Shockwave Review

For this week’s blog, I will be talking about my review of Shockwave Therapy.  We borrowed the machine from the wholesaler and used it on patients in the office for over a month. This is why I am so happy that I am able to give you a comprehensive review of what the results were when we used Shockwave therapy for our patients.  

We were able to see a wide range of different issues, injuries, ailments, and varying levels of acute versus chronic. With these, we were able to get a good idea of how between two to five treatments looked and what their results were. It was kind of all over the place in what types of injuries we looked at and I just wanted to go over a few because we did decide to make that leap and invest in a very expensive machine that unfortunately isn't covered by insurance, which seems strange because it is not necessarily a new technology. It is been around for years and years, about 30 years to be exact.

The machine for Shockwave Therapy was first introduced back then to break up kidney stones. And I know that our local urologist in town uses the same type of therapy in the OR, on a much bigger scale, to break up kidney stones for you. So it uses that extra corporal shockwave therapy to use that acoustic compressive force to break up the kidney stones and gallstones. And this specific machine that we're getting into the office is the latest in technology and it's able to pinpoint down more, be a little bit more refined, so that it doesn't cause pain. It can be intense if we ramp up the depth and the pressure, but it doesn't have to be. So you have no pain at all when you're in an area that doesn't have an issue and where you feel something, that's where you have an issue and it is totally up to you how much or how little you want. It might take a little bit longer to see results if you go super pain-free with your treatments.

 It's interesting to see how it's developed through the years and the rep was able to show me a few different machines that they have. And with the later older models, the treatment time takes a little bit longer. It's not as effective. It is a little more uncomfortable. It can leave some bruising. So the machine we went with is their most advanced one and it does not have those kinds of side effects because I personally don't like to have any undue extra pain. And I thought that it would be most palatable for patients to have a product that doesn't cause a ton of pain or doesn't have to when you use it.

Recap On What Shockwave Therapy Is

So now if you want to learn more about Shock Wave, I did do a blog that just kind of introduced it and that was before I had worked on it with patients for that long period of time. But it is the acoustic compression therapy and that's basically just mechanical sound waves to remodel tissue in your body at the cellular level by addressing a large variety of conditions. So we're talking scar tissue, calcification, similar to those kidney stones and gallstones that can show up in things like muscles, tendons, ligaments in throughout your joints, in throughout the muscle fibers themselves, but also within the blood vessels as well. It works with bursitis, caps, frozen shoulders, that kind of thing.

Some of those big things that people think about using Shock Wave Therapy, or they also call it extra corporal therapy, would be carpal tunnel syndrome, tennis elbow, golfer’s elbow, plantar fasciitis is a big one. We treated a lot of plantar fasciitis while we had the machine. We also did trigger point treatments, frozen shoulder, different shoulder injuries around, that's a ton of tendon and ligament issues there, patella syndrome, which is into the knee, tendinopathies of any kind, a lot of SI joint pain we treated with the machine while we had it, and then some weird ones that I also wanted to get into a little bit and tell you about that.

Some Contraindications Preventing You From Using Shockwave Therapy  

One thing I did want to touch on are there are some contraindications. So there are some things that would prevent you from using this therapy. So if the treatment area had any infections or anything like that, we would not want to use it on there. We don't want to use it directly on the brain. We used it on people's TMJ, but we weren't directing it up towards into the brain when we did it. We don't want to do it around any area where you have any tumors or anything like that. So cancer would take it off the table for you. If you also have a pacemaker we don't want to do it right over or near where the pacemaker is at itself. We don't do it on pregnant patients.

If you're taking a blood thinner, it would be up to the physician who prescribed the blood thinner whether or not they thought the dosage was too high that this therapy might cause some issues with bruising and that kind of thing. Certain blood clotting disorders are a no-go. And if you have had something like a steroid injection, we want to wait two weeks after you've had that injection to get treated because they're two competing treatments and we don't want to lessen the effect of both because they're working against each other.

