits patients because their condition can be treated extracorporeally, meaning outside of the body. Because the treatment is non-invasive many of the expenses and risks of surgery are eliminated. ESWT has been used in internationally for over ten years. The Dornier EPOS Ultra was FDA Class 3 approved for ESWT and the treatment of chronic Plantar Fasciitis. Tennis elbow and Achilles tendonitis treatments are highly effective treatments we also perform off of the FDA label.

Looking over the history of ESWT, you must look at Lithotripsy. This is the procedure used regularly for breaking up and dispersing kidney stones. When Urologists reported that patients who had their kidney stones treated with Lithotripsy were presenting increased bone density and new tissue growth, the possibilities of Shock Wave therapy for orthopedic conditions were studied. ESWT was first considered in the United States for chronic heel pain resulting from plantar fasciitis and heel spurs. An FDA study was performed for patients who suffer chronic plantar fasciitis with or without the presence of a heel spur. Participants of the study were evaluated one year after treatment and the results were an amazing average reduction in pain of 92% with only one treatment and 94% of study participants rating their treatment as good-excellent. (This data reflects the results of the patients treated in the study who responded to surveys one year after receiving one treatment with the Dornier EPOS ESWT machine.)

Excellence Shock Wave Therapy was one of the first groups in the United States to become expert and equipped to offer this procedure. Now the physicians of Excellence Shock Wave Therapy are not only pioneers in the field of ESWT, but also among the most experienced. Our physicians have performed thousands of treatments since ESWT became available in the states. When choosing your ESWT doctor be sure to know what was involved in their training and what kind of experience they have. Unfortunately, some physicians have access to ESWT equipment with very little training and experience. Our doctors are fully trained, certified and experienced in performing ESWT with supervision. You can rest assured with any Excellence Shock Wave Therapy ESWT physician.

Excellence Shock Wave Therapy uses the Dornier EPOS Ultra for all our Orthopedic ESWT Procedures.

 

What is involved in the procedure and does it hurt?

This is the most exciting part about this new technology. It's literally an amazing advance in medical science.

First and most important is to find the root of your pain and determine the best course of action. Your doctor will complete a thorough examination and will inform you of a diagnosis and what treatment is recommended. If ESWT is right for you, here's what you can expect:

You lie back in a comfortable chair with your foot or elbow resting on a large fluid-filled rubber dome. The Excellence techinician will make sure you are comfortable throughout the entire procedure. A local anesthesia is used for the procedure to ensure patient comfort. The equipment has a wide range of settings and penetration depths. This allows our doctors to fine tune the procedure to your individual diagnosis. Ultrasound will be used to view and target the damaged location. During the treatment you will hear a repetitive clicking sound as the pulses penetrate the center of your pain site at a rapid rate. What's most important is what's going on inside of your body. The shock waves stimulate the degenerative tissue forcing your body to lay down new tendon fibers and heal itself. As your tendon heals your pain subsides.

Remember, this treatment is done with you awake while you are in a special chair chosen for your comfort during treatment. The ESWT procedure will be completed in about 18 minutes. From there the healing begins.

ESWT is not a painful or invasive procedure. With the local anesthetic you will be very comfortable. If you are especially anxious talk to your doctor, we will make you comfortable!

 

What kind of recovery can I expect?

Let's back up and first address what is most important. Immediate action. Everything you are about to read regarding recovery is influenced by how long a person has put off having treatment. In other words, the sooner you get this taken care of the better. That's somewhat common sense, but it truly does apply here.

Since the procedure encourages blood flow to the area, you may experience some mild bruising or soreness. You may walk out with no pain at all, or you may feel pretty much the same. Unliike surgery, you can not cause permanent damage to your foot. That is why this procedure is so wonderful. If you have any concerns of a long drawn-out recovery cramping your style, you can forget that. Healing is expected from the first day. The only thing that is individualized is how much relief you will get and how soon.

For heel pain in some, the majority of the pain relief is immediate. In others it gradually gets better from day one through the first six weeks. In others still, it gradually gets better from day one up to 12 weeks, a minority of patients do not feel any improvement until after 16 weeks of treatment. Patience is key, you must have the treatment and wait it out. For tennis elbow pain relief is more immediate. Most report resolution of pain within the month.

We can never be sure how much time you will need to feel pain cessation. It can help to realize that a 94% success rate was compiled from the FDA study participants who responded to surveys one year post treatment. People progressed at different rates. Tennis elbow studies show success rates of 75-85%.

