shockwave therapy for plantar fasciatis in NYC

Shockwave Therapy

Treatment for Chronic Tendinopathies

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    Benefits of Shockwave Overview:

    New Blood Vessel Formation

    Nutrient blood flow is necessary to start and maintain the repair processes of damaged tissue structure. The application of acoustic waves creates capillary microruptures in tendon and bone. Due to microruptures the expression of growth factors such as eNOS, VEGF, PCNS and BMP is significantly increased.

    As a result of these processes arterioles are remodeled, stimulated to grow and new ones are formed. The new blood vessels improve blood supply and oxygenation of the treated area and support faster healing of both the tendon and the bone.

    Reversal of Chronic Inflammation

    Chronic inflammation occurs when the inflammatory response is not completely halted. It can damage healthy tissue and results in chronic pain. Mast cells are one of the key components of the inflammatory process. Their activity may be increased by using pervasive acoustic waves.

    Mast cell activation is followed by the production of chemokines and cytokines. These pro-inflammatory compounds first enhance the inflammatory process and in the next step help restore normal healing and regenerative processes.

    Stimulation of Collagen Production

    The production of a sufficient amount of collagen is a necessary precondition for the repair processes of the damaged myoskeletal and ligamentous structures. Shockwave therapy accelerates procollagen synthesis. The therapy forces the newly created collagen fibers into a longitudinal structure which makes the newly formed tendon fibers more dense and stiff and creates a firmer structure.

    Dissolution of Calcified Fibroblasts

    Calcium build-up is most often a result of micro-tears or other trauma to a tendon. Acoustic waves break up the existing calcifications. Shockwave therapy starts the biochemical decalcification of the calcium build-up of a toothpaste-like consistency and treats the tendon. The granular particles of calcium are then removed by the lymphatic system.

    Dispersion of Pain Mediator “Substance P”

    Substance P is a neurotransmitter that mediates pain information through C-fibers. This neuropeptide is generally associated with intense, persistent and chronic pain. It relays pain messages to the central nervous system. Lowering the concentration of Substance P reduces the stimulation of afferent nociceptive fibers and thus reduces the pain. Decreasing Substance P, histamines and other nociceptive metabolites also helps inhibit development of inflammatory oedema. Acoustic waves generated by Shockwave therapy lower the Substance P concentration and trigger pain relief.

    Release of Trigger Points

    Trigger points are the principal cause of pain in the back, neck, shoulder and limbs. They are associated with palpable nodules in taut bands of muscle fibers and have extremely contracted sarcomeres. The dysfunctional sarcomeres contract so tightly that they begin to cut off their own blood supply. This causes the waste products to build up. Waste product build-up irritates the sensory nerve endings which then causes even more contraction. This vicious cycle is referred to as “metabolic crisis”. The assumed mechanism of action is that the delivered acoustic energy unblocks the calcium pump and thus reverses the metabolic crisis in the myofilaments and releases the trigger points.

     

    Shock wave therapy has emerged as a possible treatment option for patients with chronic tendon problems. The procedure uses either pressurized air or electromagnetic pulses to delivers shock waves to the body to help treat a variety of chronic disorders.

    Shockwave therapy, or extracorporeal shockwave therapy (ESWT),  is a multidisciplinary device used in orthopaedics, physiotherapy, sports medicine, urology and veterinary medicine. Its main assets are fast pain relief and mobility restoration. Together with being a non-surgical therapy with no need for painkillers makes it an ideal therapy to speed up recovery and cure various indications causing acute or chronic pain.

    What does shock wave therapy do?

    Low-energy shock wave treatments are given as a series of three or more treatments. The low-energy shock waves are not painful, or mildly painful.

    Shock wave therapy is thought to work by inducing microtrauma to the tissue that is affected by these problems. This microtrauma initiates a healing response by the body. The healing response causes new blood vessel formation and increased delivery of blood flow and nutrients to the affected area. The microtrauma is thought to stimulate a repair process and relieve the symptoms of pain.

    Sports medicine practitioners embrace benefits of ESWT

    Extracorporeal shock wave therapy (ESWT) is a noninvasive treatment that involves delivery of shock waves to injured soft tissue to reduce pain and promote healing. According to Jonathan T. Finnoff, D.O., medical director for Mayo Clinic Sports Medicine at Mayo Clinic Square in Minneapolis, ESWT is a viable option to consider for many patients who present with chronic tendinopathy that hasn’t responded to more-conservative treatments. Often difficult to treat, chronic tendinopathy is characterized by localized pain and pathological changes to a tendon. The condition affects athletes and nonathletes alike.