Interesting Results While Working With Shockwave Therapy

Some of the interesting results that I had while working with it, I had a person come in who had not been able to do yoga in a very long time. Now when you think yoga, sometimes if you're not into yoga, you might think of it as being very slow and sitting there and sitting in a stretch. I'm talking a very intense high level yoga that this girl's performing. So she has practiced for a decade. She could do all sorts of arm balances, handstands, back bends, all sorts of crazy postures. And she had hit this period where she had such severe low back pain that she wasn't even able to attend class or do any core work without having very intense pain in her low back that kept her from doing just day-to-day stuff like moving around, easily picking things up, just making it through the day. So it really decreased her quality of life in that way and kept her from coming to the yoga classes that she liked for years.

I happened to be in a yoga class and I'm so used to not seeing her there that it didn't even occur to me that she'd be there even though I knew that the treatment was working for her. I'm in the middle of a class, she's behind me, and I realized she was behind me and we were doing a backend and I'm looking behind me and I'm seeing her. And she, instead of doing just a regular normal camel pose, and if you don't know what that is, you're basically just arch backwards, she was able to stand up, raise her arms up and drop back all the way back into a back bend. And that was so far from attainable for her before she had these treatments. So it was really unbelievable results for her. That's like a decrease in pain, ability to move more, and increase in range of motion that happened for her and that was low back and SI joint issues.

My dad has had a long laundry list of symptoms. I have done some blogs about his crazy journey of a motorcycle accident right at the start of COVID and then the rehab of that broken shoulder. He's also had another fractured shoulder from motocross racing when he was younger. He has a fusion in his cervical spine from the 90’s. As you use the segments above and below your fusion, after a while those wore out even faster and then you're kind of back to square one. So that's kind of where he is at.

He also just had a hip replacement this past spring. He is an avid golfer. We've rehabbed him up one side and down the other with his motorcycle accident and then he had his hip replaced and he did really well. He always goes really hard with his rehab. He follows everything to the tee because he has basically one goal and it's to get back to golfing. It is his love and he doesn't like to sit very much. So just in general getting back to moving is very important for him.

So he returned to golf very quickly after his hip surgery, but he is very competitive and does not like to just simply return to golf. He likes to be competitive and the hesitancy of his swing and not having the full range of motion with his shoulder from his injury with the motorcycle accident, those things combined limited him, shortened up his swing and he was shooting in the 80’s, which might be great for some people, but for him he was super dissatisfied, not loving it.

We treated him I think six times and he had really good increase range of motion. The increased range of motion happened in the neck, shoulder area where he had lots of calcification, lots of scar tissues. He had 13 fractures throughout his ribs, multiple places on individual ribs, fractures throughout his scapula or his shoulder blade on the one side, so a ton of scar tissue. We worked through that. We worked through scar tissue around the hip where he had his surgery. You can use this therapy right over your hip replacements, that is not an issue. Got in better range of motion there and he has been shooting in the 70’s. He's down to a five handicap and he is very happy.

He also has something that is not as advertised that this therapy works for, but one of the benefits of this therapy, it helps on a couple different levels, but one of the levels is that it basically improves your circulation and by circulation I'm talking blood flow and then it helps to regenerate cells. So with an increase of blood flow, he has Raynaud’s. Raynaud’s is an autoimmune disease which gives you less blood flow to your hands and feet. So you get different changing of color in your hands and feet and it's very, very painful when you go out in any type of cold weather. And he also likes to golf all year round. So he golfs in pretty crazy ridiculous weather. So we treated his hands because that's his trouble spot more so than the feet. We treated his hands a few times at a pretty low level because they're, you know, much less density to get through with the treatment and he had really great results with less discoloration. So not even just the feel of less pain went out in the cold, but also the visual appearance of his hands. He did not have them go completely white, that is something we were able to treat his other issues more, more treatment times, and we only treated his hands a few times. So we'll definitely continue with that and hopefully have better improvement of the blood flow to his hands.

What Shockwave Therapy Helps With

Now with that Raynaud’s being an autoimmune disease, that I'm not sure, but I'm guessing will probably need some maintenance appointments because it would be an ongoing inflammatory based kind of thing. Now with that Raynaud’s, what the helping part of this therapy to help with that is that it improves blood circulation and stimulates the body's own metabolic process to accelerate healing. So we're accelerating healing with this.

