Shock wave therapy for many diseases of the musculoskeletal system, including radiculitis and spinal hernia, is a relatively new method of physiotherapy, and is used mainly in arthrology, that is, for joint pathology. SWT is also prescribed as a means of rehabilitation in sports, after various injuries and in other areas of medicine, for example, in urology. UVT is also widely used in cosmetology. What is the principle of shock wave therapy?
What is a herniated disc?
The intervertebral disc plays a fixing and shock-absorbing role for the vertebra. Its diameter reaches 4 cm. It is the discs that are responsible for optimal pressure and natural mobility of the spine.
Typically, intervertebral discs include the following components:
- Nucleus pulposus. It consists of elastic fibers having a radial direction and collagen threads having a random arrangement. There is water inside the core that prevents compression. As the body matures, the amount of fluid in the core decreases: in newborns this figure approaches 90%, and in the elderly population it is equal to 60%;
- Fibrous ring. Includes elastic plates separated by layers of collagen;
- End plates. The vertebrae are separated from the discs in the upper and lower parts.
If there is a chronic form of osteochondrosis, trauma, excessive stress or age-related changes, then changes occur in the structure of the nucleus pulposus and disturbances in the functioning of the intervertebral disc. As a result, spinal deformation occurs and the ability to optimally redistribute pressure on the disc is lost, which can lead to displacement of the core of any disc and severe damage to the fibrous ring.
The above pathology is called intervertebral hernia. Most often, this process is localized in the lumbar region. It is extremely rare to find it in the thoracic and cervical regions.
A herniated disc in the spine develops gradually; there are three stages:
- 2-3 mm (prolapse)
- 4-15 mm (protrusion)
- hanging drop outside the boundaries of the disk (extrusion)
As a result of compression of the nerve fibers extending from the spine, the patient feels pain in a certain area of the back, depending on the location (cervical, thoracic or spinal region). In an advanced state, a herniated vertebral disc can lead to the following manifestations: an increase in pain, resulting in atrophy of tissues and nerve roots, impaired mobility of the spine, decreased control over urination and defecation, and weakness in the legs.
Symptoms
One of the main symptoms of osteochondrosis of the cervical spine is pain in the back of the neck, which is caused by pinching or inflammation of the nerve roots. The pain usually radiates to the cervical-collar area, shoulder, forearm and under the shoulder blade. The pain can spread to the left or right hand and lead to numbness in some fingers.
In addition to pain, cervical osteochondrosis is characterized by:
- dizziness,
- "flies" before the eyes,
- hearing impairment,
- memory loss,
- headache localized in the back of the head and temples.
If the disease lasts for several years, then vascular atherosclerosis and discirculatory encephalopathy (serious decline in mental abilities) may be added to it.
When moving the head in a circular motion, a patient with cervical osteochondrosis usually hears a characteristic crunch.
What signs indicate the presence of a hernia?
Due to the different location of the hernia, certain symptoms of the disease may occur. If the lumbosacral region has undergone such a destructive process, pain is localized in the area of the affected disc and can increase as the load on this area increases. Patients also note the following unpleasant symptoms:
- A tingling sensation in the area of the damaged disc;
- Irradiation of pain to the buttock;
- Loss of sensation in the lower extremities, the appearance of weakness;
- Periodic numbness of the legs;
- Dysfunction of the genitourinary system.
If the hernia is in the cervical region, then the following signs will be characteristic of the pathology:
- The appearance of severe headaches;
- Frequent dizziness;
- Periodic increase in blood pressure;
- Shooting pain in the upper extremities;
- Numbness in the fingers.
If the hernia is in the thoracic region, a person may experience acute pain while at work. In some cases, the discomfort may become chronic. To make an accurate diagnosis, a thorough examination (MRI/CT) is performed. If the results of the above studies reveal that the disc is displaced by 25–50%, this indicates the presence of a hernia. If this figure exceeds 50%, then we can talk about protrusion.
Treatment methods for intervertebral disc herniation
There are several methods for treating a herniated disc in the spine. At the onset of the disease, surgical intervention is not required. According to indications, analgesics and drugs that stop the inflammatory process are prescribed. However, in order to cope with the cause of the disease, other methods of treating intervertebral disc herniation are required. In some situations, surgery is indicated for the patient.
