Shock wave therapy of the tendon. Ligament damage

In recent years, sports injury has confidently taken first place in reports on the causes of injury.
Unfortunately, no person is immune from physical injury - be it in the form of broken bones, torn muscles, sprained connective tissue or bruises. Any injury is primarily a surprise. A blow, a fall, a dislocation, or a fracture always occurs suddenly and abruptly knocks a person out of his usual way of life.

An incorrectly designed training regimen, insufficient warm-up, large overloads can also cause tissue damage or the so-called chronic or fatigue injury: tendonitis (tendon inflammation), neuritis, cartilage wear, bursitis (inflammation of the mucous membrane of the joint capsule), stress fracture (bone cracks) and many other equally “pleasant” phenomena. Quite painful when acute, sports injuries often lead to chronic conditions that require specialized treatment and recovery.

As practice shows, recovery takes a lot of time and effort. That is why every athlete strives to find out how to quickly recover from an injury. Old methods used by doctors in the treatment of sports injuries have not satisfied athletes for a long time, because a conservative approach (massages, procedures, etc.) gives temporary results, and the pain returns again. Today there is a solution that allows you to quickly forget about injuries and their consequences. We are talking about extracorporeal shock wave therapy. This method was developed by German and Swiss doctors. It is simple and effective. Its principle of operation is based precisely on the effect of a series of vibrations on the foci of the disease.

One of the most effective methods to help combat the consequences of sports injuries is currently recognized shock wave therapy. Shock waves are acoustic in nature, in the infrasound spectrum, and have a frequency lower than that perceived by the human ear. SW are fundamentally different from sound waves from other sources in their higher energy amplitudes and short pulse duration. The mechanism of the analgesic effect of shock waves is due to the interruption of the reflex arc of transmission of the pain impulse from the pathological focus due to overstimulation of the nerve endings. In addition, biologically active substances formed as a result of the cavitation effect in the area of ​​ESWT influence change the function of nerve endings, cell membranes and induce regeneration. Shock wave action removes the process from a “frozen” state and “disinhibits” chronically inflamed tissue. This reduces pain, improves blood circulation at the site of the disease, and stimulates regeneration and repair processes in the damaged area of ​​tendons, muscles, and bones. In terms of its effectiveness, shock wave therapy exceeds almost all methods of conservative treatment used today. All major professional sports clubs have shock wave therapy devices in their arsenal.

Indication ESWT includes tendon diseases (tendopathies) of various locations (rotator cuff and impingement syndrome, upper and lower poles of the patella, in the area of ​​attachment of the Achilles tendon to the calcaneus, greater trochanter of the femur, epicondyles of the humerus - epicondylitis, “heel spur” etc.), as well as fractures with delayed consolidation, tight pseudarthrosis, restructuring processes of bone tissue, tendinoses of various localizations, muscular-tonic syndrome, glenohumeral periarthropy, trigger pain, ligament diseases (ligamentopathies), inserticitis (“tennis elbow”) ", Achillodynia, etc.).
The wide range of uses of this method allows you to treat various sports injuries. Such an excellent alternative to surgical intervention as shock wave therapy provides excellent results in a really short time. This method is absolutely safe, it cures complex and old injuries and does not cause complications.

Contraindications for ESWT are considered:

Unclosed growth plates in children and adolescents,
- ruptures of muscles and tendons, damage to the capsular-ligamentous apparatus of joints,
- deforming arthrosis,
- pregnancy,
- coagulopathy,
- oncological and infectious diseases,
- collagenoses,
- chronic diseases of the nervous system,
- diseases of the cardiovascular system (heart rhythm disturbances, and especially pacemaker implantation).

Benefits of shock wave therapy:

Outpatient method;
- non-invasive therapy;
- short duration of treatment;
- no risks of surgical intervention;
- anesthesia is not used;
- as a result of treatment, scars and other cosmetic defects do not form;
- an attractive alternative to surgical intervention from a financial point of view (costs for bed days, after-care, treatment of side effects or consequences, anesthesia, and medications are excluded).

Shock wave therapy allows you to:

Relieve inflammation;
- relieve and eliminate pain;
- get rid of joint pain, shoulder pain, muscle pain, heel pain;
- eliminate arthrosis of any localization;
- restore range of motion in joints;
- increase load tolerance;
- resume professional or household activities;
- prevent subsequent exacerbations.

