Calcific Tendinopathy: Focused Shockwave Therapy is the most efficient and cost effective treatment
There are 4 alternatives to managing calcific tendinopathy in the shoulder: corticosteroid injections, surgical repair, focused shockwave (FSW) and living with it. Circled in blue on the left side of the image below is an example of a calcific deposit in the rotator cuff muscles. This condition is a common cause of serious chronic shoulder pain. On the right is the same shoulder after being treated with FSW. BOOM, no calcification, no risk of infection, no downtime.
Corticosteroid injections are commonly prescribed in Australia but they are painful with poor long-term outcomes because they do not get rid of the calcification. The strong anti-inflammatory injection simply masks the symptoms for a short period. Many sufferers of this condition are offered 2-4 injections, at a cost of a few hundred per injection over a year with minimal relief. When the pain recurs they are told that they can’t have any more injections due to adverse health risks.
The surgical correction can remove the calcification but it is way more expensive, costing thousands of dollars, with a risk of infection, requiring time off work and a lengthy rehab program.
The easiest, safest, most efficient and cost-effective procedure to eliminate tendon calcification is with FSW. The before and after photo at the top of the page shows what FSW can do after three treatments. The calcification was gone and the damaged tissue was repaired, allowing the individual to get on with life. On average, the calcium is reabsorbed 1-3 months after 1-3 weekly treatments delivering 2000 shocks at 6Hz. Each treatment takes 10-15 minutes.
Mild to moderate pain, 5/10, is experienced during treatment and most patients experience decreased pain and an improvement in their shoulder’s range of motion immediately after the treatment. In a study of 23 patients, at follow-up, 82.6% of cases show complete resorption and 8.7% show partial resorption. The remaining 8.7% showed no significant change in radiographic imaging.
The final alternative, living with it. Living with it means sleepless nights, having painfully reduced shoulder ranges of motion, reduced strength, having to reduce daily activities of living and a possible reliance on drugs. Since I have been trained in the use of FSW and have experienced it on my shoulders I can apply the therapy to your shoulders and prescribe the required exercises to rehabilitate the damaged tissues. There is no need to delay getting better.
To make an appointment for FSW please call us on 3823 2282 or 0409878180. If we are unable to answer your call, please leave a voice message. Alternatively, send us an SMS on 0409878180 and we will get back to you as soon as possible. For the computer savvy, you can book online at The Book Now icon is at the top right of the webpage.
Knee pain and Osteoarthritis (OA): why we get it and what to do about it
May 27, 2024 by manager • Uncategorized Tags: knee pain, osteoarthritis, Shockwave •
Most knee pain is not due to arthritis. It is due to faulty movement patterns because of mobility dysfunction/tightness in the pelvis/hip or foot/ankle. The knee is trapped between the hip and the ankle. If the hip or ankle do not move fluidly the knee cops the strain and experiences pain. Improving the mobility of these areas is an essential component of managing knee pain due to movement pattern/tracking disorders. If left unchecked poor quality movement patterns predispose one to developing knee OA.
The main risks of knee pain developing into OA include traumatic injuries, heavy manual work, overuse, sports injuries, older age, genetics and excess weight. Treat the cause of the knee pain before it develops into OA.
Knee injuries constitute 35% of overuse injuries and are a common cause of disability. According to the study by Liao C. et al. (2018), focused shockwave (FSW) significantly reduces knee pain, improves functional recovery, and increases the overall treatment success rate. In a clinical case, the morning knee pain of a 28 years old professional runner dropped from 8/10 to 0/10 after 5 sessions of FSW in 8 weeks together with a personalized strengthening program. Ultrasound images, after the treatment as compared to the pre-treatment images showed increased collagen alignment and decreased tendon thickness/swelling. Pain management with FSW allows patients to do their rehab exercises. The stronger you are the easier it is to align your knees, move better, get fitter, manage weight and reduce the risk of developing OA.
If you already have OA in your knees FSW can alleviate the pain through a few mechanisms. Chronic inflammatory cytokines activity and substance P are flushed from the area and their production is down-regulated. Lubricin production in the synovial tissues of the joint capsule and tendons increases, improving lubrication, allowing the joints and tendons to move freer. There is a proliferation of blood vessels and stem cells in the bone under the cartilage. As the bone regenerates, and becomes stronger and healthier it is more able to nourish and heal the damaged overlying cartilage. Stem cells are also drawn into the cracks and fissures in the cartilage to rebuild it.
Getting OA of the knee treated with FSW may mean being able to participate in your desired activities and avoid an expensive joint replacement. Even knees with a bit of bone on bone are worth treating but they may require a booster dose every 6-8 weeks. Keep up your rehab exercises and you may experience relief for decades.
Alternative treatments for OA
Corticosteroid injections are commonly prescribed for knee pain in Australia but they have poor long-term outcomes. The strong anti-inflammatory injection simply masks the symptoms for a short period but increases the rate of joint degeneration. When the pain comes back it is worse. Many sufferers of OA are offered 2-4 injections, at a cost of a few hundred per injection over a year with minimal relief. When the pain recurs they are told that they can’t have any more injections due to adverse health risks. If you get corticosteroid injections into the knee you diminish the possible benefits of PRP (platelet-rich plasma) injections and FSW.
If you want an injection in your knee get a PRP injection. The PRP injection bathes the entire inside of the joint with numerous white blood cells and platelet-associated growth and anti-inflammatory factors. This cleans up the surface of the joint space and draws stem cells to the cracks/fissures in the joint cartilage to heal it. There is no problem combining PRP injections with FSW. The FSW reinforces the benefits of PRP inside of the joint and can specifically address the damaged tissue on the external aspects of the joint like the surrounding tendons, ligaments and fascia.
Living with knee OA means sleepless nights, difficulty going up and down stairs, an inability to get down on the floor and up again without using your hands, reduced strength, difficulty getting out of a chair, having to reduce daily activities of living and a possible reliance on drugs with their toxic side effects. Since I have been trained in the use of FSW, have experienced it on my knees and do regular rehab exercises I can apply the therapy to your knees and prescribe the required exercises to rehabilitate your movement patterns, like in the image below, and damaged arthritic knee tissues. There is no need to delay getting better.
To make an appointment for FSW please call us on 3823 2282 or 0409878180.