Focal Shock Waves

What are the focal shock waves

They are high pressure and high energy sound waves that promote biological changes for the recovery of damaged tissues.

They have been used in urology for more than 35 years to disintegrate kidney stones (lithotripsy), and for 30 years with GREAT SUCCESS in musculoskeletal pathologies such as plantar fasciitis-fasciosis and calcifying tendinopathies.

Types

Types of shock waves depending on:

Energy:

High Energy:allows to project the sound wave in depth to reach injured tissues that are at a significant depth from the skin.

Medium-Low Energy: allows to treat superficial or medium depth lesions.

Focusing:

Radial or defocused: their zone of maximum therapeutic efficacy is on the surface, close to the skin.

Focal: its zone of maximum therapeutic efficacy is located in depth, allowing to penetrate more or less in the tissues by varying the intensity in the device parameters.

Indications

Tendinitis, tendinosis, calcifications (epicondylitis, shoulder, patellar, achilles).
Calcaneal spur.
Trochanteritis, fasciitis / fasciosis, calcaneal spur.
Herniated disc, lower back pain.
Post-surgical fibrosis (after disc herniation).
Postlesional scar fibrosis: poorly healed muscle ruptures fibrosed and poorly healed sprains.
Pseudarthrosis (delayed fracture healing).
Carpal tunnel, metatarsalgia, meniscal lesions.
Growth diseases: legg perthes, sever, osgood schlatter.
Bone consolidation problems

Effects

Analgesic effect: reduction of pain by reducing pain sensory endings, and Gate Control effect.
Anti-inflammatory effect: degradation of inflammatory mediators.
Neovascularization and biochemical effects: promotes recruitment of stem cells and release of local growth factors.
Stimulation or reactivation of the regeneration of the affected tissue. For example in tendons (proliferation of tenocytes).
Osteogenesis: stimulates osteogenic factors (osteonectin). Very indicated in delayed fracture consolidation.
Anti-fibrotic effect: favors the viscoelasticity of fibrous or scar tissues, allowing to soften or soften scars (both internal and external).

Secondary Effects

Contraindications

Treatments should not be performed in the proximity of the lungs and intestine, hollow and membranous viscera filled with gas, which could rupture or explode and cause bleeding injuries and effusions.
Treatments affecting large vessels and nerves should not be performed because of the possibility of injury or bleeding.
As a precaution, in general, Shock Wave treatments should not be performed on pregnant women, especially in areas affecting the trunk and abdomen.
In children, treatments should be performed with great caution: Treatments should not be performed on the growth nuclei in the apophyses as it could affect or stop it, causing dysmetries and deformity.
Under no circumstances should shock wave treatments be performed on patients with coagulation disorders.
Nor should these treatments be performed in anticoagulated patients who have not been adequately reversed beforehand in the correct time frame. Maximum caution in these patients when the treatments are to be applied in the proximity of joints, for example Shoulder or Knee, etc, due to the possibility of developing tension hemarthrosis.
Shock Wave treatments should not be performed in patients with diagnosed Rheumatoid Arthritis.
Shock wave treatments should not be performed on systemic tumors.
Shock Wave treatments should not be performed on tissues that have been recently infiltrated with depot corticoids, since there is a risk of a massive release of these corticoids into the bloodstream. It is necessary to let 5-6 weeks elapse from the infiltration before starting to treat those areas.

Equipment

Frequently Asked Questions

What does a shockwave session consist of?

A shockwave session starts with the exact localization of the painful area through the use of ultrasound (not all centers that use this technique rely on the use of ultrasound equipment for diagnosis and treatment to obtain maximum precision). Gel is then applied to the injured area and treatment is started.

What should I expect in the days following the treatment?

After the treatment there is usually a slight discomfort that usually lasts 24-48 hours and are very similar to the stiffness that appears after doing high intensity sports.

Can I do sports after the treatment?

In many cases, sports activity can be started after 24 hours, but each case must be assessed on a personalized basis since many injuries require control of the loads and efforts for proper recovery.

How many sessions do I need?

It depends on each injury but it usually ranges between 1 and 6 sessions that are usually necessary.

How much time should pass between sessions?

1 week is usually the usual

Why is it convenient to perform an ultrasound prior to the application of Shock Waves?

When using a high power Focal equipment it is essential to direct the sound wave just to the lesion focus to guarantee the maximum impact on the injured tissue and therefore the maximum therapeutic effectiveness.

Otherwise, a large part of the energy generated by the sound wave would be lost in the environment of the lesion, reducing the desired therapeutic effectiveness.

Duration
Between 15 – 20 minutes.

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Focal Shock Waves

What are the focal shock waves

Types of shock waves depending on:

Energy:

Focusing:

Frequently Asked Questions

Duration

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