Stoßwellentherapie

Since 1989, we have been harnessing the power of shockwave therapy in orthopedics to enhance the healing of bone fractures and tendon attachment complaints. This treatment is applicable to almost all joints of the body and has proven highly effective.

In my private practice here in Berlin, we employ extracorporeal shockwave therapy (ESWT). This method is a gentle yet effective conservative treatment option for a variety of orthopedic conditions. Especially for conditions like calcific shoulder, heel spurs, and tennis elbow, which can cause significant pain and limited mobility, shockwave therapy can provide relief and lead to lasting healing.

Using the modern Piezowave2 device and my extensive clinical experience, I am able to effectively and promptly alleviate your pain—without the need for injections, medications, or surgery! Another advantage of this therapy is the minimal side effects compared to other treatment methods. It is also low-risk and can be excellently combined with other forms of therapy.

Why not schedule an appointment with me at my orthopedic private practice in Prenzlauer Berg and see for yourself how shockwave therapy can help you. Just give us a call at 030 4427905. We look forward to helping you live a more pain-free life!

Shockwaves are high-energy waves that can penetrate water and soft tissue. They are generated when ultrasound is accelerated beyond the speed of sound, thereby releasing mechanical energy. When a shockwave encounters a solid object, such as calcium deposits in tendons, it discharges its energy. This allows various tendon inflammations, such as Achilles tendonitis (Achillodynia) or tennis and golfer's elbow (epicondylitis), to be treated without surgery. Shockwave therapy has also proven to be successful in treating poorly healing bone fractures and wounds, calcific shoulder (tendinosis calcarea), osteoarthritis of large joints, and pain from heel spurs.

The modern extracorporeal shockwave therapy that I use in my practice enables long-term pain relief. The focused extracorporeal shockwave therapy I apply in my Berlin private practice is significantly different from cheaper radial shockwave devices. The latter work with lower-energy pressure waves and are based on the principle of dispersion, where the ultrasound remains below the speed of sound and thus has no effect at depth.

In orthopedics, shockwave therapy is used for both acute and chronic conditions. Depending on the complaint and region, the therapy is conducted with different energy levels. Low-energy shockwave therapy is primarily used in pain therapy for superficial tendon attachment conditions, such as tennis elbow and Achilles tendonitis. Medium-energy waves penetrate deeper into the body and mainly alleviate the discomfort of calcific shoulder (tendinosis calcarea). Due to the pain that can occur during shockwave treatment, local anesthesia is usually necessary. High-energy shockwaves are mainly used for pseudarthrosis (non-healing bone fractures), as greater forces are needed here.

Discover how shockwave therapy can help you in my private orthopedic practice in Berlin Prenzlauer Berg. Schedule an appointment and let us work together to alleviate your complaints.

Procedure In my private orthopedic practice in Berlin, I first provide a thorough explanation of shockwave therapy before treating your complaints, answering any questions you might have. I also examine you and inquire about your individual symptoms. One benefit of this treatment is that it can be performed on an outpatient basis.

