Shock wave therapy
Pain relief through high-energy pressure pulses
(Extracorporeal) shock wave therapy refers to a treatment method in which high-energy pressure pulses are generated by a special device and then transmitted to the patient's body. The aim of the treatment is to relieve pain, for example in the area of tendons, muscles or bones.
Shock wave therapy is also used to dissolve calcium deposits. This means that functional limitations caused by complaints can also be treated. Since shock wave therapy is applied externally, this treatment method is one of the non-invasive therapy options and accordingly has few side effects. Thus, pain relief can be achieved in many cases without the use of regular painkillers.
Definition
Focused and radial shock wave therapy
A distinction is made between focused shock wave therapy and radial shock wave therapy. The most important difference between these two forms is the depth of penetration. The radial form has a more superficial effect and is mainly used to treat muscle tension or in fascia therapy.
Focused shock wave therapy, as the name suggests, is more targeted than radial shock wave therapy. Through this method, a specific point can be fixed and treated. Due to the short wavelength of these shock waves, areas of the body can also be reached that lie in depth.
Only focused shock wave therapy is used in our practice. In order to achieve optimal treatment success, we use the latest generation of devices. These devices are characterised by a lack of impedance loss when the shock waves pass from the device to the skin. This means that the energy of the device can be transferred to the patient's body without loss. Thus, structures can be treated in depth with precision and surrounding structures can be protected from the shock waves.
Effect & Procedure
How does shock wave therapy work?
The sound pressure waves used contain a lot of energy that is released when they hit solid structures such as calcium deposits in the shoulder. This allows them to be destroyed in a targeted manner.
Shock wave treatment also improves blood circulation in the tissue. This leads to a stimulation of the body's self-healing powers and thus to an acceleration of healing. Growth factors are released and an activation of stem cells is stimulated. Furthermore, a blocking of pain receptors and thus a direct reduction of pain is discussed.
How does shock wave therapy treatment work?
As a rule, the treatment can be tolerated without painkillers. During the treatment, the doctor carrying out the therapy consults with you and adjusts the intensity of the therapy to your pain sensation. The more often the treatment is applied, the less painful it becomes. The entire treatment usually lasts up to 10 minutes.
After the therapy, patients do not need to take any special precautions. The treatment is carried out on an outpatient basis. This means that the patients only come to the practice for treatment and can be discharged back into their normal everyday life after the treatment. Side effects are usually not to be expected.
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Indications
For which clinical pictures or diseases is shock wave therapy used?
Originally, extracorporeal shock waves were developed to treat kidney and gall stones. In the course of time, however, shock wave therapy was also used in other areas and is now widely used in the orthopaedic field.
Typical clinical pictures that can be treated by focused shock wave therapy are calcifications in the shoulder area (calcified shoulder, tendinosis calcarea). This method can also be used for so-called "tennis elbow" (synonym: epicondylitis humeri radialis) or "golfer's elbow" (synonym: epicondylitis humeria ulnaris). Patients who suffer from a heel spur (calcaneal spur) or Achilles tendon irritation (Achillodynia) and have discomfort when stepping can also benefit from treatment.
Further areas of application of focused shock wave therapy
In the area of the knee joint, shock wave therapy is used, for example, to treat patellar tendinitis. This is a painful tendon inflammation in the area of the kneecap (patella). (Chronic) bursitis, which occurs for example in the hip or shoulder, can also be successfully treated with shock wave therapy. The German-speaking International Society for Extracorporeal Shock Wave Therapy (DIGEST) also recommends treatment for painful metatarsal heads, or for arthrosis in the metacarpophalangeal joint of the thumb.
Whether focused shock wave therapy can lead to an improvement of the symptoms and the course of the disease in your individual case is best clarified in a personal consultation with your treating doctor.
When should shock wave therapy not be used?
There are some patients who should not be treated by shock wave therapy. These include children, pregnant women and patients with pacemakers. Patients with malignant tumours in the area of application should also not receive shock wave therapy.
Patients with blood clotting disorders or who are taking blood-thinning medication such as Marcumar or Xarelto should have individual counselling and risk assessment by the attending physician.
Opportunities & Risks
What are the chances of successful treatment using shock waves?
Following shock wave therapy, there is usually a rapid improvement in symptoms. Patients who are treated for pain often experience a reduction in pain or even freedom from pain.
However, since the shock waves stimulate cellular mechanisms, there may also be a short-term and temporary worsening of the symptoms (initial worsening). In this case, pain-relieving medication can be used so that the initial worsening gives way to treatment success after a few days. Since a single application usually does not achieve long-term treatment success, three to five applications are necessary to be able to subsequently assess the effect of the entire shock wave therapy.
What side effects can occur during the therapy?
Side effects and complications are very rare with focused shock wave therapy. In rare cases, redness, swelling or slight bleeding (haematoma) may occur at the point of contact with the shock wave head. These side effects usually do not require any further treatment and healon their own.
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Cost absorption
Does the health insurance cover treatment with shock wave therapy?
Focused shock wave therapy is not included in the catalogue of services provided by the statutory health insurance funds (GKV) and must therefore always be paid for by the patients themselves (so-called individual health service or IGeL). This also applies to the treatment of heel spurs. A complete shock wave therapy usually consists of 3-5 applications. The costs per application amount to 95,- EUR. You will receive advice and a transparent overview of the costs of the entire treatment from your treating doctor.