In addition, one of the most important advantages of using shock wave is that during the course of treatment and after it, the patient can continue to lead an active lifestyle - no rehabilitation period is required. Thus, in the event of injury during competition or in the process of recovery from injury, athletes have a unique opportunity to continue performing (or continue training) only by reducing the load on the problem area and abandoning “explosive”, sharp loads. This factor is very important for professional athletes who, when undergoing conventional conservative treatment, are forced to completely abandon training. Also, the use of shock wave therapy devices allows professional athletes to recover faster after a performance, get rid of muscle cramps and other negative consequences of physical activity.

In our Center, sports injury treatment is carried out using the Swiss Duolith SD1 shock wave therapy equipment.

Treatment aimed at repairing damaged tissue using sound waves can have a positive effect in the treatment of chronic injuries of the hamstring tendons. A small study conducted among professional athletes yielded interesting results.

Sound therapy, better known as shock wave therapy*, works due to sound impulses aimed at injured body tissues through special devices placed on the skin.

Shock wave therapy has been extensively studied, for example, as an alternative treatment for various orthopedic and competition-related injuries when conservative therapy is not possible. For example, for heel pain caused by plantar fasciitis (heel spur), tennis elbow (inflammation of the tendon of the ulnar muscle due to its overexertion - website note), injuries to the Achilles tendon, fractures and frozen shoulder (chronic pain and severe limitation of mobility of the shoulder joint) .

Today, shockwave therapy machines are approved in the United States for the treatment of plantar fasciitis and tennis elbow, although this type of therapy is more common in Europe.

In a new study published in the American Journal of Sports Medicine, Italian researchers published the results of a study effectiveness of shock wave therapy for chronic injuries of the proximal hamstring in 40 professional athletes.

With this injury, the tendons connecting the muscles of the back of the thigh, which are attached on one side to the popliteal joint and on the other to the pelvic bone, are damaged. The typical presentation will be tenderness in the upper hamstring tendon extending to the entire hamstring during activity or while sitting. Magnetic resonance imaging shows thickening of the tendon.

In general, all types of tendon injuries can be treated well with conservative measures such as rest, anti-inflammatory and pain medications, and physical therapy. It was not clear whether shock wave therapy would be helpful in this case.

All athletes in the study had recurrent hamstring pain for at least 6 months. The researchers, led by Dr. Angelo Cacchio from the University of Rome, randomly assigned patients to either 4 shockwave therapy treatments or standard conservative therapy consisting of rest, pain medication, physical therapy and specific stretching exercises.

3 months after the start of treatment, patients who received shock wave therapy course reported a greater reduction in pathological symptoms compared with those treated conservatively. 17 of 20 who received shock wave therapy reported at least a 50% reduction in pain, versus 2 of 20 in the comparison group.

Athletes in the wave therapy group also reported less mobility limitations compared to their conservatively treated counterparts.

Angelo Cacchio said that the initial results give every indication of the good effectiveness of treatment with shock wave therapy, but additional, more extensive studies are required to confirm the findings.

The study involved only professional athletes - footballers, rugby players, long-distance runners and track and field athletes - but not only them, but also ordinary people can suffer from chronic injuries. Whether shockwave therapy may be beneficial for those who exercise only on weekends will depend on various factors, such as whether it will be available to such a person at all.

Cacchio says that in general shock wave therapy used as a last chance to avoid surgery after rest, pain medication, physical therapy and exercise therapy have failed. Shock wave therapy is contraindicated for some people, such as those taking certain medications or those at risk for internal bleeding. You also need to understand how safe it is for children, pregnant women, people with nerve damage and certain diseases, such as diabetes.

During this study, no serious complications were identified, but Angelo Cacchio notes that if you make a little mistake, tissue damage will not be avoided, which means that the doctor’s qualifications play a great role. The most common side effects are temporary swelling, soreness and irritation of the skin in the contact area.

Nobody understands clearly How exactly does shock wave therapy work? in the case of orthopedic injuries. The main theory suggests that local microtrauma is first formed, which stimulates blood flow and spurs natural tissue regeneration.

In Italy, the cost of 4 procedures, according to Cacchio, was around 200 US dollars. How much it will cost in other countries if the method is approved is still difficult to predict.