A revolutionary innovation in the treatment of vertebral disc herniation is treatment using the SWT method. In this case, a powerful directed flow of sound waves of a certain frequency has a therapeutic effect. What happens is that the contents of the herniated intervertebral disc turn into a suspension, which easily penetrates into the surrounding tissue, where it is naturally absorbed.
It “dries out”, leaving only folds of the damaged fibrous membrane. Thus, the herniated disc is removed. Additionally, rehabilitation measures can be carried out for the affected nerve.
When diagnosing a herniated vertebral disc, the shock wave therapy method gives the best results with a minimum of side effects. This conclusion was unanimously reached by specialists from all clinics specializing in the treatment of the musculoskeletal system. When using this method in the treatment of intervertebral disc herniation, surgical treatment can be prescribed only in exceptional cases.
Make an appointment Online booking
- Clinic on Krasnopresnenskaya +7 (499) 252-41-35 Volkov lane, 21
- Clinic on Varshavskaya +7 (499) 610-02-09 Varshavskoe highway, 75, building 1
- Clinic in Annino +7 (495) 388-08-08 Varshavskoe highway, 154, building 1
Effects of UHT
The effectiveness of UVT is very high - more than 80% of patients are completely cured or have a stable remission after completing a two-month course.
- Early effects : pain relief, improved blood circulation, accelerated metabolism in damaged tissues
- Delayed effects : loosening of fibrous foci, destruction of calcified fibroblasts, bone growths, resorption of their fragments, increasing the strength of tissues (ligaments and tendons), reducing inflammatory processes, updating and improving the capillary system, healing of burns, wounds, accelerating the consolidation of bone tissue after fractures, recovery joint mobility
Course of treatment with UVT The course of treatment depends on the nature, location and severity of the disease and includes from 3 to 8 sessions (usually 5-6), which are carried out for 15-30 minutes at intervals of 5-9 days. The therapeutic effect of treatment with the UVT device persists for several more days after each procedure.
SWT for spinal hernia
Shock wave therapy is considered effective only for spinal hernia, but also in other areas. This technique was first used in the 90s in the field of sports medicine and cosmetology. In our country, this type of treatment became widespread in 1997.
Today, the UVT method is widely in demand for hernia, osteochondrosis, injuries of the lower extremities, plantar fasciitis, arthrosis, etc. The technology described above is based on the use of acoustic waves. Modulation of infrasonic oscillations with a short duration makes it possible to create electromagnetic pulses. At the same time, during the procedure, the patient feels pinpoint tapping, as during a massage.
Experience in using shock wave therapy in medicine and cosmetology in Krasnodar
Medical Krasnodar
Yu.S. Kuznetsov, I.V. Kanksidi, M.G. Sulimov, P.V. Khachatryan, A.V. Zhukov
The history of the development of extracorporeal shock wave therapy (ESWT) began in 1951 in the USA, when Dr. F. Rieber used a shock wave generator to treat brain tumors. The results were unsatisfactory, but scientists did not give up attempts to use shock waves in medicine, thanks to which in 1980 in Munich, for the first time, a stone in a human kidney was destroyed without surgery, but with the help of shock waves.
Experiments with shock waves continued, as a result of which in the late 80s it was discovered that if the pressure and density of the energy flow of the pulse is reduced, its ability to destroy will decrease, but it will have an anti-inflammatory, analgesic and stimulating effect on tissues. Traumatologists and orthopedists were the first to adopt ESWT. Since then, the designs of wave generators have been repeatedly modified and their capabilities expanded. Today, extracorporeal shock wave therapy is widely used throughout the world. This gentle technology is successfully used in orthopedics, neurology, rheumatology, phlebology and aesthetic medicine.
The operating principle of shock wave therapy is based on the transformation of the impulse from the shock wave into a sound wave, which is transmitted to the external environment. The human body consists of 65-80% water, and the acoustic wave propagated through it is absorbed at the border with the bone. The difference in tissue density affects the power of the impact, with the greatest effect being achieved in denser tissues, as well as at the tissue interface, for example, bone and tendon, muscle and fascia.
