A Case of Hip and Wrist Pain, Urination (Prostate) and Stool Problems Treated Successfully with Shockwave Therapy

Sat, 09 Jan 2021 19:59:40 +0000

A 54 year old male who is a long-time patient, cancer and stroke survivor was seen in early December 2020 for “prostate issues.” He was interested in receiving low intensity extracorporeal shockwave therapy (ESWT or EPAT) for urgent and frequent night-time urination. He had a history of esophageal cancer that was cured, hypertension, being overweight, a stroke four to five months ago, stool urgency, frequent night-time urination with incomplete voiding, a painful right wrist exacerbated by holding the throttle on his motorcycle, as well as left shoulder pain and an actual decreased pain recognition on the whole left arm believed to be caused by his stroke.

NOTE: A shock wave is NOT an electric shock. It is a pulsed sound wave (acoustic, pressure wave) that creates a response in body tissues that releases natural body compounds that promote healing, circulation, new tissue formation, anti-inflammation, and breakdown of fibrous tissue.

Prostate Treatment Protocol

He was started on a treatment regimen of focused shockwave therapy (fSWT) at 2000 shocks at .25 mJ/mm2 over the perineum (the area between the scrotum and rectum or in women the area between the vagina and rectum) and he also received radial shockwave therapy (rSWT) of 1000-2000 shocks at 2.5 bar/15 Hz over each crura which is the area on each side between the scrotum and the rectum. These treatments were done on a weekly basis approximately 20-30 minutes each.

Stool and Urination Controlled After 3 To 4 Treatments

He has had four such treatments and what he noticed over the last four weeks is a remarkable reduction in his night-time urination from four to five urination down to one and he is also noted a remarkable reduction in urgency when having to have a bowel movement where there were times where he could not hold his stool to get to the toilet. He also notes now more complete evacuations of the stool as well as more complete voiding of his urine.

Wrist Pain and Mobility Dramatically Improved

He also came in with the complaint of severe pain in the right wrist joint especially when he would ride his motorcycle and holding the throttle for long periods of time. He has had four treatments with a combination of vibration therapy (V-Actor) followed by focused shockwave therapy (fSWT) of 2000 pulses at .25 mJ/mm2 on the front and back side of his wrist (1000 shocks on each side). This has been followed by radial shockwave therapy (rSWT) of 2000 pulses on either side of his wrist, up and down is forearm, and the palm of his hand. All of the hand sessions repeat the vibration (V-Actor) at the end.

He noted immediate improvement in his right wrist the first treatment and today after four treatments he feels it is almost pain-free while flexing and extending the wrist.

Night-Time Urination Dramatically Reduced with Stool Normalization

His night-time urination has been reduced from 4 and 5 times per night to one-time per night. His sense of stool urgency has been reduced dramatically. He feels like he has a complete evacuation of his stool and at the same time he has much more control over his stool urgency where at times he would almost have an accident. 

Mobility and Pain Reduction in Shoulder

His right shoulder had remarkable improvement in its range of motion and reduced pain just from the first treatment. After the second treatment he had even further improvement.

Diet, Inflammation and Pain Reduction

Normally I have all patients go on some type of “anti-inflammatory diet” to enhance pain reduction. Food causes pain. If I could get every one of my patients to do a 5 to 7 day water fast, they would experience how much of their symptoms, and in these cases pain and mobility, would improve by going on very simple diet that eliminated commonly eaten foods. In this patient’s case he was supposed to be on a hypoallergenic pea and rice protein supplement with anti-inflammatory components (Inflamx we sell at the office) but he got caught-up in the holiday spirit and consumed excessive amounts of food to the point where he actually gained six pounds over a two to three weeks while his pain was going down and these symptoms were improving. So, his pain reduction couldn’t have been attributed to him going on an anti-inflammatory diet which makes most of the benefit, if not all, coming from the treatments using vibration (V-Actor), focused shockwave therapy (Duolith SD1, Storz Medical), as well as radial shockwave therapy (OrthoPuls 100 Ultra, Storz Medical).

Variations of shockwave therapy have been around since the early 1980s when high energy shockwave therapy (the above treatment is using low energy shockwaves) was used for the breaking up of kidney stones among other hard stones which is called lithotripsy. Over the next 20 to 30 years low frequency shockwave therapy (LiESWT) has been used to treat all kinds of musculoskeletal disorders or virtually any “…ITIS” as well as recalcitrant angina (chest pain), bone and wound healing.

