Pain and regenerative therapy

PAIN AND REGENERATIVE THERAPY

In modern times, people have increasing problems with diseases of the spine, large joints, tendons and muscles.

Changes can be degenerative in nature (premature aging), due to excessive wear ("overuse") or as a result of injuries. They are accompanied by pain and reduced mobility, which greatly affects the quality of life and work capacity.

The purpose of therapy is to reduce pain and improve the function of the affected part of the body.

Accurate assessment of the health problem:

Before starting therapy, it is important to have a clinical examination and, after professional judgment, at least one morphological imaging examination (X-ray, CT, MRI, ultrasound) of the affected part of the body.

With the help of a clinical examination and imaging studies, we can determine that it is basically one or a combination of several disease defects:

Degenerative changes (accelerated aging): arthrosis of the joints and tendinosis of the tendons with or without calcifications
Inflammation of the joints, bursae, tendons or sheaths (arthritis, bursitis, tendinitis/peritendinitis, synovitis)
Nerve compression and other changes to the nerves
Injuries: tendon and muscle tears, bone fractures

At the center, we perform ultrasound diagnostics of joints, muscles, tendons and nerves. This allows us to determine the cause of the problems more quickly and accurately and advise on appropriate therapy.

Technologies we use for pain relief and regenerative therapy:

Extracorporeal shockwave therapy (ESWT) or shockwave therapy - Storz:
- F-SWT focal shockwave therapy
- R-SWT radial shockwave therapy
High-intensity pulsed magnetotherapy:
- EmfieldPro - Zimmer
- EMTT - Storz
Electrotherapy or treatment with high, medium and low frequency currents - Winback Back 4:
- TECAR
- Hi-EMS
- Hi-TENS

What is ESWT and how does it work?

ESWT (Extracorporeal shock wave therapy) therapy with acoustic shock waves is a modern, non-invasive treatment approach of pain and functional impairment of patients with degenerative and calcinating changes in the tendon - muscular system.
The effects of acoustic shock waves were in medicine originally used to destroy kidney stones (ESWL - litotripter), in modern times, the use spread to the tendon - muscular pain therapy. The medical center use Duolith SD1 technology of the innovator and pioneer in the use of acustic shock waves in medicine - Storz Medical.

Research in recent years have shown that the shock waves, introduced by the therapeutic probe in the painfull area of the body, stimulate:

the flow of blood and lymph
metabolism
the permeability of cell membranes
proliferation of stem cells to replace old cells
anti-bacterial and anti-inflammatory response
strengthening of the connective tissue
production of growth factors

ESWT therapy improves tissue perfusion and facilitates processes that through normalization of local conditions allow the gradual restoration of the affected area.

The therapy is performed by an experienced doctor trained in the use of the above technologies.

We perform ESWT shockwave therapy (focal shockwaves F-SWT and radial shockwaves R-SWT), high-intensity pulsed magnetotherapy EmfieldPro and EMTT, and TECAR, Hi-EMS and Hi-TENS electrotherapy.

ESWT - SHOCK WAVE TREATMENT

ESWT treatment with acoustic shock waves is a modern, non-invasive approach to treating pain and functional impairment in patients with degenerative and calcifying changes in the tendon-muscle system.

The effects of shock waves were originally used in medicine to break up kidney stones (ESWL - lithotripter), but in modern times their use has expanded to include muscle and tendon pain therapy.

In the medical center, we use Duolith SD1 technology from the innovator and pioneer in the field of shock waves in medicine - Storz Medical.

In order to assess the suitability and scope of ESWT therapy, a clinical and ultrasound examination is required before starting treatment.

Mechanism of action

Research in recent years has shown that shock waves, which are directed to the body area with a therapeutic probe, stimulate:

blood and lymph flow and metabolism
cell membrane permeability
proliferation of stem cells
anti-bacterial and anti-inflammatory response
strengthening of connective tissue
production of growth factors
Results of therapy
improved tissue blood supply
normalization of local conditions
disintegration of calcifications
gradual regeneration of the affected area
long-term pain reduction
reduction or elimination of calcifications in the tissues
improved mobility of the affected limb

According to previous experience, the first results are usually seen after the 3rd therapy, and the condition continues to improve for 3 months after the end of treatment.