The impact of shock wave impulses does not destroy tissues, but “looses” them, improving microcirculation and stimulating damage repair processes. Even one session of ESWT significantly reduces the severity of pain, helps restore range of motion in the joints and increases resistance to physical activity. In recent years, the use of extracorporeal shock wave therapy has increasingly made it possible to avoid surgical intervention in the treatment of musculoskeletal injuries and degenerative diseases.
7 main effects achieved in the affected area when using ESWT:
- Stimulation of blood circulation and lymphatic drainage, formation of new vessels.
- Disruption of the structure of calcium deposits, which leads to their resorption.
- A change in the permeability of the cell membrane, due to which the transmission of the pain impulse stops.
- Pain relief using hyperstimulation.
- The release of endorphins necessary for a person.
- A change in the reflex arc that controls muscle tone.
- Increased diffusion of cytokines (peptide information molecules) through the walls of blood vessels, which significantly accelerates the process of overall recovery.
Medical specialists were the first to use the extracorporeal shock wave therapy method in Krasnodar. The clinic is equipped with the most modern device at the moment, “Master Pulse MP-200” (Germany). The device, using a wide range of attachments, allows you to accurately dose the intensity of the treatment, regulate the depth of wave penetration and clearly mark the treatment area. In this case, the wave does not generate heat and does not form a high-density electromagnetic field, therefore, if the patient has metal structures in the affected area, this is not a contraindication to the use of the ESWT method.
The ESWT method is used in medicine to treat:
- glenohumeral periarthritis (subacromial bursitis, rotator cuff tendinitis);
- enthesopathies in the elbow joint (“tennis elbow”, medial epicondylopathy, bicipital and tricipital tendinopathy);
- wrist joint (styloiditis);
- hip joint (trochanteritis);
- knee joint (tendoperiostopopathy of the upper and lower poles of the patella);
- feet (achilles bursitis, heel spur);
- arthritis, deforming osteoarthritis;
- intervertebral disc herniation;
- radiculopathy, sciatica;
- old injuries of ligaments and tendons;
- delayed consolidation of fractures of long tubular bones;
- trophic ulcers;
- pathological changes in subcutaneous adipose tissue (cellulite, fatty edema).
Extracorporeal shock wave therapy in orthopedics
In recent years, the method of extracorporeal shock wave therapy has been increasingly used in orthopedics. This is due to the fact that, despite the use of other modern methods of treating musculoskeletal injuries and degenerative diseases, many problems arise. For example, bone fractures in 10-13% of patients are complicated by the development of contractures, ankylosis of joints and post-traumatic arthrosis. Also a fairly common pathology is a painful syndrome at the attachment points of tendons and ligaments. According to experts, 80% of the adult population suffers from these diseases, and physiotherapy, the use of non-steroidal anti-inflammatory drugs, corticosteroid injections, acupuncture and massage do not bring relief in all cases. With surgical intervention, it is also not always possible to achieve the desired result; moreover, this is always associated with a long rehabilitation period and the risk of complications.
A shock wave therapy session is carried out once every 5-8 days, the D-actor and R-15 attachments are mainly used, the duration of one procedure is up to 20 minutes. Main indicators: pressure - from 1.6 to 3.0 bar, frequency on average 8 Hz, number of pulses up to 4000 per procedure. Pain decreased immediately after the first procedure in 70% of treated patients.
The ESWT method allows in many cases to speed up recovery and also avoid surgery.
Extracorporeal shock wave therapy for the treatment of trophic ulcers
In medical treatment of trophic ulcers, shock wave therapy and photodynamic therapy are used. Thanks to ESWT, tissue damage restoration processes are stimulated, microcirculation is improved, metabolic processes are accelerated, and microcapillaries grow in the area with pathology. All this leads to restoration of blood supply to the tissues and healing of the ulcer.
Complex therapy is prescribed after diagnosis and identification of the cause that caused the appearance of a trophic ulcer. During the course of treatment of trophic ulcers, 5-8 ESWT sessions are performed with intervals of 5-7 days between them. The D-actor attachment is used, the duration of one procedure is up to 30 minutes, the main indicators are: average pressure 2.6 bar, average frequency 7 Hz. Number of impulses up to 5000 per procedure. Both the edges of the wound and its center are treated through a sterile oilcloth. The success rate of treatment is more than 90%.
