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Impact Waves



Shock waves represent one of the most recent and effective non-invasive therapies for the treatment of certain diseases of the musculoskeletal system.
                  What differentiates shock waves from traditional therapies such as ultrasound, magnet therapy, infiltrations? Traditional physical treatments do not go beyond trying to control inflammation and symptom pain; they are therefore "passive" treatments as they do not intervene on the causes responsible for the disease.
On the other hand, high-energy impact shock waves induce "biological effects" by intervening at the origin of the cascade of events responsible for inflammation and pain.
The shock waves emitted have a depth of penetration that varies according to the pathology to be treated; the high precision of focusing causes the shock waves to be effective exclusively in the area to be treated without damaging the neighboring tissues.
Clinical indications in Orthopedics are represented by:
• degenerative tendinopathies and / or calcifications of the shoulder (so-called scapulo-humeral periarthritis)
• epicondylitis and epitrocleitis (tennis elbow)
• calcaneal spine and plantar fasciitis
• insertional tendonitis of the ankle, goose leg tendonitis
• trochanteric bursitis
• stretching and muscular tears
• pseudoarthrosis or consolidation delays (carpal and hand bones, radius and ulna, tibia, tarsal and hand bones).

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The absolute contraindications to treatment are represented by:
• congenital or acquired changes in coagulation
• pregnancy
• pace-maker (for some types of appliances)
• skin inflammation or infections in the area to be treated
• growth cartilages near the field of application

Tearing of the rotator cuff and tendinopathies associated with severe glenohumeral arthrosis are relative contraindications.
High-energy shock waves are also used in Neurology: treatment of polyneuropathies, reduction of post-trauma spasm - in Angiology, Dermatology and Surgery: wound healing, skin burns, scar treatment.
In the literature there are no real side effects, except for a temporary skin reddening, in rare cases microhematomas, petechial haemorrhages can occur.

The treatment is short, 15 minutes, and well tolerated: the number of sessions and their frequency vary according to the pathology to be treated; in most cases three or four sessions are sufficient with weekly or fortnightly frequency. Immediately after the treatment the patient can resume normal activities. Immediately after treatment and in the next 4-5 hours there is a decrease in pain; after 24-48 hours a transient flare-up of the pain symptomatology is sometimes possible.
The therapy can be repeated without any negative effect on the organism.

To access shockwave therapy, you must undergo a specialist orthopedic examination to ascertain the indications, program a correct therapeutic protocol necessary to optimize the results and verify that there are no contraindications.
In addition to the clinical examination and the radiographic documentation of the district to be treated, ultrasound or MR are sometimes required.
The effects of the treatment in the indicated pathologies, varying from a significant improvement of the symptomatology to the resolution of the clinical picture, are to be considered positive in 70-80% of the cases according to the different cases.
It is however important to know that shock waves are not able to stop degenerative processes, but slow down their evolution. For this reason, an annual inspection visit is useful.
Shockwave treatment is useful to associate a "personalized" functional rehabilitation program to speed up the resolution of the pathology and consolidate the result obtained.

The effectiveness, non-invasiveness and high tolerability of this new therapeutic opportunity has opened new horizons in the treatment of some of the most frequent musculoskeletal disorders.

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