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ESWT: NON-SURGICAL TREATMENT FOR PAINFUL JOINTS

Author: Silvan S. Prayogo, BSc., MSc.

Published in Suara Merdeka Newspaper (27 April 2008, Sunday).

Pain or inflammation on joints like heels, knees, hand wrist, shoulder, or elbow is common. Even prime-physique athletes are not invulnerable. Calcification around a joint and tendon inflammation (tendonitis) may result in painful joints. Osteoarthritis (cartilage degradation) is also blamed for the pain. Normally, cartilage at the ends of a bone functions as a shock absorber between two colliding bones.

 

Another well known joint complaint is plantar fasciitis that results in an agonizing pain around your heel and foot sole when walking. Plantar fasciitis is inflammation of plantar fascia, a thick band of connective tissue along the bottom of your foot that connects your heel bone to your toes. Plantar fascia functions as a shock absorber on your foot sole when you run or walk.

 

Inflammation and tear can occur on this thick connective tissue if it bears too much tension and heavy load such as running, a long distance walk without an adequate rest, standing too long, and overweight due to obesity or pregnancy. Arthritis and aging can lead to plantar fasciitis because they reduce plantar fascia's elasticity.

 

Improper foot wear is also a risk factor for plantar fasciitis because your foot is forced to function in an abnormal position for a long period of time. An X-ray photo of a plantar fasciitis usually shows a sharp bone spur (calcification) projecting outward from a heel bone. This bone spur intensifies the pain.

 

Risk factors of osteoarthritis are aging, heredity, rheumatoid disease, metabolic disorder, obesity, hormonal disorder, and accidents or mechanical stress that injure a joint. An injured joint triggers your body to respond by releasing substances to stimulate a new bone formation around the joint to repair a damaged cartilage. Unfortunately, this response leads to calcification that appears as a disorderly and thick bone outgrowth (bone spur).

 

Minimize Risk Factors

There are several ways you can do to minimize joint problems. You should maintain an ideal body weight to avoid obesity, do stretching (warm-up) before exercise, adhere to proper sport techniques, avoid performing physical tasks that are dangerous or out of your physical capability. Wear a proper and comfortable foot wear and regular intake of healthy food supplements such as glucosamine and chondroitin may keep your joint to last longer.

 

Several conventional treatment for those who are suffering joint problems include pain killer medications, steroidal injections such as cortisone or corticosteroids, physiotherapy, apply an ice pack, or a surgery. These conventional treatments may not have a satisfying result. Some of these conventional treatments may have side effects. Steroidal injections usually only provide a temporary pain relief.

 

Surgery on the other hand, only has a 50% chance of success and may have a risky complication, surgical wound may heal slowly, and there is a risk of infections. Furthermore, surgery is expensive and must be performed in a hospital. Thus, a patient must stay in a hospital for several days. Surgery is normally offered as a last resort when pain is no longer unbearable or all other non-surgical options have failed.

 

Extracorporeal Shock Wave Therapy

So, what treatment is advanced, safe, economical, and without side effects? The answer is Extracorporeal Shock Wave Therapy (ESWT), which was invented in Germany and has been approved by the U.S. FDA (Federal Drugs and Administration) in 2001 to treat joint problems. ESWT was originally used to destroy gall stones.

 

However, studies prove that shock waves can treat painful joints. An ESWT machine fires shock waves that stimulate blood flow towards an inflamed joint so that pain is reduced. Moreover, shock wave may reduce bone spur that causes the pain.

 

In the U.S., ESWT is an alternative therapy for osteoarthritis before surgery. "Many patients have tried ESWT and were successfully treated in a short period of time", said George Theodore MD, an orthopedic from Massachusetts General Hospital in Boston, U.S.A.

 

ESWT does not need hospitalization. Thus, patients save hospitalization costs. Patients may also continue their daily activity after ESWT. Patients' joints usually pain free for several years without another ESWT. ESWT procedure is quite simple. An X-ray photo of the painful joint must be taken before ESWT to specifically identify the painful locations in the joint. ESWT runs for approximately 30-45 minutes depending on the patient's condition.

 

Anyone can suffer joint problems for various reasons. Taking care of your body such as eat nutritious food, maintain an ideal body weight, and careful when doing physical activities such as sport can keep you away from joint problems.



                                          
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