Extracorporeal shock wave therapy in the treatment of herniated discs
Currently, such methods of non-surgical treatment of herniated discs as manual therapy, skeletal traction, epidural blockades and physiotherapy are used. However, all these methods only eliminate the consequences of the disease, and the hernia itself remains unchanged and continues to progress. The use of shock wave therapy for a long time has proven its effectiveness in comparison with other non-invasive treatment methods, which in fact only allow you to postpone surgery for some time. Moreover, this method has a number of advantages over surgery.
Main advantages of the method
- high efficiency of therapy;
- carrying out treatment on an outpatient basis while maintaining the usual lifestyle;
- absence of scar changes;
- exclusion of postoperative complications;
- low probability of recurrence of intervertebral disc herniation (less than 4%).
In this case, a focusing attachment and a D-actor are used. The indicators are as follows: pressure - average value 2.0 bar, frequency average 7 Hz. Number of impulses up to 3000 per procedure.
Extracorporeal shock wave therapy in the treatment of cellulite
Cellulite not only spoils the figure from an aesthetic point of view, but is also associated with excess weight gain, pain, deterioration in well-being, and also negatively affects a person’s psychological self-esteem.
Medical offers a comprehensive solution to the problem of cellulite using the method of extracorporeal shock wave therapy and lymphatic drainage. As a result, in a short time, metabolic processes in tissues are activated, lymph flow and blood flow are improved, swelling disappears, tissue elasticity increases, skin sagging is eliminated and body volumes are reduced. This method really allows you to get rid of fat deposits and effectively treat cellulite without surgery.
Biomechanical stimulation (BMS) with D-Actor technology, D35 attachment are used. Number of sessions per week -2, number of procedures from 5 to 10, number of impulses per zone from 1000-2000, frequency 8Hz, energy 3.0-4.0 bar. At the end of each procedure, vibration therapy with a V-actor attachment is added. Patients are advised to maintain a balanced diet and drink plenty of fluids (up to 3 liters of fluid per day).
Analysis of experience in the use of ESWT in medicine (Krasnodar)
In 2010-2012, 2,322 patients were treated at the medical level using ESWT. It should be noted that a total of 2,688 people applied, but due to the presence of a pacemaker, the period of pregnancy and lactation, as well as the presence of tumors, some applicants were denied ESWT. The treatment plan in each case was drawn up individually based on the results of the collected medical history, examination by a doctor and additional diagnostics. The bulk of those treated were patients with diseases of the musculoskeletal system, as well as neurological diseases.
| № | Nosology | Number of patients | Improvements | No change | Deterioration |
| 1 | Achilles tendon-Achilles bursitis, injuries | 246 | 221 | 5 | |
| 2 | Heel spur, plantar fasciitis. | 667 | 598 | 69 | |
| 3 | Spinal diseases (dorsopathy, osteochondrosis, protrusions, disc herniations) | 186 | 170 | 14 | 2 |
| 4 | Shoulder joint (humeral periarthritis, injuries, sprains). | 165 | 152 | 13 | |
| 5 | Epicondylitis, elbow joint injuries | 110 | 108 | 2 | |
| 6 | Arthrosis, arthritis of joints I-II degree | 275 | 265 | 10 | |
| 7 | Arthrosis, arthritis of joints III-IV degrees | 90 | 62 | 28 | |
| 8 | Trophic ulcers | 123 | 120 | 3 | |
| 9 | Sports injuries | 240 | 230 | 10 | |
| 10 | Cellulite | 220 | 205 | 15 | |
| Total treated with ESWT | 2322 | 2131 (91,8%) |
The collected data showed the high effectiveness of treating diseases using ESWT, especially musculoskeletal and neurological diseases. Improvements occurred in 91.8% of all treated patients. Moreover, in the long-term period, from the second week to a month after the final procedure, the percentage of improvements increased to 93%.
All patients underwent the procedures without complications. Cases of deterioration of the condition after the course of treatment in two patients were explained by the presence of large herniated intervertebral discs with pronounced neurological disorders at the time of treatment. The patients themselves insisted on undergoing treatment after being warned about the possible consequences, and therefore signed consent. A month later, the condition of these patients stabilized, and after a course of conservative therapy, they were successfully operated on at Clinical Hospital No. 1. It is also worth noting that in 15 patients after the first procedure there was an increase in pain, which went away on its own without taking analgesics.
