About The Treatment:

Extracorporeal Shockwave Therapy, or extracorporeal shock wave therapy, is an innovative non-invasive method for the treatment of localized musculoskeletal pain. Since the early 1990's, German investigators have studied the use of shock waves for the treatment of painful musculoskeletal disorders.

Chronic pain associated with tendinitis of the shoulder, elbow, knee, and foot was first treated. Initially, these treatments were administered by modified kidney stone lithotripters. However this was often cumbersome since the kidney stone devices were not designed to treat multiple areas of the body in many different positions. In addition, the kidney stone lithotripters usually delivered relatively high-energy shock waves.

Treatment with these devices therefore was painful and required regional or general anesthesia. It soon became apparent that treatment with lower energy shock waves (much lower than those used to treat kidney stones) was effective in the treatment of musculoskeletal pain. These findings led to the development of the Sonocur®, a variable energy shock wave machine made specifically by SIEMENS Medical Systems for the treatment of tendinopathies and other specific types of localized painful musculoskeletal conditions.

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Criteria

The following is a guide to some of the more common disorders that may be treated with the Sonocur® system. Prior to any treatment however, it is essential that your physician first confirms a correct diagnosis. This will require the following:

• Your physician will evaluate your complaints and ask questions to find out how you developed the pain and how long your symptoms have persisted.
• Your physician will perform an examination and will try to pinpoint the painful area.
• An imaging study such as an x-ray, CT scan or magnetic resonance imaging (MRI) may be needed.
• In some cases, your doctor may order blood tests to rule out a systemic disorder such as arthritis, gout, or diabetes.

Sonocur® extracorporeal shock wave system is used to treat a very specific area of pain that can be identified by pressing your finger against the painful area.

Sonocur® treatment is extremely safe. Because it is safer than some drugs or steroid injections, many physicians believe it should be used prior to these methods. Certainly it should be considered prior to undergoing surgical treatment.

Studies show that, in appropriately selected patients, Sonocur® therapy has a success rate of between 70 and 90 percent. It is not, however, a "miracle cure", and its pain relieving and healing effects may need to be combined with other forms of treatment (i.e. physiotherapy, braces, orthotics).

About the Device

The Sonocur was designed to administer a wide range of finely tuned low energy shock waves, which allows for anesthesia free treatment. Variable, energy settings allow the patient to be treated with the energy level best suited for his or her medical condition.

An articulating arm suspends the shock wave head so that it can be easily positioned and coupled to the patient on any body part. The coupling head allows for the focal point of the shock wave to be adjusted to various depths below the skin to exactly position the treatment energy in the best therapeutic location.

The SONOCUR analgesic therapy system has been used to successfully treat hundreds of thousands of patients in Europe without significant complications. It is frequently used to treat the following common conditions:

• Tendinitis of the shoulder
• Tennis or Golfer’s elbow (Lateral or Medial Epicondylitis)
• Tendintis of the Knee (Patellar tendinitis)
• Tendinitis of the Foot (Achilles tendinitis)
• Heel Spur (Plantar Fascitis)

How It Works

The Sonocur Device is a sophisticated Extracorporeal Shockwave Therapy device in which a shock wave is generated at the base of the shock tube by an electromagnetic acoustic source. When a voltage pulse from a capacitor reaches an aluminum membrane, the membrane is repelled causing a shock wave to course through a water filled generator. The shock wave moves through the water into an acoustic lens. The lens then focuses the energy of the shockwave on a concentrated point at a fixed distance from the lens.

Interaction:

The Sonocur administers a wide range of low energy shock waves, without the need for anesthesia. The articulating head of the Sonocur machine is placed onto the area where you feel pain and fine adjustments are made to focus the shock waves on the area of therapeutic focus. This might be your elbow for instance.

The treatment consists of initiating a preset number of pulses or shock waves. As the treatment progresses, a trained technician will graduate the energy level to therapeutic levels.

