Apollo-Wave extracorporeal shockwave therapy
Low-energy extracorporeal shockwave therapy known as soft wave is an intervention used in medicine to assist in the healing of injured and inflamed tissues with tissue regenerative technology. The technology from a company in Germany that has spearheaded decades long research on this therapy in lithotripsy devices for gallstones and renal stones has now focused its attention to a device much smaller and applicable for office use for several maladies.
From the first investigation of the application of shock waves in medicine until today is a very short time. During WWII it was observed that the lung of castaways was fractured because of the explosion of waterbombs although no outer symptoms of violence existed. This was the first time that the influence of shock waves, created by the exploding bombs, on tissue was observed.
In the 1950s the first systematic investigations for the use of shock waves in medicine was performed. For example, it was published that electrohydraulic generated shock waves were able to crush ceramic plates in water. In the USA the first patent of an electrohydraulic shock wave generator was accepted (Frank Rieber, New York, Patent No. 2.559.277). End of the 1950s the physical properties of electromagnetic generated shock waves have been described.
In 1966 the interest in shock waves on humans was stimulated accidentally at the Dornier MedTech GmbH a German company. During experiments with high velocity projectiles an employee touched the plate in the very moment where the projectile hit the plate. He felt something in his body like an electrical shock. Measurements show that no electricity was present. The generated shock wave traveled from the plate over the hand in the body. From 1968 until 1971 the interaction between shock waves and biological tissue in animals was investigated in Germany. The devices developed were for both human and veterinary use.
In 1980 the first patient with a kidney stone was treated in Munich with a prototype machine called Dornier Lithotripter HM1. In 1983 the first commercial lithotripter (HM3, Dornier) was installed in Stuttgart/Germany. In the next years in-vivo and in-vitro experiments with extracorporeal generated shock waves with the goal to disintegrate gallstones were carried out. Millions have been treated to break up kidney stones over the years all over the world. It is now not limited to renal calculi treatment.
Animal experiments showed that shock waves have osteogenic potential and stimulate fracture healing. Histological investigations confirmed the influence of shock waves on the activation of osteoblasts. In 1988 the first shock wave treatment of bone non-union in humans was successfully performed in Bochum/Germany. At the same time Valchanow et. al. reported about shock wave therapy on non-unions and delayed unions. His success rate was 85% but the requirements of his clinical study were not exactly specified. In the next few years different clinical studies reported success rates between 60% and 90%. As side effects local hematomas, petechial hemorrhage and local swelling were found. These side effects disappeared within a few days without any complications.
The first investigations and treatments on humans were performed with lithotripters, which are designed for the requirements of shock wave application in urology. Because of the anatomical decentralization of the therapy areas (shoulder to foot) it was necessary to develop a special orthopedic shock wave device. In 1993 a special orthopedic shock wave device, OssaTron (HMT AG) with a free moveable therapy head became available.
At the beginning of the 1990s the first reports about shock wave therapy on tendinitis calcarea were published. Further investigations lead to successful treatment of epicondylitis and heel spur with reported success rates between 70% and 80%. Because of the increasing significance of shock wave therapy on soft tissue diseases, HMT developed a special shock wave device, the ReflecTron. The new concept of its electrode (ReflecTrode) is an increased durability of 50000 shock waves. For the scientific evaluation of the ESWT for orthopedic diseases many clinical studies and publications are available. Design, protocol and contents of the published studies are different but all publications agree that ESWT show high efficiency but very low complications and side effects.
The device in use at our office, the OrthoGold100, is FDA 510K cleared for activation of connective tissue, registered for pain reduction and improvement of blood supply. Treatments are usually 10 to 20 minutes. In musculoskeletal (MS) conditions success rates are at 91%. Other therapies outside of MS have a very high success rate following our protocols.
If you are interested in this therapy, call our office and speak with one of our advanced providers to be evaluated for this intervention. You can contact us at info@carolinaholisticmedicine.
