0101T Extracorporeal shock wave involving musculoskeletal system, not otherwise specified, high energy

Name of the Procedure:

Extracorporeal Shock Wave Therapy (ESWT), High Energy
Technical Term: High-Energy Extracorporeal Shock Wave Therapy involving the musculoskeletal system

Summary

Extracorporeal Shock Wave Therapy (ESWT) is a non-invasive treatment procedure utilizing high-energy shock waves to treat chronic pain and musculoskeletal conditions.

Purpose

ESWT is designed to reduce pain and promote healing in various musculoskeletal conditions. It is particularly useful for conditions where other treatments have failed to provide relief.

Indications

• Chronic tendinitis (e.g., Achilles tendinitis, plantar fasciitis)
• Calcific shoulder tendinitis
• Tennis elbow (lateral epicondylitis)
• Chronic heel pain
• Non-healing bone fractures

Preparation

• No major preparation is typically required.
• Patients may be advised to stop taking certain medications, such as blood thinners, a few days before the procedure.
• Basic diagnostic tests like X-rays or MRI might be conducted to accurately locate the treatment area.

Procedure Description

1. The patient is positioned comfortably, and the treatment area is cleaned.
2. A gel is applied to the skin to better conduct the shock waves.
3. A handheld device emitting high-energy shock waves is placed against the treatment area.
4. Shock waves are delivered in a series of pulses, focusing on the problem area.
5. Anesthesia is generally not required but may be used in some cases for pain management.

Duration

The procedure typically takes between 20 to 30 minutes.

Setting

ESWT is usually performed in an outpatient clinic or a specialized treatment center.

Personnel

• Trained physician or physical therapist
• Supporting nurses or clinic staff

Risks and Complications

• Mild to moderate pain during or after the procedure
• Temporary reddening or bruising of the skin
• Rarely, temporary nerve damage or tendon rupture
• Risk of infection is minimal due to the non-invasive nature of the procedure

Benefits

ESWT often provides significant pain relief and may promote faster healing. Benefits can usually be felt within a few weeks after treatment.

Recovery

• Minimal downtime; most patients can resume normal activities immediately.
• Follow-up appointments may be necessary to monitor progress.
• Patients might be advised to avoid strenuous physical activities for a few days.

Alternatives

• Physical therapy
• Corticosteroid injections
• Surgery (in severe cases)
• Pros: Non-surgical treatments like physical therapy are less invasive; surgery may provide a more permanent solution.
• Cons: Non-invasive options might be less effective for severe conditions; surgery involves greater risks and longer recovery.

Patient Experience

During the procedure, patients might experience mild discomfort or pain due to the shock waves. Post-procedure, some soreness or bruising at the treatment site is common, but over-the-counter pain relievers are usually effective for managing this. Most patients can return to daily activities almost immediately.