Treatment Procedure

• Report to the treatment area at the assigned time. No special preparation is necessary . You may eat and drink normally.
• The treatment technician will examine the site, which is to be treated. It is very important that you indicate the exact point where you are having the most pain
• After determining the exact point of pain, the technician will apply a gel to the skin. The gel will transmit the shock wave.
• The tech will place the SONOCUR treatment head on the point of maximum pain or tenderness and adjust the shock wave penetration or depth.
• Shock wave application will begin at a very low energy level. The tech will move the treatment head to be sure that the shock waves are being given to the point of maximum tenderness. You should not move the body part being treated once the treatment head has been adjusted optimally.
• The energy level may be slowly increased to a level necessary to adequately treat your condition. Energy levels and penetration depths vary depending on the treatment site and the thickness of the tissues overlying the tendons.
• Usually, a single session takes about 10-15 minutes. During treatment, you will feel a mild stinging sensation in the treated area. If the stinging sensation becomes too uncomfortable, tell the technician and the energy level may be adjusted.
• After treatment, the technician will remove the transmission gel and you will be discharged to return to normal activities. You will be scheduled for your next treatment
• Some aching discomfort may be present after treatment for a short period of time.
• After the treatment has been completed, you will be to drive yourself home.

Follow-up

Treatment is usually given over three sessions. These will be every other day in some cases. In others, treatment will be administered once weekly for three weeks.

Many patients will notice that their condition markedly improves after only one treatment. Others may not improve until after several days after their last treatment. In all cases, it is important to complete all the treatments ordered.

Most patients will notice reddened skin at the treatment site. Some will have a few small pinpoint bleeding sites or bruises on the skin. These should resolve with a few days after the final treatment.

The complete post-treatment document is now available. Review the procedures within the Adobe .pdf after your Sonorex Treatment is completed.


Sonorex Post Therapy Patient Instructions

You have been treated at a Sonorex Therapy Center with the Sonorex Treatment Protocol. This protocol uses the SIEMENS Sonocur extracorporeal shock wave therapy (ESWT) system and is designed to give you the optimal treatment for your particular painful condition. Recent medical studies have found that for most conditions, 75-90% of those treated will have significant relief of their pain. However, the remainder of those who undergo ESWT may not improve. Prior to treatment, it is currently impossible to accurately determine who will respond and who will not. Many will find that they are much better immediately after treatment while others may not get maximum effect until six weeks after their last treatment session. In order to maximize the possibility of successful treatment of your painful disorder, you should do the following:

• Complete all prescribed treatments (usually three, but in some cases as many as five).
• Continue with any adjunctive treatment or regular therapy (medications, physiotherapy, stretching, home exercises, orthotics, braces, etc.).
• Although there no specific limitations on what activities you may pursue during and after treatment, you should avoid activities that make the pain worse. The time to resumption of full activity will vary with your diagnosis, and with your speed of rehabilitation and level of conditioning.
• Return to your referring health care provider as scheduled or within six (6) weeks of your final treatment session.

ESWT is associated with minimal side effects or complications. You may notice a reddened area or superficial discoloration of the skin overlying the treated site. Some may have mild tingling or a dull ache over the site for a short time, and occasionally, there is pain sufficient to require pain-relieving measures. If pain is troublesome, you may wish to do the following:

• During the early post-treatment period, place an ice pack over the treated area for 15-20 minutes every 6-8 hours.
• Unless you have a known medical sensitivity, take acetaminophen (eg. Tylenol) or another over the counter anti-inflammatory drug such as ibuprofen (Motrin, Advil), or naproxen (Naprosyn, Aleve). Take only according to package or pharmacist's instructions.

Other than noted above, treatment imposes no limitations on your activities. You may eat, drink, drive, work, or go about any of the normal activities which you did prior to ESWT. Your physician is aware that the treatment is effective in 75% to 90% of patients. If the SONOREX treatment fails to relieve your symptoms, you should consult your physician regarding other therapy.

The Sonocur® Orthopedic Extracorporeal Shockwave system is available in Canada and other countries where regulatory approval has been obtained. The Sonocur® Basic is FDA approved in the United States for the treatment of chronic lateral epicondylitis (tennis elbow).

© 2000 Sonorex, Inc. All rights reserved. This material is for informational purposes only and is not a substitute for medical advice or treatment for any medical conditions. You should promptly seek professional medical care if you have any concern about your health, and you should always consult your physician before starting a fitness regimen.