So another thing that this helps with is peripheral neuropathy. And peripheral neuropathy can be just unexplained. Some people just get it and doctors don't know why or people who are diabetic often get it. It can be progressive and it can be, you know, you can take certain medications that might, may, or may not work for you. So this is a non-invasive, non-surgical, non-medication based way to treat peripheral neuropathy simply by using those pressure waves that go into the injured tissue and nerve area to improve that circulation and simulate healing process and accelerate healing.

So what if we're talking about nerves with peripheral neuropathy and we're saying we're doing an increased blood circulation. The tie there is that nerves need blood flow to function properly and that's what brings in oxygen to help heal things. So it's an excellent way to treat that diabetic and peripheral neuropathy without the side effects of medication and you don't require downtime between treatments. It’s relatively pain-free and we would, let's say you had peripheral neuropathy in your feet, start on the soles of your feet and then work our way up your leg in that path of that peripheral nerve to help encourage blood flow to the lower extremity or your foot. And we would do one session a week and these sessions are only about 10 to 15 minutes, depending on the area. And they're pretty, as I said, not too painful depending on how much intensity you want. It looks almost like an ultrasound head. So it would have a little handheld device depending on which area we're using. And then we use a gel, it's kind of like an ultrasound gel to conduct those sound waves into your tissue. So it's a goo that we put on, we swirl around and it makes a little clicking noise as it delivers the pulses, takes about 10 minutes and that is it. And then you do it once a week for however many weeks until you get that full amount of treatment.

How Long Would The Treatment Be

Now with how many treatments are going to be a good range of treatments, for my dad who has years of buildup of scar tissue and adhesions and all those things, you know, fractured shoulder from, well older than me, so over 40 years ago, injuries, spinal fusion in the 90’s, motorcycle accident and a few years ago like all these very chronic long standing things, he had more treatments, six treatments and saw good results but he'll probably need maintenance treatments and he's good with that and he just wants to be functioning at his peak. That's important to him.

I did have someone who came in with plantar fasciitis, which is on your foot. It's painful when she would get out of bed, every time she'd get out of bed there'd be a ton of pain. Initially, pain right after teaching, you're on your feet all day, the floor is cement I believe and not forgiving, and she had incredible results with just one treatment and it really gave her substantial relief in one visit and lasted for a very long time. Now that is unusual, I would say, that usually takes between four to six treatments for something like plantar fasciitis, but you could have that exceptional results where you have a lot of relief in just one visit.

We had another really good case where we worked on someone who had golfer’s elbow. So that is a tendonitis in the tendons around the elbow. You can have golfer’s or tennis elbow. It works the same kind of concept. We applied the gel onto his forearm and his arm, and the thing is, when you're doing these treatments, we'll be waving the little head around back and forth with the goo and we'll ask you, it's a very back and forth kind of treatment. We're not just applying it where we think it's going to help and that's it. I'm asking you, “Do you feel anything? Do you feel anything?” Because if you're not feeling anything, we either need to use more intensity or a deeper depth with the heads or we're in an area that you don't have an issue. So if the tissue is healthy, you will feel nothing. And that really helps us narrow down if we're in the right spot. And it helps me for when I treat you regularly because I can focus the exercises I give you to target the area that I know now as dysfunctional and I can use my cupping and other things to really accentuate this treatment in the spot that I know is dysfunctional.

So we'll find the area that you do have an issue with and then we hold the lawn there or wave it around a little bit if it's too intense. And then we're waiting for the area to calm down a little bit and as that eases, we move along and find some more spots that might be a little dysfunctional as well. So with his elbow, he had really great results within a few visits and back to normal. So very positive.

