Shockwave questions

[lehughes]

Hi Laurie,

It was very nice meeting you in New Jersey! I've signed up to your site, this time without any hitches. LOL. Your course was amazing. I am practicing and going over the techniques every day. I am so grateful that I was able to attend.

I do have a few questions about Shockwave. In your video demo it doesn't look like you are using gel. Do you use the gel with dogs/cats? In the shockwave information I have read, it states that shockwave shouldn't be used near large nerves, the spinal column or head. It seems in your demo you are using it on the spine. Could you please explain where you wouldn't use it. There really isn't any information/demos on using the Shockwave for osteoarthritis. Everything I've looked at is soft tissue. For osteoarthritis where do you use the Shockwave - right into the joint?

Thanks for all of the info!
E.

[lehughes]

Hi E!

I saw that you had signed up successfully! Hooray!
It was nice to meet you as well, and I’m glad you enjoyed the course!

In regards to your shockwave questions:

We no longer use gel. The manufacturer told us that the only reason to use gel was to be able to slide the unit over the body part. This makes good sense when dealing with a human (our skin doesn’t slide so well) or a hairless dog or cat. We find however that the unit slides quite well through fur. With radial shockwave, there is no need to create an interface - as you do with ultrasound machines or even the Focused shockwave units.

I use my radial shockwave on the lumbosacral junction for L-S Disc Disease… and it’s miraculous. I first got the idea while visiting Fitzpatrick Referral Centre in England and while on tour of their facility, I noticed that a number of dogs were in for L-S Shockwave. When I asked more about it, the reply was that they were not only doing it, but seeing great results as well. I came home and tried it with two cases of mine and was delighted. I’ve been using it as a standard pard of my L-S protocol ever since. I don’t use it on other discs however. The L-S junction is unique in that you can directly target nerves (and perhaps the disc) without the spinal cord being there to worry about. I would still be nervous about using shockwave along the spine elsewhere… that being said, I do feel comfortable using RADIAL shockwave to target nerves… but not the spinal cord. (At least, at this time of writing and/or unless shown otherwise.)

There is some great information on shockwave and osteoarthritis. Check out the FourLeg Newsletter Archives for some article reviews: I put them all in one place at www.fourleg.com/Shockwave. The newsletters are specifically 2015 Volume 4; Issues 1 A (and then 1B…I had so many articles), and also 2016 Volume 5; Issue 3. I shockwave around the joint. Studies show that you can target inside the joint or on the bone just adjacent to the articular surface to have an effect on the joint. As well, I look for trigger points / areas of tension near an affected joint (i.e. deep gluteal in a hip OA case). So really, you can’t go wrong!!!

I hope this helps!

Cheers,

Laurie

[David Lane]

Are you approaching the LS joint from the dorsal aspect, or from a different angle? Standard 2 bar pressure? I have not yet started using it for that application, but have been curious to try.

David Lane

[lehughes]

Hey David!

So yes, I approach from the dorsal aspect and traverse back and forth along the L-S junction. I start at 2.0 bar and work up to 3.0 or more as they acclimatize (over multiple sessions). I use 12Hz, and aim for 2000 - 3000 shocks per session in that region

It is now standard protocol at my clinic for the L-S patients, and I think it has made a huge difference!

Laurie

[David Lane]

Thanks. Will give it a try.

[David Lane]

Follow up question on LS ESWT.... are you using it purely for pain control, or do you feel it improves neurologic status?

[lehughes]

I am using it on cases where they are walking & mobile but licking / chewing at their feet and who are occasionally lame or offloading.

I think that I am improving the neural irritation (subjectively, as determined by owner seeing dog chew/lick feet less and/or by less porphyrin staining, as well as less lameness in the dogs with associated lameness). Dogs with just back pain, owners are seeing them stand straighter and then perform tasks (i.e. stairs) that they hadn't been.

Some of these dogs have been discharged and some come on a semi-regular basis.

Laurie

[David Lane]

thanks