*Shock wave therapy uses infrasound, i.e. sound waves with a frequency below 16-25 Hz. The essence of the method is based on the cavitation effect that occurs at the interface between two media, for example, soft tissue and tendons. In fact, the sound wave passes through soft tissue and hits bone, cartilage and any other dense tissue from which the sound will be reflected. Modern equipment allows you to accurately select the desired characteristics of sound waves, which allows you to provide the most accurate impact.

One of the modern methods of physiotherapeutic treatment is shock wave therapy. Its action is based on the work of low frequency sound waves. The procedures are performed only in medical institutions; they are not done at home, as professional equipment is required.

How does shock wave therapy work?

Shock wave therapy works on the basis of infrasound, the frequency of which is no more than 16 Hz and a person cannot distinguish it. It is possible to feel its action only when resonance occurs from some internal organs, such as the lungs, esophagus or other hollow organs.

Due to the fact that in nature such waves occur during various disasters, for example, earthquakes, hurricanes, the human body perceives them as a danger. In everyday life, such waves can be emitted, for example, by a washing machine or refrigerator. If infrasound affects a person for a long time, it can cause a feeling of depression. Infrasound is often used by police to disperse demonstrations.

In medicine, the effect of infrasound is used during shockwave therapy.

The effect of such a wave on the human body leads to increased blood circulation and loosening of calcification areas.

Indications for use

Shock wave therapy in modern medicine is used for the following diseases:

1. Joint contracture, its use improves tissue nutrition by increasing blood circulation, ligaments become elastic, which ensures normal joint movement.
2. Indications for use will be the presence of calcification of articular cartilage and when degeneration occurs, this method allows the destruction of Ca crystals, and its use together with other methods leads to the restoration of articular tissue.
3. It is also effective in rehabilitation after fractures, since damaged tissues are restored faster, which is achieved due to their improved blood circulation and metabolism is accelerated.
4. In combination with other methods, UVT is used to destroy fatty deposits and for fibrosis of adipose tissue, as a result of which adipose tissue is restored and brought to a normal state; it is not used at home.
5. Indications for use will be the presence of ulcers or other damage to the skin, since this method allows for faster skin regeneration, but it cannot be used on infected wounds.
6. It effectively helps destroy kidney stones, so in many cases you can do without surgery.

Contraindications to shock wave therapy

Contraindications to its use will be the presence of the following factors and diseases:

1. If a woman is pregnant.
2. Not for use in children and adolescents as long as bone growth areas are not covered. In this case, the age after which shock wave therapy can be used is determined individually, since each person’s bone growth zones close at different ages. In some people this happens at 17 years old, in others it can last up to 23 years, if shockwave therapy is used at this age, it can stop bone growth, which often leads to various deformities.
3. If a person uses a pacemaker, then the use of infrasound will lead to interference with the operation of the specified device or its failure, which is unacceptable.
4. The impact should not be carried out in the head area, since prolonged exposure to infrasound can cause rupture of blood vessels and even a stroke.
5. It is impossible to influence the intestines, lungs and large vessels, since the infrasonic wave can cause them to enlarge, which will lead to rupture, and thrombosis may form in the vessels.
6. When acting in the field of oncological diseases, due to increased blood circulation, the tumor may enlarge and spread to other organs.
7. If blood clotting is poor, then the impact of the shock wave can damage the vessels and cause bleeding, as well as large hematomas.
8. Action directly on the nerves or their plexuses can lead to temporary paresis and sensitivity in the indicated area will be lost.
9. Contraindications for use would be the presence of inflammation or infection, since increased blood circulation leads to its spread throughout the body, so this method cannot be used.
10. Although some non-specialists prescribe shockwave therapy for the treatment of and, most doctors do not recommend this. There is a possibility that the nerve roots will be damaged. Blood flow increases in the area, which often leads to the formation of hemangiomas in the spinal body and the vascular network grows.

If you follow all the recommendations for the use of shock wave therapy, then there will be practically no side effects from it; they can only manifest themselves in the form of minor muscle pain at the site of exposure, as well as in the form of fatigue or headache.

How is the treatment carried out?

This treatment method is a good alternative to surgery. Due to its effectiveness, UVT is becoming increasingly popular and successfully competes with other conservative treatment methods.

Sometimes patients do not complete the full course of treatment, since in the first sessions very often pain occurs, which is caused by the action of infrasound; pain can occur not only during the procedure, but also after it. This leads to the fact that some patients do not want to undergo this treatment and voluntarily refuse it.