Areas of application of ESWT

1. Pain due to degenerative changes and calcifications of tendons:

Shoulder (rotator cuff)
Achilles tendon
Heel (spina calcanea - heel spur)
Foot (plantar fasciitis)
Elbow (medial, lateral epicondylitis)
Knee (patellar tendinitis)
Hip (trochanteric tendinitis)

2. Chronic muscle pain in the neck or back (muscle knots)

More information about ESWT treatment and the full range of indications approved by the ISMST (International Society for Medical Shockwave Treatment) can be found on their website - ISMST.

Before ESWT therapy, we perform:

a clinical examination by a doctor
an ultrasound examination of the affected region
an assessment of functional impairment
an assessment of risk factors and possible contraindications
determining the area and depth of therapy
determining the number of ESWT shock wave therapies
determining the interval between individual therapies

Course of ESWT treatment

As part of the treatment, we perform 4 - 6 therapies, which are performed every 5 - 9 days. The treatment can be extended if necessary.
During ESWT therapy, the patient lies or sits. A harmless ultrasound gel is applied to the skin over the affected area. The therapy is performed according to the selected protocol in two parts - in the first part, we use the F-SW probe, and in the second part, the R-SW probe.

Special instructions or recommendations

a day's rest after each ESWT therapy
greater physical exertion during ESWT therapy (2-4 weeks) is not desirable
usual daily activities are generally not limited
clinical control of the treatment results three months after the last therapy

Foto: Storz ESWT SD1 ultra

MAGNETOTHERAPY - EMFIELD PRO (Zimmer)

HIGH ENERGY INDUCTION THERAPY EMFIELDPRO

THEORETICAL BASIS OF PULSED ELECTROMAGNETIC THERAPY

The human body is a good conductor of magnetic fields. Inside and outside the cells, we have atoms and molecules with a charge. The cell membrane of a living cell also has an electric potential. A cell without an electric potential on the membrane is a dead cell. The membrane charge of normal, healthy cells is higher than the charge of diseased or aged cells. The same applies to bacteria and viruses. Cells with a reduced membrane potential generate too little energy to provide and maintain the necessary intracellular processes.

Electromagnetic fields can pass through cells, tissues, organs, bones without deformation or loss, activating electrochemical reactions of tissues. Stimulation with a pulsed electromagnetic field increases the energy in the cell and improves intracellular processes.

Pulsed electromagnetic field (PEMF) increases the threshold of pain sensitivity, strengthens pain-relieving mechanisms, stimulates the production of opioid peptides and increases the capacity of muscle fibers. The effects of electromagnetic therapy last for a longer time, the pain-relieving effects of the therapy even 7-14 days after the last therapy.

PRESENTATION OF THE EMFIELDPRO DEVICE (ZIMMER)

The EMFIELDPRO device represents the most modern generation of high-energy induction pulse electromagnetic therapy. It can create a magnetic field of up to 3T, which is 600 times stronger than the magnetic field of a conventional magnet.

The device allows for:

Deep penetration to all structures in the body
Non-invasive and contactless treatment
Two applicators for different disease states (3.0 T and 2.5 T, 1 - 100 Hz)
Therapeutic protocols (Program, Popular, Expert)
User-friendly interface

Due to the high power of the applicators, a deeper effect and a shorter treatment duration are possible. The therapy is performed according to the selected protocol, static or dynamic, active or passive, with an adjusted magnetic field strength and frequency. The device's superior technical features with great adaptability are a guarantee for good results.

AREAS OF APPLICATION

High-energy induction therapy enhances beneficial physiological processes by accelerating circulation and blood supply to tissues, accelerating regenerative processes, reducing pain and stimulating nerve and muscle cells. The positive effects of the therapy are used in the following areas of application:

Pain therapy
Accelerating the regeneration of nerves, tendons, ligaments and muscles
Increasing the tensile strength of tendons and ligaments
Reducing muscle mass loss after surgical procedures
Improving mobility and faster functional recovery
Increasing circulation, blood supply and capillary blood vessel formation
Accelerating the healing of bone fractures
Faster healing of skin wounds
Reducing inflammatory processes
Reducing tissue death
Reducing chronic fatigue
Reducing urinary incontinence
Reducing problems due to oversensitive bladder and enlarged prostate.