There is much research published by the ISMST (International Society of Medical Shockwave Treatment)
Softwave Can Help Doctors Treat the Following Conditions
- Neck & Back Pain
- Bone on Bone Joint Pain
- Arthritis
- Carpal Tunnel
- Tennis/Golfer Elbow
- Plantar Fasciitis/Heel Spurs
- Neuropathies
- Tendinopathies
- Patellar Syndrome
- Muscle Trigger Points
- Fractures
- Wounds (wound healing)
- Genitourinary Issues (in males and females)
- Erectile Dysfunction
- Peyronie’s syndrome
- And more…
The ISMST provides a full list with Indications and contraindications:
Indications
1. Approved standard indications
1.1. Chronic Tendinopathies
1.1.1. Calcifying tendinopathy of the shoulder
1.1.2. Lateral epicondylopathy of the elbow (tennis elbow)
1.1.3. Greater trochanter pain syndrome
1.1.4. Patellar tendinopathy
1.1.5. Achilles’ tendinopathy
1.1.6. Plantar fasciitis, with or without heel spur
1.2. Bone Pathologies
1.2.1. Delayed bone healing
1.2.2. Bone Non-Union (pseudarthroses)
1.2.3. Stress fracture
1.2.4. Avascular bone necrosis without articular derangement
1.2.5. Osteochondritis Dissecans (OCD) without articular derangement
1.3. Skin Pathologies
1.3.1. Delayed or non-healing wounds
1.3.2. Skin ulcers
1.3.3. Non-circumferential burn wounds
2. Common empirically-tested clinical uses
2.1. Tendinopathies
2.1.1. Rotator cuff tendinopathy without calcification
2.1.2. Medial epicondylopathy of the elbow
2.1.3. Adductor tendinopathy syndrome
2.1.4. Pes-Anserinus tendinopathy syndrome
2.1.5. Peroneal tendinopathy
2.1.6. Foot and ankle tendinopathies
2.2. Bone Pathologies
2.2.1. Bone marrow edema
2.2.2. Osgood Schlatter disease: Apophysitis of the anterior tibial tubercle
2.2.3. Tibial stress syndrome (shin splint)
2.3. Muscle Pathologies
2.3.1. Myofascial Syndrome
2.3.2. Muscle sprain without discontinuity
2.4. Skin Pathologies
2.4.1. Cellulite
3. Exceptional indications – expert indications
3.1. Musculoskeletal pathologies
3.1.1. Osteoarthritis
3.1.2. Dupuytren disease
3.1.3. Plantar fibromatosis (Ledderhose disease)
3.1.4. De Quervain disease
3.1.5. Trigger finger
3.2. Neurological pathologies
3.2.1. Spasticity
3.2.2. Polyneuropathy
3.2.3. Carpal Tunnel Syndrome
3.3. Urologic pathologies
3.3.1. Pelvic chronic pain syndrome (abacterial prostatitis)
3.3.2. Erectile dysfunction
3.3.3. Peyronie disease
3.4. Others
3.4.1. Lymphedema
4. Experimental Indications
4.1. Heart Muscle Ischemia
4.2. Peripheral nerve lesions
4.3. Pathologies of the spinal cord and brain
4.4. Skin calcinosis
4.5. Periodontal disease
4.6. Jawbone pathologies
4.7. Complex Regional Pain Syndrome (CRPS)
4.8. Osteoporosis
Contraindications
1. Radial and focused waves with low energy
1.1. Malignant tumor in the treatment area (not as underlying disease)
1.2. Fetus in the treatment area
2. High energy focused waves
2.1. Lung tissue in the treatment area
2.2. Malignant tumor in the treatment area (not as underlying disease)
2.3. Epiphyseal plate in the treatment area
2.4. Brain or Spine in the treatment area
2.5. Severe coagulopathy
2.6. Fetus in the treatment area
References:
https://www.shockwavetherapy.
https://www.shockwavetherapy.
https://softwavetrt.com/
https://softwavetrt.com/
https://softwavetrt.com/
https://softwavetrt.com/bone-