With each subsequent procedure, such pain becomes less and then completely disappears. If you have an increased sensitivity threshold and cannot tolerate pain for a while, you will have to use other methods that are used in treating the musculoskeletal system.

UVT sessions should be carried out no earlier than every other day. This is necessary for complete tissue regeneration to occur. When performing this procedure, a person must take a lot of fluid per day (at least 2.5-3 liters). This will ensure normal excretion of metabolic products from the body. The procedures are carried out in a room with a certain temperature to stimulate blood exchange. During therapy, the body must be subjected to physical activity, for this it is necessary to do jogging, fitness, and swimming.

If treatment is carried out by a highly qualified specialist in compliance with all norms and rules, then a positive effect from the use of shockwave therapy is observed in 90-95% of all patients.

Side effects

Although shockwave therapy is used in combination with other methods in the treatment of many diseases, there are also diseases for which its effect will be ineffective. This is, for example, . In this case, pain occurs due to the fact that the deformed disc pinches the spinal nerve root and it will not be possible to eliminate this cause with the help of infrasound.

With sciatica, pain occurs due to inflammation of the sciatic nerve. The use of shockwave therapy will lead to an increase in blood flow, and since the inflammatory process occurs, this can increase it even more.

The use of shock wave therapy is safe, but only if the conditions for its use are met and everything is carried out in a specialized medical institution; it cannot be used at home.

When performing this procedure, infrasound affects the entire body, so before using it it is necessary to undergo a full examination and only after that the doctor will be able to prescribe shockwave therapy. This method cannot be used at home, as it is performed using special equipment and under the supervision of a qualified doctor.

Based on the information received, we can conclude that the use of shock wave therapy as a treatment method is effective for many diseases, but it should not be perceived as a method of treating all diseases. Its use is associated with many risks, therefore, this procedure must be prescribed by a qualified doctor; after a full examination of the patient, it cannot be used at home.

Tendons They are dense tissue that attaches muscles to bones; tendons are flexible, but not elastic.

Sprains muscles, tendons or ligaments - this is a stretch, tear or complete rupture of the tissue. Muscle, tendon, or ligament sprains are classified according to the severity of the injury and are grade one, two, or three.

A first degree sprain is simply a stretch or tear of less than 25% of the fibers of the ligament, a second degree is a tear of 25% to 75% of all the fibers of the ligament, and a third degree is a complete tear of the ligament.

Healing time for sprains varies greatly depending on the specific ligament and the severity of the injury, ranging from 1 to 8 weeks.

We must not forget that after the ligament has healed, careful rehabilitation is necessary to restore the strength and flexibility of the ligament.

Treatment methods injuries to muscles, tendons, and ligaments usually involve immobilizing the damaged part of the body, applying fixing bandages, applying ice, applying splints and plaster casts. In advanced cases, surgery may be necessary to remove calcium deposits and free the tendon for movement.

Bursitis occurs when irritation of the mucous membrane causes it to fill with fluid and become inflamed.

Bursae They are fluid-filled sacs located in parts of the body that are subject to friction and pressure. Bursae are found between bones, muscles, tendons and other tissues. The purpose of the bags is to reduce friction between different types of tissues and protect the underlying tissues from impacts.

Causes of bursitis:

Repetitive movements and small impacts,

Frequent pressure.

Symptoms: pain and sensitivity, limited joint mobility.

Treatment of bursitis usually conservative: rest, applying ice, applying a pressure bandage. Only in extreme cases is surgery necessary to remove the mucous bursa.

Most bursitis (for example, calcareous) responds well to treatment with Extracorporeal Shock Wave Therapy; complete cure usually requires 4-6 sessions with an interval of 3-6 days, the number of pulses per procedure is 1500.

Tendinitis(tendon inflammation) microtears in the tendon fibers caused by repeated stretching. Tendinitis is particularly common in the Achilles tendon, rotator cuff, biceps tendon, and around the knee.

Achilles tendonitis is an inflammation of the thick tendon that connects the calf muscles to the heel. The inflammation is a reaction to a series of micro-tears caused by repeated stretching of the tendon. Because the blood supply to this tendon is poor, inflammation of the Achilles tendon is extremely difficult to overcome. Achilles tendonitis is especially common among people over 30 years of age due to degenerative changes that occur in the tendon from age 25 and make it weak and inelastic.

