Here are some answers to the most frequently asked shockwave questions we receive. If you don’t see your question and answer here, feel free to call or contact us.
Q: Why is Shockwave Therapy better than other forms of treatment ?
Q: What is Mechanotransduction?
Q: What does “Extracorporeal” mean?
Q: Are there any side effects to ESWT?
Q: Is shockwave therapy painful?
Q: Does this treatment require anesthesia?
Q: Why is a shockwave loud?
Q: Which transmitter tip is to be used for which areas?
Q: What is required to set up the MASTERPULS series units?
Q: What is required to set up the DUOLITH unit?
Q: How do I exchange the tube & projectile in my radial handpiece?
Q: Do you offer training sessions on the use of the shock wave units?
Q: Is financing available?
Q: How long does it take to complete a treatment session?
Q: What happens after each treatment session?
Q: What is trigger point therapy and how does the D-ACTOR technology address this?
A: Shockwave therapy does not require the use of drugs or surgery and there are virtually no side effects and risks. Studies have shown that it is equal to or more effective than any other form of physical therapy, while being quicker and much more convenient. Mechanotransduction is the specific effect of shockwaves that causes all the biological reaction in the cells and tissue and is the important factor that differentiate SWT to ultrasound, laser, radiation, and any other therapy forms.
Q: What is Mechanotransduction?
A: Mechanotransduction refers to the many mechanisms by which cells convert mechanical stimulus into chemical activity. This chemical activity, in turn, causes a healing effect in the area.
A: Extracorporeal simply means “outside of the body” and refers to medical procedures conducted outside the body. For example, extracorporeal shock wave lithotripsy (ESWL) is a non-invasive procedure in which a device held outside the body is used to break up kidney stones inside the body, thus termed extracorporeal.
A: Only a small number of patients have shown skin redness, minor bruising, and soreness at the treatment site which was found to subside within hours or a few days post-treatment.
A: Different technologies of producing the wave cause different pain effects. For example, the electromagnetic technology is perceived to be less painful than the electro-hydraulically produced shockwave.
It all depends on the indication, for example treatments close to bone are more painful then treatments of muscles or ligaments and tendons. The individual threshold of pain of your patient also plays a factor.
When treating animals, it is difficult sometimes to interpret whether it is painful for them. We have found that when administering ESWT on horses for example, they actually seem to enjoy the treatment, especially when it is on sore backs and other muscle areas. When the treatment applicator makes contact with the affected area, the horse will actually lean into the hand piece to make the shock waves go deeper. In general, because the shock wave intensity can be adjusted up or down to accommodate any patient tolerance, we recommend simply starting at a lower intensity setting and administering the treatment at a low pulse per second rate. The patient will adapt quickly to this intensity setting and will be able to tolerate a higher setting. At this point, slowly increase the intensity to complete the treatment. If needed, you may increase the total number of pulses per second while staying at a very low intensity setting in order to complete the treatment.
There is also the theory of hyper-stimulation analgesia: thanks to the so-called analgesic effect, pain can also not be transmitted. Because of the strong stimulus of the shockwave, certain nerve fibers get activated. This causes a blockage of the transfer of the pain information through the spinal cord. As a result the receptors cannot give the signal “pain!” when they don’t receive the information. Accordingly, the pain cannot be felt at the location of the treatment.
You can test this on yourself!
A: No sedation or anesthesia of any type is necessary for radial ESWT treatment. Sometimes, the veterinarian will use sedation in the area if the patient is high-stressed to prevent kicking or other aggressive reactions. The STORZ MEDICAL units are not as noisy as most on the market, but the sound can sometimes aggravate the patient. Some Veterinarians use the ‘trick’ to shock a few times without touching the animal’s body so it gets used to the sound. If you can also keep the horse in a calm environment for example with other horses, the horse most likely will stay calm too. In general horses get accustomed to the sound quickly after or even during the first treatment.
A: The reason for shock waves being loud is because they are acoustic (sound) waves. There are two types of shock waves: focused and radial.
The two most common ways to generate a focused shock wave are electrohydraulic and electromagnetic. STORZ MEDICAL uses the electromagnetic technology. No matter which technology is used to produce the shock wave, a sound will occur.
The electrohydraulic method of generating a shockwave can simply be compared with lightning under water. To create the shock wave, a special spark plug, similar to one in a car, is triggered in the water. Immediately the liquid around it gets heated up and creates a pressure wave that extends very fast. This method of shock wave generation is very loud and sounds similar to a car backfiring continuously.
The electromagnetic method of generating a shockwave uses a different principle called Magnetism. The sound of the shock wave originates from a membrane around a magnetic inductor that gets expanded and then falls back to its original position, similar to the function of a loudspeaker membrane. The expansion of the membrane is very fast, creating the shock wave and a sound, which is not very loud.
The radial type of pressure (shock) wave generation is yet another way. Here a bullet-like object impacts a target and thus generates a pressure (shock) wave. These are transmitted into the tissue by different tips. It sounds like a deep tapping/cracking noise like that when playing the game of pool and two balls collide.
Thus, shock waves emit some sort of sound, regardless of which technology is used.
A: The shockwave transmitter tips for the MASTERPULS series units and the areas they treat are:
Ø6mm Acupressure – simulate acupuncture
High Precision – very painful, tense small defined areas close to bone
Ø15mm CERAMAX – tendons, ligaments, bone, joints
Ø20mm D-ACTOR I – muscle and tissue areas; trigger point therapy
Ø35mm D-ACTOR II – large muscle and tissue areas
The DUOLITH focus hand piece is complete with two stand-offs which treat all areas at different depths. They are:
No stand off attached (50mm): focal area is 35-65mm and therapeutic efficacy is 0-125mm
30mm stand off: focal area is 15-45mm and therapeutic efficacy is 0-105mm
15mm stand off: focal area is 0-30mm and therapeutic efficacy is 0-90mm
A: All STORZ MASTERPULS series units plug into a standard wall outlet and can be operated on any table top or equipment cart. They are also easily portable with the assistance of an equipment cart or transportation case or custom shoulder bag.
A: The STORZ DUOLITH unit plugs into a standard wall outlet and can be operated on any table top or equipment cart. It is also available in a Tower unit. The DUOLITH is easily portable with the assistance of a transportation case or equipment cart.
A: To see full instructions please watch our video.
A: FOCUS-IT, LLC will provide on-site professional training for qualified personnel at each location that enters into an agreement to obtain a shock wave unit.
A: FOCUS-IT, LLC offers a wide range of financing options for you from numerous leasing and financing companies. Some companies offer deferred monthly payment plans where you pay no money up front on approved credit. Speak to us to determine which program is best for you.
A: The time to treat each painful area takes between 5 to 10 minutes depending on how many impulses are applied per area. Typically, 3-5 treatment sessions are scheduled with 5-10 days in between sessions. The number of sessions may vary depending upon the location and severity of the condition being treated.
A: It is important for the patient to rest (hand walking 2x daily for 20 minutes is suggested) for a couple of days or weeks depending on the injury and subsequently restart with a controlled rehabilitation protocol. Increase the exercise/training continually depending on the soundness of the patient. This will ensure the best possible therapeutic results, will avoid further injuries and enable the patient to return to full work more quickly.
A: Trigger point therapy involves applying concentrated pressure to trigger points (or painful irritated areas in the muscle) in order to break the cycle of pain in the affected area. The D-ACTOR technology is designed to apply a unique bio mechanical deep pressure (hyper-stimulation) to these areas in order to release the latent trigger points and relieve the pain in the area.