SIDE EFFECTS

Taking into account the contraindications, there are no or minimal side effects during treatment and they are transient.

DURATION OF TREATMENT

The length and intensity of treatment depends on the patient's medical condition.
As a rule, treatment lasts 4-6 weeks. During this period, a total of 6-8 therapies are performed.
Individual therapies are performed 1-2 times a week. Therapy lasts 20-30 minutes.
To enhance the effects, emFieldPro treatment can be combined with shock wave therapy (ESWT).

Photo 1: emFieldPro: Two applicators 2.5 and 3.0 Tesla, 1 – 100 Hz

Photo 2: Example of passive therapy with a static applicator

Photo 3: Example of active therapy with a mobile applicator

MAGNETOTHERAPY - EMTT (Storz)

EMTT INTRODUCTION

Extracorporeal magnetotransduction therapy (EMTT) with the MAGNETOLITH (Storz) device is the most modern implementation of pulsed, high-energy magnetic therapy, which opens up new possibilities for accelerated regeneration, rehabilitation and pain relief therapy.

EMTT differs significantly from previous implementations of pulsed electromagnetic therapy (PEMF). The most important differences are:

increased magnetic pulse power by 40%
a single magnetic pulse is constructed with high-frequency magnetic oscillation of 100-300 kHz.
increased penetration and action depth up to 18 cm
broader application area, can be combined with shock waves (ESWT).

During EMTT therapy, a high-energy pulsed magnetic field is transmitted into the body, tissues and cells, where it increases cellular energy, improves metabolism and strengthens physiological processes of restoration or regeneration.

EMTT is a non-invasive and outpatient treatment method. Taking into account contraindications, there are also no reports of undesirable effects.

EMTT can be used in various areas of musculoskeletal and tendon system damage, especially when these are associated with the presence of pain.

PRESENTATION OF THE MAGNETOLITH DEVICE:

High-frequency magnetic field (100 - 300 kHz)
Digital adjustment of power, frequency and number of pulses
Water-cooled applicator with a simple position adjustment mechanism
Simple plug for replacing the applicator

EMTT TREATMENT PROCEDURE:

EMTT treatment is comfortable. You can remain fully clothed during the therapy, direct skin contact is not necessary. Before starting the therapy, remove all metal accessories or equipment, especially electronic devices such as mobile phones, digital watches, pendants, electronic door and car keys. The magnetic field can demagnetize them and thus damage them. Store objects at least 1 m away.

The therapist places or places the applicator over the affected area. The therapy is performed dynamically or statically. In static therapy, the applicator is placed on a special holding arm.

The device allows for great flexibility. The strength and basic frequency of the pulsed magnetic field can be adjusted, as well as the number of magnetic pulses during one therapy.

The duration of each therapy and the number of repetitions depends on the specifics of the disease and the patient's response to treatment. Each therapy can last from 5-20 minutes. 6-8 therapies are usually performed as part of the treatment.

AREAS OF EMTT APPLICATION:

Pain:

Pain in the spine (cervical, thoracic, lumbar or sacral spine)
Pain in the extremities (arm, leg, small and large joints)
Muscle pain
Neuropathic or neuralgic pain due to nerve damage or compression

Overuse of tendons, joints and spine:

Degeneration or inflammation of tendons and their attachments (tendinosis, tendinitis, enthesopathy)
Rotator cuff tendinosis
Achilles tendon tendinosis
Heel spur with plantar fasciitis
Elbow epicondylitis, etc.
Arthrosis of large and small joints of the uper and lower extremities (shoulder, elbow, hands, hip, knee, ankle, foot)
Inflammation of small joints of the spine and damage to the intervertebral disc (spondyloarthritis, disc herniation)

Sports injuries: