Extra-Corporeal Shock Wave Therapy


Extracorporeal Shock Wave Therapy (ESWT) is a relatively new procedure used to treat a variety of conditions, including some causes of heel pain like plantar fasciitis, heel spurs, calcifying tendinitis, some varieties of Achilles Tendinitis, delayed unions and non-unions, and bone fractures.  

It works by sending strong, specialized shock waves towards the area of pain, thereby stimulating healing of the painful tissues. 

In fact, the technology is the same used in lithotripsy, where waves of energy are used to break up kidney stones.  The difference with these sorts of units is that they are designed to treat musculoskeletal problems.

The Piezoson 100
Extra Corporeal Shock Wave Therapy (ESWT) Unit

There are a couple types of shock wave therapies available to patients--Focused Extra-Corporeal Shock Wave Therapy and Unfocused (Radial) Shock Wave Therapy.  A few words on each technology:  

Focused ESWT

Focused ESWT uses a very special machine that is able to generate variable strengths of energy and focus that energy down to a specific level of inflammation and tissue damage to promote healing.   The energy literally passes through the body's undamaged tissues (like, say, skin and muscle) without effect, then is precisely focused and concentrated on the damaged tissue.  

Both the strength of the energy wave and the depth of the wave is able to be adjustable, making the newest form of focused ESWT technology, piezoelectric shockwave therapy, very precise.

Richard Wolf PiezoVet 100

The earliest versions of this sort of machine was frequently rather painful and required the use of anaesthesia.  They're also costlier, bulkier, and less precisely focused. 

But as of 2004, the newest technology available in Europe --the Piezoson 100-- was approved for use in Canada.  Piezoelectric ESWT is able to be very precisely focused, it's adjustable in strength, it can be applied painlessly so no anesthesia is required. 

Piezoelectric ESWT technology is so new that it is still not available in the United States; in fact, ours is the only facility in western Canada to offer this technology. 

Our Surrey office, in conjunction with our partners, Shockwave Therapy - BC, is the first and currently only facility in western Canada to offer this newest version of Extra Corporeal Shock Wave therapy.  If you have a heel pain condition non-responsive to treatment, and are interested in whether ESWT may be right for you, call our main office 604.589.5234 for more information as to whether you may be a candidate.  

 

How well does it work?  

ESWT offers rather impressive success rates for difficult-to-heel musculoskeletal conditions.  For example, studies indicate that success rates for otherwise non-responsive heel pain is approximately 85%.  And these are the people who already did not respond to other treatments.   There is more on ESWT research on our partner Shockwave Therapy - BC's website.   

Unfocused Radial Shock Wave Therapy

Another type of shock wave treatment available in British Columbia is one known as Unfocused Radial Shock Wave Therapy, or RSWT.   RSWT is not the same as ESWT (Extra-corporeal shock wave therapy) because the treatment works in a different way. 

Unlike Extra-Corporeal Shock Wave Therapy (ESWT) which can pass the energy wave through undamaged tissues like skin and muscles, Radial Shock Wave Therapy (RSWT) uses a pneumatic generator to physically deliver the shock wave to the skin, (which may cause some bruising), and from there it passes into the body.  It is perhaps most analogous to a tiny pneumatic jackhammer striking the skin to create the shock wave.  

Because the force of the energy of unfocused RSWT is applied directly to the skin, the energy waves begin to dissipate as soon as it hits the skin.  This makes it impossible to focus the depth of RSWT shock waves, making it much more difficult to ensure the shock waves are being delivered at the proper strength and to the proper depth of tissue inflammation and damage.  This limits RSWT's applications and effectiveness to superficial structures.   

It's generally up to the patient to make certain of which technology is being offered, as the difference may not be made clear without your asking.  

At present, ours is the only site in all of western Canada offering Piezoson 100 ESWT.  

How much does ESWT cost?  

In the United States, a course of the previous-generation ESWT frequently run in the $4,000 USD range, but it can run up to $9,000 USD, depending upon the technology and location.  So we're pleased to say that by acquiring the latest in ESWT technology, the Piezoson 100, we can now offer ESWT for significantly less expense.  In fact, patients may now have a series of treatments for under $1,000 Cdn. for a course (which may require several visits).  

ESWT is a particularly inexpensive when compared to alternative treatments such as surgery-- and the cost is well worth the expense for those whose pain is otherwise unresponsive to alternative treatments.  

ESWT is not currently covered by the Medical Services Plan (MSP)--though some government agencies (WCB, ICBC, RCMP) and many extended plans may cover the cost.  Usually this is on a case-by-case basis.  

We accept a variety of forms of payment including Visa, Mastercard, Interac, Cash, Cheques, and Travelers Cheques.  

You can also have ESWT (or any other medical expenses financed through Medicard, a company that finances private medical expenses.  Contact our office for more details.  

interac_direct_payment

Because most types of heel pain can usually be controlled treated and remedied through alternative and less expensive treatments, ESWT should be reserved for those whose heel pain condition has been non-responsive to alternative therapies.  

And it cannot be used for pain caused by conditions such as bone tumours, infections, and some nerve disorders.  

But for the most common causes of heel pain that are chronic and non-responsive to conventional heel pain--like heel spurs, fasciitis, calcific tendinitis, Achilles tendon pain, and slowly- or poorly-healing bone (delayed-unions and non-unions)--Extra-Corporeal Shock Wave Therapy (ESWT) may be a treatment alternative just right for you.  

To learn more about shockwave therapy, please visit our partner Shockwave Therapy - BC's website,  www.shockwavetherapy.ca

 


 

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S. A. Schumacher, D.P.M., F.A.C.F.A.S., F.A.C.F.A.O.M.  
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