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Hi all,

I referred a patient, 6 yr FS spaniel mix, for shockwave therapy for a R radius/ulna mid-diaphyseal delayed union fracture. She's had her tx and will receive 3 total, each 2 weeks apart. Her owner is a retired PT (and is fabulous) and doing well with leash walking, PROM and hydrotherapy (walking in water). My experience with shockwave is only referring patients for it, so my question is how long after each tx do I wait to tx with laser therapy and if indicated. She was sent home with 4 days of carprofen following tx, which is a bit different that some things I have read. I've had other patients treated with other, non-NSAID analgesics after tx.

Thanks,
Sarah

Hi Sarah,

Great question!

So, the rationale behind shockwave is to stimulate the tissue in order to stimulate healing. Laser does the same, ultrasound does the same, PEMF does the same. Different mechanisms, but same goal - stimulate tissue.

So I'd laser as soon as it was feasible to get the dog back in for laser. I'd not be worried about negating the shockwave treatment. In fact when I use shockwave (radial) in my clinic, it is most often in accompaniment of laser.

In regards to NSAIDS... we'll one could say that a Pain Killer might be more appropriate - Gabapentin or Acetaminophen for example, so as to not quell the inflammation / stimulus just put in. The other side of the coin would be that a day or two of NSAID might be okay and wouldn't have an overall deleterious effect on healing. But don't extend the dose beyond a day or two. NOTE: This really only pertains to Focused shockwave.

I hope this helps with your thought processing and what you might advise to your client and future clients!

Cheers,

Laurie

Thank you! Saw her today and improved WB after one tx, fingers crossed.
Sarah