Focused and Radial Shock Waves Promote

1)      Neovascularization the building of new blood vessels
2)      Release of growth factors such as endothelial nitric oxide synthase. This produces nitric oxide which is a powerful vasodilator
3)      VEGF (vascular endothelial growth factor) helps build new blood vessels
4)      PCNA (proliferating cell nuclear antigen) which helps build new tissue (DNA repair)
5)      An anti-inflammatory effect
6)      A breakdown of fibrous tissue
7)      Stimulation of stem cells

How Shock Waves Work  

All the above lead to increased blood flow to the area and promote growth of new blood vessels and tissue repair. All this is activated by the pulsed shortwaves through either method generated: 1) By an electromagnetic coil (focus shockwave therapy) or 2) air compression moving a mechanical bullet up-and-down a chamber moving a particular tip up-and-down rapidly against the skin surface (radial shockwave therapy). Focused shockwave therapy results in its maximum energy being delivered deep within the tissue where radial shockwave therapy delivers its maximum energy right at the surface of the skin and disperses in a radial fashion. They can be used individually or in combination which is how I use them.

  What to Expect With Shockwave Therapy?

When treated with shockwave therapy it is on a weekly basis or at least five to seven days apart and three things can usually happen after that initial visit.

1)      The pain goes away and when it returns in a day or two it is less than when you started.

2)      The pain is a little aggravated for a day or two and then it is reduced to something less than
when you started.

3)      Nothing happens in which you wouldn’t go past 5 weekly treatments and we would look for
an underlying cause (i.e. fracture, etc.).

4)      Both techniques can create some discomfort during treatment, but it is mild and very
tolerable. I constantly tailor the strength of the treatment by watching and talking to the
patient as I am doing the treatment.

How Long and The Cost

This therapy builds on the therapy of the week before and so at least three to five treatments needed for most conditions and then it is tailored to the individual response. Even after you stop the treatment these growth and healing factors continue to be stimulated for weeks. Increased blood flow to any tissue increases healing. That is why this therapy can be used for so many conditions. There cost is usually $150 per treatment (single body part) lasting 20-30 minutes.

Conditions Which Respond to Radial and/or Focused-ESWT
3-5 Weekly Treatments $150/per body part (20-30 min)

Achilles Tendinitis – Avascular Necrosis (hip) – Benign Prostatic – Hypertrophy (BPH) – Bicep Tendinitis – Bursitis Hip – Calcium Deposits – Carpal Tunnel Syndrome – Erectile Dysfunction (6-18 weekly or twice per week treatment sessions***) – Greater Trochanteric Syndrome (hip pain)
Low Back Pain – Lymphedema (8-12 weekly) – Muscle Strains – Overactive Bladder – Neck Pain (stiff neck) – Neuroma’s (feet) – Neuropathies (feet) – Nocturia (nighttime urination) – Patellar Tendinitis – Plantar Fasciitis – Rotator Cuff Partial Tears – Shin Splints – Shoulder Pain – Tennis Elbow (outside) – Trapezius Pain – Urinary frequency – Wound Healing

  Action Steps if Interested…

If you would like to receive this therapy make a one hour initial appointment (916-489-4400) with me where I can take a medical history, do a focused exam and then do your first treat (initial hour with treatment session is $245/$215) then each following treatment is $150 (20-30 minutes).

If you have questions you can call me between 8:00 and 9:00 in the morning, or you can make a short, free 10-15 minute phone call appointment to see if you are a good candidate for this therapy (916-489-4400).

  Keys To Reducing Pain

The keys to reducing pain and promoting healing are:

1. Going on an anti-inflammatory diet. I use the following options:
a) The basic elimination diet (BED)
b) The Fasting Mimicking Diet
c) Inflamx (2 scoops 1-3 x daily) plus non-starchy vegetables and whole fruit
d) In some cases a water fast

 2. Extracorporal Shockwave Therapy using individual or in combination radial and/or focused shockwave devices from three to five weekly treatments initially for most conditions. Conditions such as lymph-edema and erectile dysfunction may take 8-20 treatments. Neuropathies may have an initial series then ongoing monthly or bimonthly maintenance treatments.

3. Range of motion and strengthening exercises and some type of aerobics are critical to stimulate blood flow and healing.

4. Certain anti-inflammatory nutrients such as curcumin, vitamin C & D, omega-3 fatty acids, zinc, enzymes are commonly used.

5. Avoidance of cortisone or non-steroidal anti-inflammatory drugs/injections after EPAT/ESWT treatment if possible. Using a pain control medication such as Tylenol is preferred.

I would be happy to answer your questions and I’m excited about this new therapy with these two devices because it gives me an opportunity to help people initially with pain reduction and then lead them into living lifestyle patterns that improve their overall health and well-being because almost all chronic conditions (heart disease, diabetes, arthritis, obesity, etc.) start with increased inflammation and this combined program will help reduce body inflammation.

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Kirk Hamilton PA-C
Prescription 2000, Inc.
Health Associates Medical Group
3301 Alta Arden, Suite 3
Sacramento, CA 95825
(916) 716-2295 (m) / (916) 489-4400 (w)
krhammer@surewest.net
www.KwikerMedical.com
www.HealthyLivingforBusypeople.com
www.StayingHealthyToday.com