With successful ESWT Therapy the pain and the causal condition will begin getting better immediately after the treatment. You do not need to plan time off from work or your life!

 

I'm in pain, but want to postpone getting treatment. Is that OK?

It's natural to want to put it off, but that is not a good idea for tendonosis conditions. What is concerning is the risk of putting off treatment. Tendon problems are nasty because you can't completely use and aggravating the condition. You can be unknowingly causing yourself more harm every day.You see, every time that you feel pain when you place weight on your heel or lift something with your arm it's because you are pulling against the tendon fibers, possibly creating more damage. This is why some people are left with no alternative but invasive surgery. Something you truly want to avoid.

Unfortunately, the problem doesn't stop with your heel or elbow. You will naturally compensate to protect yourself from pain. You will change your walking gait, you will stand differently, and you will limp. All of these abnormal movements will, in time, cause undue strain to your knees, hips and lower back. With elbows you can create compensation pain in your shoulders and wrists. You don't need new painful conditions in your life.

 

What ESWT equipment is used by Excellence Shock Wave Therapy?

Dornier's Epos Ultra is a shock wave therapy system designed specifically for orthopedic use. Shock wave therapy was originally developed by Dornier MedTech to break up kidney stones in the body. Shock Wave therapy was discovered to be beneficial for orthopedic use in the treatment of soft tissue and some bone injuries. Our equipment, the Dornier EPOS Ultra, is FDA Class 3 approved for the treatment of chronic Plantar Fasciitis. This is the highest quality, most state-of-the-art equipment available for ESWT.

There are many reasons why Excellence Shock Wave Therapy chose the Dornier Epos Ultra as our ESWT equipment. Three main technical factors should be of interest to our patients:

1. The Dornier Epos uses in-line ultrasound during the treatment process. This means the doctor can actually locate, view, and target the specific area of damage / injury with pinpoint accuracy. Shockwaves are directed exactly where they are needed to ensure a successful treatment.

2. The Dornier Epos treats plantar fasciitis by sending the shockwaves in through the tendon from the side of the heel. Other equipment sends the shock wave in from below the heel, which directs the shockwaves up and impacts the heel bone. This bone impact can be painful. Because we do not impact the bone, we do not need to use unnecessary "twilight sleep" or general anesthesia. Excellence Shock Wave Therapy advocates a painless procedure without the risk of putting someone to sleep.

3. The Dornier Epos Ultra uses electromagnetic technology to create the shock waves. Other manufacturers use what is called "spark gap." We prefer the electromagnetic method because each pulse administered has a consistency of power. With a spark plug system, the shocks change slightly as the gap from the spark "plug" (called an electrode) becomes worn from use. Electromagnetic technology delivers the same powerful shock wave time after time. This means you have a stable, consistent treatment, and what we consider a more reliable outcome.

 

What are the differences between the Dornier equipment used by Excellence Shock Wave Therapy and the Ossatron and Sonocur equipment?

Excellence Shock Wave Therapy has selected the Dornier EPOS Ultra as our equipment of choice because it offers the highest, yet most variable energy output. It also incorporates ultrasound to view the damaged tissue and target the shockwaves directly at and only to the damaged tissue. FDA results showed a 13% higher patient satisfaction rate with the Dornier than the Ossatron.

The Dornier is capable of performing both low energy and high energy treatments. Excellence Shock Wave Therapy does not perform low energy shock wave therapy for Plantar Fasciitis. Only high energy is FDA tested and approved for Plantar Fasciitis.

High energy ESWT causes cavitation or microtrauma to the tissue. This forces the body to lay down new fibroblast tissue and actually repair the tendon while ALSO affecting pain receptors.

Low energy shock wave therapy affects only the pain receptors. Low energy shock wave therapy can not be performed with a local anesthetic because a local injection has shown to nullify the results of low energy treatments on pain receptors. This means the patient must be able to tolerate the pain of the treatment. Once tolerance has been reached the energy level can not be increased. Multiple treatments are required to affect the pain receptors with low energy shock wave therapy.

 

Ask yourself, "What do I have to lose? What do I have to gain?"

Please don't be among those people suffering needlessly. We would like to offer you a complimentary examination to see if ESWT can benefit your heel pain condition.

