Shock-wave therapy on the “Master plus 100” (Switzerland Storz medical) device

 The history of the development of extracorporeal shock wave therapy (ESWT) began in 1951 in the United States. In 1980, in Munich, for the first time without surgery, a stone in a human kidney was destroyed with the help of shock waves.

Experiments with shock waves continued, as a result of which in the late 1980s it was discovered that if the pressure and density of the energy flow of an impulse are reduced, then its ability to break down, but it will have anti-inflammatory, analgesic, and stimulating effects on tissues. The first ESWT was adopted by traumatologists and orthopedists. Since then, the designs of wave generators have been repeatedly modified and their capabilities have expanded. Today, extracorporeal shock wave therapy has found widespread use throughout the world. This gentle technology is successfully used in orthopedics, neurology, rheumatology, phlebology, and aesthetic medicine.

The principle of operation of shock wave therapy is based on the transformation of an impulse from a shock wave effect into a sound wave, which is transmitted to the external environment. The human body is 65-80% water, and the acoustic wave propagating through it is absorbed in the border with the bone. The difference in tissue density affects the power of the impact, while the greatest effect is achieved in denser tissues, as well as at the interface between tissues, for example, such as bone and tendon, muscle, and fascia. The impact of shock-wave impulses does not destroy tissues, but “loosens” them, improving microcirculation and stimulating the processes of repairing the damage. Even one session of ESWT significantly reduces the severity of pain, helps restore range of motion in the joints, and increases resistance to physical stress. In recent years, the use of extracorporeal shock wave therapy has increasingly made it possible to avoid surgical intervention in the treatment of injuries of the musculoskeletal system and in degenerative-dystrophic diseases.

7 main effects achieved in the affected area using ESWT:

• Stimulation of blood circulation and lymphatic drainage, the formation of new vessels.
• Violation of the structure of calcium deposits, which leads to their resorption.
• Changes in the permeability of the cell membrane, due to which the transmission of the pain impulse stops.
• Pain relief with hyperstimulation.
• Release of endorphins necessary for a person.
• Changes in the reflex arc that controls muscle tone.
• An increase in the diffusion of cytokines (peptide information molecules) through the walls of blood vessels, which significantly speeds up the process of general recovery.

The DMC clinic is equipped with the most modern device “Master Pulse MP-100” (Germany). The device, using a wide range of nozzles, allows you to accurately dose the intensity of exposure adjust the depth of wave penetration, and clearly mark the treatment area. At the same time, the wave does not generate heat and does not form a high-density electromagnetic field; therefore, if the patient has metal structures in the affected area, then this is not a contraindication to the use of the ESWT method.

The ESWT method at the DMC Medical Center is used to treat:

• humeral-scapular periarthritis (subacromial bursitis, rotator cuff tendonitis);
• enthesopathies in the elbow joint (“tennis elbow”, medial epicondylopathy, bicippital and tricypital tendopathy);
• wrist joint (styloiditis);
• hip joint (trochanteritis);
• knee joint (tendopathy of the upper and lower pole of the patella);
• feet (achillobursitis, heel spur);
• arthritis, deforming osteoarthritis;
• herniated disc;
• radiculopathy, sciatica;
• chronic damage to ligaments and tendons;
• delayed consolidation of fractures of the long bones.

Extracorporeal shock wave therapy in orthopedics

In recent years, the method of extracorporeal shock wave therapy has been increasingly used in orthopedics. This is due to the fact that, despite the use of other modern methods of treating injuries of the musculoskeletal system and degenerative-dystrophic diseases, many problems arise. For example, bone fractures in 10-13% of patients are complicated by the development of contractures, ankylosis of the joints, and post-traumatic arthrosis. Also, a fairly common pathology is a painful syndrome in the places of attachment of tendons and ligaments. According to experts, 80% of the adult population suffers from these diseases, and physiotherapy, the use of nonsteroidal anti-inflammatory drugs, corticosteroid injections, acupuncture, and massage do not bring relief in all cases. With surgical intervention, it is also not always possible to achieve the desired result, moreover, this is always associated with a long rehabilitation period and the risk of complications.

A session of shock wave therapy is carried out once every 3-5 days; the duration of one procedure is up to 20 minutes. Main indicators: pressure – from 1.6 to 3.0 bars, frequency on average 8-15 Hz, number of impulses up to 4000 per procedure. Pain syndrome decreased immediately after the first procedure in 70% of treated patients.

The ESWT method allows in many cases to speed up the recovery, as well as to avoid surgery.

The main advantages of the method:

• high efficiency of therapy;
• carrying out treatment on an outpatient basis while maintaining the usual way of life;
• lack of cicatricial changes;
• exclusion of postoperative complications.