Shockwave/Radial Pressure Wave for OA/SIJ

[Philippa]

Hi All,

Has anyone used or are using their radial pressure wave machine for sacro-iliac joints? (In addition to laser and manual treatment). I have a FHO who is now getting more SIJ issues and I was wondering if adding in RPW would make our treatments last a little longer like they have done with the lumbo-sacral disease patients.

And what protocols is everyone using for RPW and osteoarthritis? I can't seem to see much info on frequency/settings? Also when using for OA are you starting at the same time as other treatments (eg. laser) or staggering?

Our machine is sitting around a bit as I've only been using it for lumbo-sacral and tendon issues and it cost enough money that I really want to get it working more.

Many thanks,

Dr. Philippa Mitchell MRCVS CCRP

[David Lane]

My cookbook RPW protocol is 1.5-2 bars (as high as will be tolerated) 2000 shocks at a freq of 10Hz weekly for 3 weeks, then prn or q3m afterward. If there is no clinical improvement before the 3rd round, then I give up and try something else.

We routinely laser at the same time, mostly for convenience, but I would argue that since the mechanism of action is different, they are more likely to complement each other than they would negate each other, but I have no data to validate that belief.

[Philippa]

Thanks David

[lehughes]

I'll chime in here... because I have told David in the past that he is under-shockwaving in regards to Radial shockwave!

Check out the shockwave newsletters - use the search bar to search shockwave.

I found that most of them were using 11 - 12Hz, starting with 2000 shocks, and you work up to as high of a dose as tolerated. I agree with David that I start somewhere between 2.o & 2.6 Bar.

You can shock the joint line as well as the bone / joint ends to improve cartilage.

I have used up to 6000 shocks per joint... I got talking one day. The owner messaged me the next day to say that the dog was lightyears better after that treatment and hoped that I would be as chatty everytime I shockwave from there on in.

The Q3weeks is specific to Focused shockwave, where tissue damage can occur. You can shockwave weekly or even daily with Radial. I tend to start dogs off on a weekly or Q2wk protocol for start and stretch out treatments from there as able. There is no maximum amount. It is a very safe modality.

I always laser as well within the same appointment.

Best of luck!

Laurie

[lehughes]

Oh... and in regards to SIJ... why not???!!
Hit the piriformis at the same time... but don't forget that strengthening the glutes is key to long term SIJ success once you have mobilized the joint.

Cheers!

Laurie

[Philippa]

Thanks as ever Laurie! My SIJ patient was much better at her last visit - I got the owner doing her homework again (she had lapsed) and it was much improved!!! Nice to have the RPW as a backup though. Will let you know how I get on if I do use it for that.

Happy New Year to you!