Bottom line
An analysis of the data collected in Krasnodar, carried out by experts, confirms that the use of ESWT in various fields of medicine is not only justified, but also has a number of advantages over both conservative treatment methods and surgical intervention. Thanks to the skill and experience of medical specialists, many serious diseases are already being treated in Krasnodar, including spinal osteochondrosis, herniated discs, arthritis, arthrosis of the joints, heel spurs, trophic ulcers, sports injuries and cellulite with a positive effect in 90-95% of cases.
After the second procedure
After the fifth procedure
Hernia treatment with UHT: limitations for the procedure
Shock wave therapy for spinal hernia, as evidenced by numerous reviews, gives positive results. However, despite the success of such therapeutic effects, it has its limitations. That is why you should resort to the above method only after a complete examination.
And, if during the diagnosis, at least one contraindication is identified in the patient, shock wave therapy for a spinal hernia is not performed.
Below we present a list of restrictions for implementing this procedure:
- If the patient has an artificial heart pacemaker;
- Pregnancy period;
- Infectious and inflammatory processes in the body;
- Presence of malignant neoplasms.
Moreover, it is prohibited to perform infrasound effects in the area where large arteries are located. Manipulation in the area of the intestines and skull is also not recommended. However, regardless of whether shock wave therapy is planned for a herniated disc or in the presence of any other pathological process in the body, strict monitoring by a physician is a prerequisite. The type of impact is determined after careful study of the patient's chart.
Infrasound and its features
Infrasound (wave frequency below 16 Hz) is inaudible to the human ear. It is possible to feel the vibrations of these frequencies if they resonate with the hollow organs of the body: lungs, esophagus, vestibular apparatus, nasopharynx.
In nature, infrasonic waves occur during earthquakes, volcanic eruptions, and hurricanes. These waves are unconsciously perceived by a person as a signal of danger; at high amplitude (“loudness”), a desire to escape arises. Infrasound also occurs in everyday life; its sources can be operating electrical appliances (for example, a washing machine, refrigerator or external unit of a split system), vehicles, and industrial machines. With sufficient intensity or duration of exposure to such waves on the human body, suppression of the nervous system (nervousness) and vestibular apparatus (motion sickness in transport) can occur; similar properties of infrasound are used by the police of European countries to disperse demonstrations. The full impact of infrasound on the human body has not yet been determined.
And yet man has learned to use these dangerous waves. The first step in conquering them was the discovery of the piezoelectric effect (1880), followed by the invention of the piezoelectric element. With the help of this simple device, it becomes possible to perceive and generate waves of any frequency, including infrasound. (More information about piezoelectric elements can be found in Google, search for “piezoelectric effect”). The piezoelectric element is present in seismographs (for sensing vibrations of the earth's crust) and metal detectors. The piezoelectric element in lighters has a similar design. For medical purposes, the piezoelectric element was first used for diagnostic ultrasound installations, but in them it generated and received only ultrasound. Infrasound generation was first used for shock wave therapy devices.
When exposed to the human body, the shock wave increases blood circulation at the site of impact and loosens areas of calcification.
How is shock wave therapy performed in the presence of a hernia?
Regardless of whether SWT is planned for a lumbar or thoracic hernia, it is recommended to carry out such therapeutic effects only on the territory of a medical clinic. However, it should be remembered that not all medical centers may have the equipment to carry out such treatment. As a rule, these devices are available in regional hospitals.
To increase the effectiveness of shock wave therapy in the treatment of spinal hernia and expect full restoration of health, the patient must follow several sequential steps:
1. Get an appointment with a specialist who has extensive experience in the field of spinal restoration.
2. Complete all necessary laboratory tests.
3. Wait for a conclusion from the doctor and the prescription of appropriate treatment.
4. Perform the first block of SWT for a herniated lumbar/thoracic spine.
5. If necessary, go through a repeat block.
6. Take a course of physical therapy to consolidate the effect.
Despite the fact that shock wave therapy is considered an effective technique for intervertebral herniation, it is advisable to undergo the entire range of treatment measures to achieve the best effect.
In addition, to obtain better results from SWT for lumbar or thoracic spinal hernia, the patient should adhere to the following rules:
- Use a corrective corset to correct your posture;
- Regularly perform yoga or physical therapy exercises;
- Get massage treatments;
- Do not overdo it with physical activity;
- Use special vitamin and mineral complexes containing calcium.