Patients are positioned stably before the treatment, and local anesthesia is applied as needed. Depending on the findings, an X-ray is taken to visualize the calcification, and the focus is adjusted. You, as the patient, will lie on an examination table with the affected body part resting on a soft, semi-circular plastic cushion filled with water. The shockwaves, initiated either by semi-circularly arranged piezocrystals or through wave reflection at a half-ellipsoid, continue in the watery medium and are focused at the point of calcification. Other body structures near the calcification, such as blood vessels, nerves, and tendons, are impacted by the shockwave but not damaged as they are not in the focus of the shockwave. A single shockwave is audible as a loud sound and felt as a thump, similar to a small hammer strike. The frequency of the shocks is about 60–300 per minute, and the intensity of the shock can be adjusted to match the calcification. For superficial treatments, such as those for venous ulcers, the shockwaves are not focused but are broadly applied to the treatment area. This requires a strong energy source as the energy of the shockwaves is distributed over a larger area and thus becomes weaker. To maintain effectiveness, it must be ensured that shockwaves with sufficient pressure reach the diseased cells throughout the treatment area. In addition to the defocused shockwaves, linear focusing piezo shockwaves are also used. Generally, the focus of the modern shockwave device is aligned to the area being treated. Shockwaves are then transmitted into the body through the device's head at a frequency of 2–4 Hertz and with increasing energy. This causes pain that is perceived differently by individuals, even with local anesthesia. I always ensure that this pain remains tolerable for you, continually monitor your sensation, and adjust the energy and treatment as necessary. Each treatment session with a shockwave device lasts between 5 to 15 minutes, typically with 1 to 3 sessions spaced 2 to 4 weeks apart. Each session delivers between 1,000 and 2,000 shockwaves. An exception is pseudoarthrosis (formation of a false joint), where treatment can vary significantly depending on the case. I am happy to inform you about the exact procedure of shockwave therapy in my private orthopedic practice in Berlin and answer any remaining questions.

Mode of Action The effectiveness of shockwave therapy has been proven in numerous scientific studies and is clinically documented. Molecular medical research has shown that shockwaves in bone tissue promote the production of bone growth factors. These hormones act as signals in the tissue to form new bone cells. Shockwaves are short, high-energy mechanical-acoustic waves that can penetrate water or water-containing tissues without attenuation. They also propagate through elastic body tissues, including muscles and fatty tissue. The contained energy is only released when the shockwave hits solid tissue components—like kidney stones, gallstones, or tendon calcifications—causing mechanical destruction of these foreign bodies. The shockwaves grind them into fine particles, which are then absorbed by the body and physiologically transported and excreted via the bloodstream. Shockwaves are generated outside the human body with a device and transmitted into the body through a water-filled cushion. By focusing the energy, shockwaves exert their effect precisely in the diseased area, selectively not reaching other tissues. This focus can be precisely calculated, allowing the shockwave effect to be exactly aligned to the desired zone to avoid side effects. In my private practice for orthopedics at the Europa Center in Berlin (Dr. Shami), I use a state-of-the-art PiezoWave2 device for Focused Shockwave Therapy.

Indications for Shockwave Therapy include:

• Calcifications (e.g., calcific shoulder)

• Shoulder impingement

• Tendon attachment diseases (e.g., tennis elbow)

• Poorly healing bone fractures

• Kidney and gallstones

• Wound healing disorders

Other applications in my orthopedic practice include:

• Sprains

• Tensions

• Hardenings or cramps

• Accelerated healing of inflammations

• Pain reduction

The therapy is also suitable for trigger point treatment in muscle hardenings. New applications such as trigger finger or Dupuytren's contracture also show good treatment results. Shockwave therapy can do much more than just break up calcifications! The treatment generally also accelerates the healing process in tissues.

Feel free to describe your individual complaints to me by phone or in a personal conversation at my practice in Berlin-Prenzlauer Berg, and I will assess whether shockwave therapy is a suitable treatment method for you.

Shockwave Therapy for Tennis Elbow (Epicondylitis)

In tennis elbow, the extensor tendons of the forearm and fingers are overstrained, which can lead to severe pain. Shockwave therapy aims to stimulate the body's own healing processes through mechanical waves. Numerous studies show the positive effect of shockwave therapy on tennis elbow (humeroradial epicondylopathy). It is also recommended for almost all tendon attachment diseases, bursitis (bursitis), and other inflammations.

Shockwave Therapy for Calcific Shoulder (Tendinosis Calcarea)

Calcifications at the tendon attachments of the shoulder can be painful and prolonged. Similar to the treatment of kidney stones, shockwaves are intended to break down the calcium deposits. The effectiveness of shockwave therapy for calcific shoulder is well documented scientifically and is frequently applied. However, the treatment is not suitable for all forms of calcific shoulder and can be a good alternative to surgical interventions.