Application of shock wave therapy

The UVT method gives very good results in curing tendonitis; complete recovery occurs in 3-6 sessions with an interval of 4-7 days.

Shock wave therapy (SWT) is a modern, highly effective treatment method that is widely used in orthopedics, sports medicine, cosmetology and urology. This method allows you to quickly and effectively get rid of acute and chronic pain, increase the range of motion in the joints, and also allows you to significantly reduce or even eliminate the use of painkillers - without surgery or injections.

A shock wave is an acoustic wave that carries high energy to the problem area of ​​the musculoskeletal system, regardless of the stage of the disease (acute or chronic). Energy promotes repair and healing of bones, tendons and other soft tissues. Shock waves are characterized by abrupt changes in pressure, high amplitude and non-periodicity.

How long has this method been around (used)?

The first treatment using shock waves was lithotripsy. Then it was possible to focus shock waves so as to destroy kidney stones without surgery. Today, more than 98% of kidney stone cases are treated using this technology. The use of shock waves to treat tendon-related pain began in the early 1990s.

Since 2010, after completing my studies in Germany, I have been actively and successfully applying this treatment method in my practice, working on the best Swiss-made equipment Swiss Dolor Clast.

Medical effect

The acoustic waves used in shock wave therapy interact with tissue, producing common medical effects of increased tissue repair and cell growth, pain relief, and restoration of mobility. All processes mentioned in this section typically occur simultaneously and are used to treat chronic, subacute, and acute conditions.

• Stimulation of blood circulation. Adequate blood circulation is necessary to initiate and maintain repair processes in damaged tissues. The use of acoustic waves stimulates capillary blood flow, the formation of new capillaries in bones and tendons. New blood vessels improve blood supply and oxygenation (saturation of tissue with oxygen) to the treated area, speeding up the healing process. This also activates growth factors necessary to repair damaged tissue.
• Exacerbation of chronic inflammation. The acute process becomes chronic if the problem was not overcome at the stage of the acute process. It is important to understand that in order to cure a disease, it is necessary to convert a chronic process into an acute one. During the chronic stage of the disease, surrounding healthy tissues are involved in the process. Mast cells are one of the key components of the inflammatory process. Their activity can be increased using acoustic waves. Activation of these cells stimulates the production of chemokines and cytokines, pro-inflammatory compounds of the first level of the inflammatory process, which contributes to the launch of normal healing and restoration processes in tissues.
• Stimulation of collagen production. The production of a sufficient amount of collagen is a prerequisite for repair processes in damaged tissues. Shock wave therapy accelerates the synthesis of procollagen. The therapy causes the newly created collagen fibers to transform into a longitudinal structure, which makes the newly formed tendon fibers denser and stiffer and creates a more stable structure.
• Dissolution of calcified fibroblasts. Most often, an increase in calcium in the tissue is the result of micro-tears or other tendon injuries. Acoustic waves promote the disintegration of existing areas of calcification in tissues, triggering biochemical processes of decalcification. Granular calcium particles are removed by the lymphatic system.
• Depletion of pain mediators. A pain transmitter is a substance that transmits pain information to the brain through C-fibers. The amount and concentration of this substance is directly related to acute or chronic pain. Reducing the concentration of pain mediators reduces the stimulation of afferent nociceptive fibers and, thus, helps reduce pain. Also, the depletion of pain mediators, histamines and other similar substances prevents the development of inflammation and swelling in the tissues. The acoustic waves generated by shock wave therapy reduce the concentration of these substances and therefore reduce pain.
• Impact on trigger points. Trigger points are one of the main causes of back, neck and limb pain. These are areas of muscle fibers that are in a contracted (overstrained) state; as a result of this overstrain, adequate blood circulation in this area of ​​the muscle is disrupted, which leads to metabolic disorders and contributes to the accumulation of toxins. Toxins, in turn, irritate sensitive nerve endings, which leads to even greater reduction of muscle tissue. This vicious cycle is called a "metabolic crisis." It is believed that acoustic energy unblocks calcium pumps, thereby changing metabolic processes in muscle fibers and destroying trigger points.

What are the indications for use?

SWT is used as an independent method of treatment, but it is often used in the preoperative period, for example, to increase range of motion in a joint, reduce inflammation, etc., and in the postoperative period at the stage of early and late rehabilitation.