    Acoustic waves with high energy peak used in Shockwave therapy interact with tissue causing overall medical effects of accelerated tissue repair and cell growth, analgesia and mobility restoration. All the processes mentioned in this section are typically employed simultaneously and are used to treat chronic, sub-acute and acute (advanced users only) conditions.

    Who is a candidate for Shockwave Therapy ESWT?

    The Food and Drug Administration has approved the use of ESWT for the treatment of plantar fasciopathy. However, Dr. Finnoff, of the Mayo Clinic, notes that multiple high-quality randomized clinical trials have provided substantial evidence that ESWT is a safe and effective noninvasive option for treating tendinopathy throughout the musculoskeletal system.

    Dr. Finnoff and his Mayo Clinic colleagues are currently using ESWT to treat chronic, recalcitrant tendinopathy throughout the body. Many sports medicine specialists have found this therapy beneficial for treating the following areas of tendinopathy:

    Rotator cuff

    The rotator cuff is a group of muscles and tendons that attach to the bones of the shoulder joint, allowing the shoulder to move and keeping it stable. Rotator cuff tendinitis refers to irritation of these tendons and inflammation of the bursa (a normally smooth layer) lining these tendons. A rotator cuff tear occurs when one of the tendons is torn from the bone from overuse or injury.

    Lateral epicondyle

    Tennis elbow, or lateral epicondylitis, is a painful condition of the elbow caused by overuse. Not surprisingly, playing tennis or other racquet sports can cause this condition. However, several other sports and activities can also put you at risk.

    Tennis elbow is an inflammation of the tendons that join the forearm muscles on the outside of the elbow. The forearm muscles and tendons become damaged from overuse. There are many treatment options for tennis elbow. In most cases, treatment involves a team approach.

    Medial epicondyle

    Medial epicondylitis (golfer's elbow) is a type of tendinitis that affects the inside of the elbow. It develops where tendons in the forearm muscle connect to the bony part on the inside of the elbow. Tendons attach muscles to bones. Due to injury or irritation, they can become swollen and painful.

    Greater trochanter

    Greater trochanteric pain syndrome (GTPS), also known as Greater Trochanteric Bursitis or Gluteal Tendinopathy, is a syndrome defined by tenderness to palpation over the greater trochanter with the patient in the side-lying position.

    Proximal hamstring

    proximal hamstring tendinopathy (PHT) is a disabilitating disease often causing underperformance in the athletically demanding patients. The main symptom of PHT is lower gluteal pain especially during running or while prolonged sitting.

    Rectus femoris

    The rectus femoris is the large quadriceps muscle running down the middle of the front of the thigh. Its function is to lift up the knee and straighten the leg. ... There is unlikely to be a sudden sharp incident of pain although chronic tendonitis can develop following a rupture.

    Distal quadricep

    It is often found co-existing with patellar tendinosis, which most commonly involves the tendon distally, but also the quadriceps muscle proximally. Quadriceps tendinopathy is a clinical diagnosis characterized by activity-related anterior knee pain with localized tenderness at the superior border of the patella.

    Patellar tendon

    Patellar tendinopathy (or as it is commonly known patellar tendonitis or tendinitis) is an overuse injury affecting your knee. It is the result of your patella tendon being overstressed. A common name for it is Jumper's Knee.

    Posterior tibial

    The posterior tibial muscle and tendon help stabilize the ankle. They are responsible for pointing the foot in and down. Posterior tibial tendinopathy includes both “tendonitis” (a condition involving inflammation of the tendon) and “tendinosis” (a condition involving degeneration of the tendon over time).

    Peroneal

    Peroneal tendonitis is the common term for a peroneal tendinopathy. Peroneal tendinopathy is a condition which is characterized by structural changes of the peroneal tendon in response to load. Peroneal tendon injuries are usually due to increased loads and overuse of the peroneal muscles.

    Achilles

    Achilles tendinopathy is a condition that causes pain, swelling and stiffness of the Achilles tendon that joins your heel bone to your calf muscles. It is thought to be caused by repeated tiny injuries to the Achilles tendon.

    Plantar fascia

    Pain on the bottom of the foot may be caused by plantar fasciitis – a result of inflammation in the fascia, a connective tissue, which in this case stretches between your heal and toes.