Extra Corporeal Sound Wave Treatment (ESWT)
Extra Corporeal Sound Wave Treatment (ESWT) is commonly used for the treatment of soft tissue and bone disorders around the foot and ankle.
Originally known as Lithotripsy, sound wave technology is similar to a small sonic boom resulting from a super sonic jet breaking the sound barrier. Formerly used to break up kidney stones, in the early 1990's it was discovered that this high intensity sound wave had benefit on wound and fracture healing. Since 1993, ESWT has been used on a regular basis in Europe for the treatment of painful tendonitis (tennis elbow), plantar fasciitis (heel spur)
and to treat fractured bones that did not heal normally.
Mechanism of Action
Sound wave utilizes a high intensity sonic pulse, which can be focused on a target area in and around the foot and ankle. Although the exact mechanisms for the technology is not fully known it is believed that micro-trauma will ultimately repair and increase in development of blood supply to the area. Some have linked the mechanism to tenderizing meat by pounding a tough piece of steak with a wooden mallet and making it more soft and pliable. Often chronic problems of tendons and ligament involve infiltration of scar tissue overlying these fibers. ESWT is thought to break up this scarring and allow the body to regenerate new and improved tissue to the area.
Equipment
The equipment used to deliver ESWT is highly advanced and has been evaluated by the FDA. These types of technologies are in common use throughout the world: Electrohydraulic, Electromagnetic, Pregoelectric and Radial. The equipment consists of a computerized device with a movable arm or hand held device that allows the physician to position a water-filled rubber bladder or applicator targeting the precise point of pain.
Treatment
Two different types of treatment are utilized at the Weil Foot & Ankle Institute. We use one time treatment high energy shock wave under anesthesia and multiple treatment low energy shockwave without anesthesia. With the low energy treatment, patients use biofeedback to guarantee exact placement of
treatment. Some studies have shown that this is the most effective way to perform shockwave. Treatment is performed at intervals of 1-2 weeks and three treatments are typically performed with 3000 pulses delivered at each treatment.
With high energy shock, anesthesia is necessary for comfort and tolerance of the procedure. After confirmation of exact positioning, the computer is then set to deliver 1000-3000 high energy sonic pulses at a pre-determined intensity level. It is recommended the procedure be performed under twilight sleep in an ambulatory surgery setting or hospital. Local anesthesia may be used in special circumstances.
Recovery
With low energy shock wave, patients can resume normal activities immediately after the procedure. Patients typically leave the office feeling better than when they arrived.
Following the high energy procedure, patients are asked to take it easy the remainder of the day. The day after the procedure, almost all patients are able to resume normal activities. Significant pain relief was
noted by greater than 80% of the patients within a week following the procedure. No immobilization is required.
Results
The Weil Foot and Ankle Institute has successfully performed ESWT since February of 2000. We have participated in three FDA studies on ESWT, as well as multiple clinical studies. Our clinical studies have shown a greater than 80% success rate while using ESWT to treat plantar fasciitis and other tendon problems involving the foot and ankle. 83% of patients treated have had a reduction on a 0-10 pain scale by at least 5 for their condition. On rare occasions, patients have gone on to invasive surgical procedures. No patients have been made worse and no patients have developed complications from the ESWT. Full clinical benefits are fully realized 2-3 months following the procedure.
Dr. Lowell Weil Jr. served as the President of the International Society for Medical Shockwave Treatment from 2009 to 2010, culminating in Weil Foot & Ankle Institute's hosting the 10th Annual ISMST Scientific Congress in June 2010.
Costs
Costs are dependant upon the location of pain and the time required to treat the condition. Many insurance companies cover the cost of ESWT treatment.
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Weil Foot & Ankle Institute
(847) 390-7666
Email :
info@weil4feet.com
Website :
www.weil4feet.com