But another more odd kind of a thing with the peripheral neuropathy, I read up all on that and that is something that I know that people use this machine to treat with. I had a patient in the office with trigeminal neuralgia. Now the trigeminal nerve is in the face and trigeminal neuralgia can be excruciating and also sort of like the Raynaud’s, can be excruciating with changes in temperature. So if you live in this area and winter is coming and you want to be outside because you know that the outside is good for you but your face feels like it's on fire when you go outside and it's cold, that is a problem. And trigeminal neuralgia is an irritation of the nerve. So it's coming out, there's one on each side, it comes out, it branches out and IVs the face in a few different patterns. So you have this spider web on your face of excruciating pain.

So I had this patient, I know she has this. We do different muscle things and fascial work to help kind of relieve the area and the tension around the path of the nerve. So I thought, well I treat TMJ with this because that is a tendon issue and trigger point issue if you're clenching a lot. So why not try this for that? So we're increasing blood flow or speeding up that regenerative healing process and after I think one or two treatments with that, she had really really great results and you know, it might be something that you have to have some so tune up visits or if you buy a package of treatments and you kind of get a handle on it and gets much better and you have to do one or two treatments every couple months if you're having excruciating pain before and it keeps you from being able to go outside, it keeps you from being able to get up in the morning and be able to hop out of bed and do whatever you want or helps you to walk again.

So many people will say, I haven't walked in six months because of this pain I have. If you turn around and blink and had an issue that you thought was going to go away and then you haven't walked for exercise in six months, that's a problem and that is going to lead to many more health issues that will snowball down the road. So this is a great kind of way to keep ahead of those other things that can really decrease your health.

Shockwave Therapy And Arthritic Changes

Another one last little scenario that I wanted to throw out there, I had three patients who had some arthritic changes in, two had arthritic changes in the wrist and thumbs and then one had some arthritic changes in the toes. Now this, you know, remember helps to improve blood circulation, stimulates that accelerated healing and the pulse waves, break up calcifications and scar tissue so it can give you some relief from osteoarthritis and there is really not much people can do for osteoarthritis. And when we did a few treatments, they had varying levels of success and two of them were pretty remarkable at the amount of success they had. They went from wearing a brace for that arthritic joint to being able to throw the brace out and not have to rely on it anymore. And one went back to drumming with ease and it was pretty interesting to see because we really don't have great treatments for um arthritis.

So if we can get in there and remodel and regenerate those healing processes, that is pretty awesome. And I will definitely personally be using this preemptively on my hands because I know with what I do with my hands in the office every day, working really intensely is going to lead to arthritic changes in my hands and I want to make sure that I stay on top of it because I want to be practicing for decades, not be sidelined with pain and all the things that I see my patients struggle with.

Conclusion

So we're going to run a really big sale to start off with. The machine again is unfortunately not covered by insurance even though there are tons -- it's very medically based, you know? It was instituted 30 years ago by MDs for urology, for kidney stones and gall gallstones, and it is used by PTs and podiatrists and physiatrists. It is a very widely used thing in the medical community. And they keep improving the delivery method and making it more and more comfortable and pain free, but for some reason, it is not covered by insurance.

So we took the plunge, we're hoping that it works. We’re excited. And for the month of December we are going to do $50 a treatment. You can buy as many treatments as you want and just you have to use them within a year. And then January, the price will go up to $60 per treatment. Again, you can buy as many as you want, just use them within a year.

Starting in February of 2023, we're going to have different packages. So you can buy a package of six, which is probably a very standard treatment package if you have SI joint pain or you have plantar fasciitis and that package will be $402. So it comes out to be about $67 per treatment and then a package of four treatments, which would be $280 and that comes out to be about $70 a treatment. And then if you just wanted to buy a single treatment for a tune up or whatever, that would be $75 a treatment.

So if you have any questions or anything like that, feel free to ask me or Kris at the front desk. She knows lots about it, she's used it, she's had great results too.

We're just very excited. So let me know if you have any questions and I look forward to bringing this to the office and hopefully seeing it help a lot of people and get people out of pain so that they can more easily do the exercises that I give them because that is going to be what brings you full circle. This will help you get out of pain faster. And then you got to take it one step further, get stronger, do the exercises since you feel pain-free, so that you don't have it recur and you can have that better, more lasting results down the road.

All right, have a great one!

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