Shockwave Therapy for Heel Pain and Plantar Fasciitis

The effectiveness of shockwave therapy for heel pain and plantar fasciitis is supported by studies. This also applies to inflammation of the sole of the foot (plantar fasciitis) with or without heel spurs. Shockwave therapy works similarly well to local cortisone treatment but without the harmful side effects of cortisone.

Shockwave Therapy for Tendon Inflammations

Shockwave therapy is also successfully used for inflammations of the Achilles tendon (Achillodynia), the knee (patellar tendonitis or jumper's knee), and calcified bursitis (bursitis).

Shockwave Therapy for Poorly Healing Bone Fractures (Pseudarthroses)

Shockwave therapy is very reliable in treating pseudarthroses. Pseudarthroses are non-healing bone fractures where only soft connective tissue forms instead of new bone. High-energy shockwaves promote the formation of new bone germ tissue. Additionally, studies have shown that shockwaves stimulate the production of growth hormones (BGF). The resulting bone germ (callus) stabilizes the bone fracture and allows the development of new bone tissue.

Let's find out together how shockwave therapy can help you. Schedule an appointment at my orthopedic practice in Berlin-Prenzlauer Berg and learn more about this effective treatment method.

Like any treatment, shockwave therapy can have potential side effects. However, this therapy is generally considered very low in side effects and safe, especially when I conduct a thorough examination beforehand. It is often described as a risk-free method, particularly when compared to alternative surgeries or injections.

With years of experience in shockwave therapy, I offer you the assurance of receiving the highest quality treatment in my private orthopedic practice.

Potential Side Effects

During and after the treatment, varying degrees of pain may be experienced. A very rare phenomenon with shockwave therapy is "initial worsening" – where symptoms initially worsen after the therapy. Muscle soreness in the treated area may also occur, but there is no need for concern: these symptoms typically subside quickly, often within a day. Additionally, possible side effects include skin redness, the formation of small bruises (hematomas), swelling, or superficial skin bleeding.

Rare Side Effects

Extremely rare side effects include changes in heart rhythm. There may also be side effects related to the anesthesia used. However, with careful evaluation, continuous monitoring during treatment, and proper handling, side effects in the private orthopedic practice (Dr. med. Shami) are minimal and only temporary.

Patient Care and Safety

Of course, I will provide you with detailed information before the treatment and evaluate the risk of side effects with you. In my private orthopedic practice in Berlin-Prenzlauer Berg, you can feel confident that your therapy will be conducted safely and effectively.

Let's find out together how shockwave therapy can help you. Schedule an appointment at my orthopedic practice in Berlin-Prenzlauer Berg and learn more about this effective treatment method.

Shockwave therapy should not be used in the following cases:

• Blood coagulation disorders

• Malignant tumors in the treatment or focus area of the shockwaves

• Patients with pacemakers

• Pregnancy

Additionally, it is usually excluded in cases of acute inflammation or infections in the treatment area, where large nerve or vascular bundles run, or if the area is in or behind lung tissue, open growth plates, intestines, brain, or spinal cord.

I will be happy to inform you about all contraindications at my orthopedic practice in Berlin-Prenzlauer Berg. Schedule an appointment and let us determine if shockwave therapy is the right treatment for you.

Generally, you will not require any follow-up treatment after shockwave therapy. If you experience a temporary increase in pain shortly after the treatment, I can counteract this with anti-inflammatory or pain-relieving medications. When treating calcific shoulder, it is advisable to rest for one to two days. It is particularly important to avoid activities that require holding your hands above your head.

In most professions, shockwave therapy does not result in any incapacity for work. Ideally, you should schedule your treatment for a Friday, so you have the weekend as a rest period. A final assessment of the treatment’s success should be conducted three months after the treatment. Further improvements may occur even later, as the effects of shockwave therapy are very long-lasting.

I am, of course, available to answer any questions you may have after the treatment and will be happy to help you find a suitable appointment at my private orthopedic practice in Berlin-Prenzlauer Berg. Schedule an appointment and let us determine if shockwave therapy is the right treatment for you.