Case Study of Knee Pain Improved with Shock Wave and Electromagnetic Therapy
This is a case study of a 58 year old female runner who had fallen and over the years had 4 surgeries on her left knee including two meniscus repairs, a ligament release and surgery to clean up debris in her knee. Surgeons say she has a lot of "wear" in her left knee. She has tried other modalities such as cupping, acupuncture, ultrasound and more and nothing has helped. She was interested in prolotherapy initially which our clinic doesn't provide any more. I explained to her the possibility of her being a good candidate for low frequency shockwave therapy (radial (superficial) and focused (deeper) shockwave) and EMTT (Extracorporeal Magneto Transduction Therapy) which are high oscillating electromagnetic pulses.
Treatment Length and Results
She received 7 weekly combined (RSWT/FSWT) of 5000 pulses (not actual shocks) along with 6000 EMTT pulses in a half hour appointment. After the first treatment (1 week) there was immediate improvement in pain and swelling. The second treatment had minimal effect. After the third treatment (3rd week) she noticed a definite improvement again even though she had gotten an upper respiratory infection so overall she didn't feel well. By the fifth treatment she noticed definite reduced swelling in the medial and inferior aspect of the left knee which was her definite area of most intense discomfort at the beginning of the treatment and she wasn't noticing the treatment being as "painful". I noticed her not flinching as much or none at all over painful areas like in the first one to two treatments. This is a pattern you start to see as the patient heels. Also, by the sixth and seventh weekly treatment she was not having pain going up and down stairs which was a hallmark of her original complaints.
I felt the patient could stop treatments after the 6th or 7th treatment and let the healing biochemicals triggered by the shockwave therapy and EMTT continue which they will for 8-10 weeks. The patient wanted to do just the EMTT treatment (15 minutes only) for another 4 weeks which there is no problem doing.Also, as part of my total treatment plan I put every patient on an anti-inflammatory diet...if they will do it!
Diet Options are:
1) Eat off my BED Diet list (whole food, a palmful or less of animal food per day; no dairy products, no eggs or wheat products ; page 2) for atleast a week (preferrably during the whole treatment period (3-7 weeks).
2) Inflamx 2 scoops in ice water 2-4 x daily with all the vegetables you want cooked anyway except fried or raw and 2-3 pieces of whole fruit daily.
3) The Prolon, the Fasting Mimicking Diet for 5 days
4) Or a water fast for 4-5 days.
If you do an anti-inflammatory diet you will get faster, better and more long lasting results from the treatment. Also appropriate exercise and stretching helps.
FREE PHONE APPOINTMENT: If interested in shockwave and EMTT Therapy for your "painful" body part (s) you can make a FREE 15 minute phone appointment with me whether you are a patient or not and I will let you know if you are a candidate for these therapies. If you are sure you want to try this therapy I need a one hour first time visit at our normal office visit prices to do a history, exam and first treatment. After that treatments are $175 for a half hour (usually 1 body part), $250 for 45 minutes (2-3 body parts) and if needed 60 minutes ($300 for 3-4 body parts). CALL 916-489-4400 TO SET UP AN APPOINTMENT.
The Benefits of Low Intensity Radial and Focused Extracorporeal Shock Wave Therapy (ESWT/EPAT) and EMTT (Extracorporeal Magneto Transduction Technology)
Extracorporeal Shockwave Therapy (ESWT) was first introduced into clinical practice in 1980 as a treatment for non-invasive lithotripsy (destruction of kidney stones with “high energy” SWT) (1). In the last two decades SWT has been commonly used as a treatment for musculoskeletal disorders and the stimulation of bone growth (2) (medium to low frequency SWT). Common orthopedic conditions treated successfully treated include plantar fasciitis (heel), Achilles’ tendinopathies, patellar (kneecap) tendinitis, shoulder and elbow tendon issues, femoral head necrosis, patellar knee pain, osteochondritis and calcified shoulder tendonitis (3-6). Shock wave therapy has also been used to treat recalcitrant angina pectoris (chest pain) possibly due to its ability to stimulate angiogenesis (new blood vessel formation). (7-8) For more than 10 years low intensity shock waves have been used to treat erectile dysfunction (and prostate issues) by improving blood flow and breaking down fibrous tissue (9-11). EMTT (Extracorporeal Magneto Transduction Therapy) is usually added to the above ESWT modalities but can be used as a stand-alone weekly treatment as well. EMTT’s high oscillation frequency between 100-130 kHz allows these pulsed electromagnetic fields deeper penetration into body tissues. (13-17).
Shockwave treatment is a non-invasive therapeutic intervention without the risks of surgery and postoperative pain that has been used medically for 20-30 years. EMTT is a new technology that has been used in a variety of inflammatory disorders for the last 5 or so years.
Focused and radial shockwaves and EMTT all promote:
1) Neovascularization – the building of new blood vessels
2) Release of growth factors such as eNOS (endothelial nitric oxide synthase)
3) VEGF (vascular endothelial growth factor)
4) PCNA (proliferating cell antinuclear antigen).
5) An anti-inflammatory effect
6) A breakdown of fibrous tissue
7) Stimulation of stem cells
These all lead to the improvement of the blood supply and to an increase in cell proliferation and ultimately tissue regeneration for tissue repair (12).
1. Lancet. 1980;2(8207):1265–1268.
2. Sports Med. 2002;32(13):851–865.
3. JAMA. 2003;290(19):2573–2580.
4. Am J Sports Med. 2006;34(4):592–596.
5. Br Med Bull. 2015;116:115–138.
6. Mater Sociomed. 2018;30(2):131-146.
7. Clin Cardiol. 2010;33(11):693-9.
8. Japan. Heart Vessels. 2019;104-113.
9. Am J Mens Health. 2019;13(2):557988319846749
10. European Urology, 58(2), 243–248.
11. European Urology, 71(2);223–233.
12. Chang Gung Med J. 2003;26:220-232
13. Krath, A. et al J Orthop.2017;14(3):410-415.
14. Kluter, T. et al., Electromagn Biol Med. 2018;37(4);175-183.
15. Kluter, T. et al., J Orthop Ther. 2018: JORT-1113.
16. Gerdesmeyer, L. et al., J Foot Ankle Surg. 2017; 56(5):964-967.
17. Knobloch K. Handchir Mikrochir Plast Chir. 2021 Feb;53(1):82-86. German. REV 3/20/22
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If you are interested in shock wave (EPAT/ESWT pulsed sound waves) or EMTT (pulsed magnetic fields) for pain management, stimulating healing and/or for erectile dysfunctions make an appointment as well. I still recommend variations of "Kirk's 21 Day Program" and different fasting regimens (Prolon and Inflamx) for reversal of heart disease, diabetes and overweigh t issues. If you have concerns about memory, CIRS (Chronic Inflammatory Response Syndrome), and/or mold illness those are also areas of significant interest and study for me.
Be Well,
Kirk
Kirk Hamilton PA-C
Health Associates Medical Group
3301 Alta Arden, Suite 3
Sacramento, CA 95825
(916) 489-4400 (w)
www.KwikerMedical.com
www.HealthyLivingforBusypeople.com
www.StayingHealthyToday.com