Make an appointment Online booking
- Clinic on Krasnopresnenskaya +7 (499) 252-41-35 Volkov lane, 21
- Clinic on Varshavskaya +7 (499) 610-02-09 Varshavskoe highway, 75, building 1
- Clinic in Annino +7 (495) 388-08-08 Varshavskoe highway, 154, building 1
PROGNOSIS OF CURE
Protrusions, hernias and even osteochondrosis are diseases that signal systemic disorders. Blood supply and lymph flow work poorly, and inflammatory phenomena occur.
In the lumbar region this threatens:
- problems with the pelvic organs (from chronic diseases to oncology);
- pain in the legs, partial loss of sensation, muscle weakness.
That is why it is better to entrust the removal of a lumbar intervertebral hernia to someone other than a surgeon. Trust the author's technology for treating lumbar intervertebral disc herniation at the medical center. It has been proven that the hernia will go away on its own.
Our experience proves that you can get rid of an intervertebral hernia without surgery at any age and at any stage, but it makes sense to start treatment as early as possible.
SWT for lumbar and thoracic spinal hernia: treatment effects
If there is pain in the muscle area, the acoustic effect resembles the effect of massage procedures. This allows you to normalize muscle tone, which has a beneficial effect on the location of the vertebrae and discs.
Also, shock wave therapy for a hernia, as confirmed by reviews, helps to normalize the patient’s general condition: improvement occurs due to the restoration of blood circulation. According to some people who have undergone a similar procedure, it is thanks to this that it is possible to return the intervertebral disc to its place. However, it should be remembered that this therapy is only an additional method of treatment that enhances the overall restorative effect.
In this case, the implementation of conservative measures, which include a special diet, physical therapy, manual therapy, improved posture, etc., is of great importance. Only if an integrated approach is used can one count on a favorable treatment outcome and 80% correction of the spine.
Reviews from patients
The usual feedback from patients is that during the first second session there is discomfort, discomfort, possible bruising, as well as muscle fatigue in the area of influence. However, after the first session, long-troubling back pain disappears, and the range of motion increases, for example in the lower back.
But in order for there to be improvement and not worsening, shock wave therapy, just like any other type of physiotherapeutic treatment, should not be prescribed immediately, in the first or second day after the onset of acute back pain. On the first day, inflammation must be controlled with medications, since the swelling increases, and if you use any means of influence, the swelling will only increase, and the pain will also increase accordingly. Therefore, physiotherapeutic procedures are not prescribed on the first two days, and the use of various intensely warming ointments is prohibited, in order to avoid an increase in edema and aseptic inflammation.
But if the deadlines are met and all contraindications are taken into account, then the pronounced anti-inflammatory and reparative effect of the treatment will make it possible to achieve a lasting reduction in pain and freedom of movement. However, it should be remembered that such an improvement is temporary, nothing happened to the protrusion and hernia, it remained in its place and simply ceased to manifest itself until the next exacerbation.
If a radical cure is needed, then you need to remember the experience of such countries as Great Britain, Israel, the USA, and the Czech Republic. In these countries, approaches to the treatment of intervertebral hernias are fundamentally different from domestic ones. If there are indications, the patient undergoes a modern minimally invasive operation. The patient simply forgets about the protrusion or hernia, since the protrusion itself is eliminated, the hernia no longer exists and the patient is considered healthy.
Cost of treatment of spinal hernia using UVT method
| Service | price, rub. |
| Shock wave therapy (SWT) treatment consultation | for free |
| Treatment procedure for spinal hernia blue tip | 1200 ₽ |
| Spinal hernia treatment procedure red tip | 1 600 ₽ |
| Discount on the initial visit to the clinic | 20% |
If you have pain in your back, advanced osteochondrosis or a herniated disc, you can undergo high-quality UVT treatment in our clinic using innovative Swiss equipment. If you use a blue tip, you will have to pay 1,200 rubles for the procedure; if you use a red tip, the cost of 1 session will be 1,600 rubles. We have the lowest prices in Moscow. At the same time, you can always count on impressive discounts on your first visit to the Health Plus clinic and interaction with experienced and qualified specialists.