You have nothing to lose. Our doctors are willing to waive their customary examination fee to help you find your answers about your condition and ESWT. To make an appointment, or even to just ask questions about the doctor in your area or the procedure, give us a call and we will take care of you. You can call anytime. We look forward to helping you find your freedom from pain!

 

What is a heel spur? What happens to the spur during ESWT?

The word heel spur sounds ominous, sharp, painful, and jagged. On an x-ray they don't look much better. When patients see that spur they say, "no wonder my foot hurts!" They imagine themselves stepping down onto a spiky piece of bone. Problem is, doctors do not always properly explain what a heel spur is and why it forms. Patients are left with the misconception the spur is the cause of their pain or that they must be removed.

The fact is the heel spur is not the cause of your pain. It is not a hard piece of bone. No doubt, it looks nasty on an x-ray, but it is actually a toothpaste-consistency calcium buildup. It is not jagged or sharp at all. In the case of plantar fasciitis, the heel spur is a result of micro tears or other trauma to the Plantar Fasciia tendon. To put it simply, when the tendon pulls away from the bone the body responds by "pasting" it back together with the calcium buildup. That calcium buildup is what you see on the x-ray as the "spur."

ESWT treats the tendon, not the spur. The spur will not break apart in chunks and float around in your heel causing pain. The spur is not an issue with ESWT.

 

Signs and Symptoms that your heel pain may be Plantar Fasciitis and Heel Spurs:

• Foot pain that is very bad in the morning.
• Foot pain that gets sore after sitting.
• Foot pain that keeps you from doing the things you love.
• Burning in the sole of the foot.
• Tired, achy feet that you blame on shoes.
• Tired, achy feet you blame on "being on your feet too much." Foot pain or heel spurs "run in the family."
• Heel pain after starting a new running, walking or exercise routine.

 

Signs and Symptoms that your heel pain may be Achilles Tendonitis:

• First steps in the morning are very painful along the back of the heel.
• First steps after rest or sitting are very painful along the back of the heel.
• Pain can subside and then return after rest or athletic activities.
• Common in athletes and runners who experienced pain but ran "through it."
• Pain can be a persistent ache, a shooting pain, a burning pain, or even severe piercing pain.

 

Diagnostic Testing & Conservative Therapy

Your Certified Excellence Shock Wave Therapy practitioner will perform a thorough examination and order any necessary diagnostic tests to determine your best course of treatment for your condition. Though this report focuses on ESWT, it is the goal of every Doctor in the Excellence Shock Wave Therapy Group to provide the best possible treatment for your pain. The doctor may recommend ESWT or another course of treatment. Rest assured you will be seen by a physician who will inform you of all your treatment options and make a complete diagnoses and treatment plan. You will not have to guess if ESWT is right for you. The Doctor can help you make your treatment decisions based on your individual condition.

If ESWT is right for you we do not need to delay. We know you are in pain and will make every effort to schedule your treatment quickly and at a time convenient to your schedule. The sooner you receive treatment, the sooner you are enjoying your hobbies and active lifestyle again!

 

Evaluate ESWT Before Surgery!

Our doctors have seen the results of plantar fasciitis, achilles tendonitis and heel spur surgery for years. They are very knowledgeable in the treatment of heel pain. They know with surgery there are sometimes complications. Some are serious, some take a long time to go away, and some are serious and cause permanent disability. With ESWT, there are no permanent complications. In fact, because ESWT is non-invasive and totally safe, the American College of Foot and Ankle Surgeons now include ESWT in the Standards of Treatment flowchart before proceeding to foot surgery.

 

Why doesn't my orthopedic surgeon or podiatrist do this procedure?

There are several reasons. This procedure is fairly new to the United States. It has been available internationally for over 10 years, but has only been in the United States for a little over two years. The physicians who practice ESWT in the United States are truly state-of-the-art practitioners. You may find many physicians are not even familiar with this treatment. You are more than welcome to share this report with your physician and have him or her contact us for further physician-oriented information. We welcome this communication!

Additionally, this technology costs over a half million dollars to offer in a practice. This investment is simply not affordable. Excellence Shock Wave Therapy owns the equipment and trains physicians in the technology and practice of ESWT. Doctors who offer this treatment are proving they try to avoid unnecessary surgery and hospitalization for their patients.

 

I have had this problem for a long time. Is it too late for me?

No! The chronic sufferer has new hope with ESWT. Long term sufferers finally have a non-surgical treatment option. If you have "tried everything" don't be discouraged, this is a new weapon against your pain!