• pain in the neck
• backache
• pain in the shoulder joint (arthrosis, post-traumatic contractures, inflammation and partial ruptures of the rotator cuff tendons, adhesive capsulitis, calcifications, fractures of the greater tubercle of the humerus, glenohumeral periarthritis, etc.)
• pain in the elbow joint (arthrosis, epicondylitis, calcifications, tennis elbow, golfer’s elbow, contractures, fractures, their consequences, etc.)
• pain in the carpal joint and hand (arthrosis, condition after fractures of the bones of the forearm, chronic non-union fractures of the scaphoid, inflammation of the tendons, Dupuytren’s contracture, etc.)
• pain in the hip joint and thigh (arthrosis, contractures, consequences of fractures, trochanteritis, inflammation and ruptures of muscles and tendons, adductor muscle syndrome, pain along the back and outer surface of the thigh, etc.)
• pain in the knee joint and lower leg (arthrosis, contractures, inflammation of muscles and tendons, patellar tendoperiosteopathy, inflammation of the patellar tendon, “runner’s knee”, fractures and their consequences, stress fractures of the lower leg bones, etc.)
• pain in the ankle joint and foot (arthrosis, ankle fractures and their consequences, limitation of movements, stress fractures, tendon and ligament diseases, Achilles bursitis, partial ruptures of the Achilles tendon, heel spur, etc.)

What are the contraindications to UVT treatment?

• pregnancy
• age under 16 years (due to non-closure of bone growth zones)
• the presence of infected wounds in the problem area
• oncological diseases (the procedure can be performed after consultation with an oncologist)
• diseases associated with bleeding disorders
• mental disorders

What are the advantages of UVT?

• high efficiency of the method
• safety (no side effects or complications)
• fast and lasting effect
• non-invasive method (no cuts or injections)
• allows you to significantly reduce or completely eliminate the use of painkillers
• is not doping, therefore it can be used in elite sports in the pre-competitive and competitive periods
• procedure duration is from 3 to 5 minutes
• no restrictions after the procedure

What complications can there be?

There are no confirmed data on complications after SWT. In my many years of practice, I have never encountered this problem. The only point, if it can be considered a complication at all, is that some patients note a short-term increase in pain. This usually happens after the 3rd procedure and goes away quickly.

How is the procedure done?

• after examination and palpation, the problem area is determined
• the required amount of gel is applied to it (the use of gel is necessary for more efficient and smooth transmission of the acoustic wave)
• the applicator is brought up, lightly pressed against the skin and the procedure begins
• Duration of the procedure is 3-5 minutes (depending on the area to be treated)
• at the end of the procedure, the remaining gel is removed

Does the procedure hurt?

The level of discomfort depends on the patient's individual sensitivity and the level of pain the patient has already experienced in that area. Since the treatment lasts 3-5 minutes, most patients are able to tolerate this discomfort. As a rule, each subsequent procedure is less uncomfortable. In addition, the intensity of treatment can be adjusted throughout the session.

Does it hurt after the procedure?

Most patients experience immediate relief after the procedure. However, for 2-4 hours after the procedure, you may experience some pain in the treated area.

Where can I take the UVT course?

You can take the UVT course (by appointment and after an initial consultation) at one of the clinical sites listed on the website.

How much does the procedure cost?

The price of one procedure ranges from 3,000 to 7,000 rubles and depends on the clinical site where it is performed. Quite often UVT is covered by insurance companies.

How many treatments are needed?

The effects of the procedure are cumulative, so more than one procedure is usually necessary. On average, the course of treatment ranges from 3 to 7 procedures. The amount depends on the pathology we are treating, the stage of the disease and the individual characteristics of the patient. However, most often patients experience relief after the first procedure.

How often should the procedures be done?

Procedures are performed once every 5-7 days. At the end of the course, after 4-6 weeks, 2 more procedures are performed to consolidate the effect. The exception is professional athletes: here procedures can be performed more often.

What is the probability of success?

According to relevant literature, as well as my personal observations, up to 80% of patients are satisfied with the treatment. Many of them turned to this treatment after being disillusioned with other methods.

Conclusion

Shock wave therapy is an effective and relatively inexpensive method of conservative treatment of diseases of the musculoskeletal system. It is important for a patient to choose a doctor who:

• has been trained and has a certificate
• uses high-quality UVT equipment in his work
• has sufficient experience in using this treatment method

If you want to find out how UVT can help you, sign up for a consultation and learn about all treatment methods.

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