AFM: What is Shockwave Therapy and why is it a better alternative than surgery?
Vieira: Shockwave Therapy is formally called Extracorporeal Shockwave Therapy. It uses high energy acoustic waves to treat numerous musculoskeletal injuries; typically, chronic overuse injuries and osteoarthritis. It is non-invasive, considered an alternative to surgery, and FDA approved. As far as benefits over surgery, in 30 years of use and research with Shockwave Therapy, no serious or long term complication has ever been noted and there’s hundreds of studies backing its safety and efficacy — so more effective with none of the risks associated with surgery. A lot of people also really appreciate that there’s no downtime after the treatment, and most injuries only require a single treatment.
Sieg: Typically for patients with chronic overuse injuries, they have tried things like activity modification, anti-inflammatory medicines, bracing, and physical therapy. Sometimes those treatments are not effective, and the next step is sometimes surgery. The surgery for overuse injuries is not great. The benefits of Shockwave Therapy are it is non-invasive, there is no downtime, it doesn’t hurt when you are done with it, and it doesn’t require stitches or anything like that so you don’t have the risk of infection. So the risks are so much lower. It’s FDA approved and shown on hundreds of studies to be safe and efficacious for patients.
AFM: Why would a surgeon recommend a non-invasive procedure?
Sieg: There are certain conditions where I definitely recommend surgery; displaced fractures, hip fractures — things like that. However, many conditions patients have are chronic overuse injuries, so when you come in for chronic knee pain or foot pain, it is nice to have a non-invasive treatment method. There are lots of risks with surgery. You often have to be put to sleep, there can be a lot of scar tissue, and the outcomes are sometimes not that good.
AFM: How does it work?
Vieira: Shockwave Therapy works in three primary ways. First, it breaks apart scar tissue and calcifications. A lot of times they’re impeding healing, causing pain; so it breaks that apart. Second, it causes vascular growth into the area. So, new blood flow is introduced to the injury, which of course is good. Third, most importantly, it actually stimulates the body’s own healing process, we like to say it tricks the body into thinking a catastrophic injury occurred. The body sends all the healing processes to the area, including the upregulation of stem cells and growth factors, to actually heal the injury — so it heals the injury, goes after the root cause, it doesn’t just cover the pain. Those mechanisms are what provide the long term results.
AFM: What are the differences between the OsteoWave and the OrthoWave?
Vieira: OsteoWave and OrthoWave are both high-energy Focused Extracorporeal Shockwave Therapy treatments. OrthoWave is primarily for chronic overuse injuries like plantar fasciitis, jumper’s knee, tennis elbow — those sorts of things. OsteoWave is for osteoarthritis. We can treat knees, thumbs, ankles; really, any joint with osteoarthritis.
AFM: What kind of injuries can shockwave therapy treat?
Vieira: Shockwave Therapy can treat a lot of injuries; it can’t treat everything but it can treat a lot. The most common injuries we see are typically the injuries I previously mentioned along with meniscus tears and knee osteoarthritis. Really, almost any chronic overuse injury that has failed conservative treatments.
AFM: How can OsteoWave help OA?
Sieg: OsteoWave is a non-invasive treatment before surgery, it gives patients an option to injections and medications. In general, when people think of osteoarthritis, they just think their cartilage, the squishy stuff on the end of their bone, is worn away but in reality, the entire joint is injured. This includes the bone just underneath the cartilage responsible for the cartilage’s blood and nutrition, the subchondral bone. The shockwaves treat that subchondral bone. It increases blood flow to the area and stimulates healing, thus remodels and regenerates the bone, and then the bone can support that soft cartilage on it. What it does for the patient is significantly decrease their pain and restore their function, and can give them lasting relief.
AFM: How often should one get treatments?
Vieira: The number of treatments for Shockwave Therapy — it’s typically one for most injuries, just a single session is required for chronic overuse injuries. With osteoarthritis, it is typically one treatment for mild early onset osteoarthritis, but moderate to severe requires a three treatment protocol. Basically we do the first treatment, two weeks later we do the second and then two weeks later we do the third. After the treatment is complete the injury is actually healed. So, you know, there aren’t treatments required in the future, unless of course you injure something else.