Alternative Treatments for Musculoskeletal Pain
Extracorporeal Pulse Activation Technology (EPAT), also known as shock wave therapy, is an office-based, non-invasive, evidence-based, FDA compliant treatment for upper and lower extremity musculoskeletal pain that results from acute and overuse injuries, which includes foot & ankle pain, hand & wrist pain, knee pain, and shoulder & elbow pain. These injuries can be due to athletic, work, recreational, and normal daily activities.
How does EPAT work?
The acoustic sound waves penetrate deep into injured tissue and increase blood supply and metabolism to injured cells, especially those of tendons such as hamstrings, achilles, plantar fascia, as well as the tendons around the knee, shoulder and elbow to name a few. Tendons attached muscles to bone and as a result of injury and overuse, scar tissue develops in the tendon, which is knows as tendinosis. The acoustic sound waves delivered by EPAT, will break up this scar tissue allowing it to heal. If the tendinotic tissue contains calcifications, which are often very painful, the sound waves can break up the calcification, much like they do with kidney stones. It is also a very useful treatment for chronic shin splints (periostitis).
EPAT is performed in the exam room. Ultrasound gel is placed on the skin over the area being treated and the probe is positioned over the area of maximal tenderness. The settings on the probe are adjusted in such a manner that the treatment is not painful, although there may some soreness involved, but after a few minutes, that too, may subside. A benefit of this treatment is that no anesthesia is needed. Treatments usually take about 10-15 minutes. Depending on the condition being treated and how long the symptoms have been present, most patients will need 3-5 treatments done on a weekly basis. Most patients will notice a reduction in pain after the third treatment although some may experience pain relief sooner. Those that have symptoms for an extended period of time may take longer to improve. It may take 6-8 weeks after treatment to achieve a full benefit.
There are no needles or injections used with EPAT. There is no need for crutches, braces, slings, or pain medicine. Dr. Stiene and his staff will formulate a return to activity program based on the nature, chronicity and location of your injury. With EPAT, one of the biggest benefits is that there is minimal downtime after treatment. You can remain active, but not to the point where a given activity increases your pain while or during the specific activity as the injury needs to be given time to fully heal. Certain high impact activities and those involving repetitive motion may be restricted a bit longer depending on your individual situation.
What disorders can be treated?
Frequently Asked Questions about EPAT
What are the possible side effects/complications?
Side effects are minimal as there is no penetration through the skin making an infection extremely rare. There may be some redness or soreness at the treatment site for a few days. With EPAT, one of the biggest beneﬁts is that there is minimal downtime after treatment. Dr. Stiene and his staff will formulate a return to activity program based on your injury.
What does payment look like?
Insurance typically does not cover the EPAT®/ESWT procedure. While FDA compliant, and evidence based most US insurers do not pay for EPAT although the cost can be used toward a qualiﬁed health savings account. Beacon has patient advocates that can take you through the payment process. This non-invasive option will be particularly appealing to those patients who are eager to return to work or normal activities in a reduced amount of recovery time with just as good, if not better, clinical results compared to traditional treatment methods, including surgery.
Although insurance typically does not cover the cost, patients are generally surprised at the affordability of the procedure. Beacon’s patient advocates will work directly with the patient to discuss the payment plan that works best. Dr. Stiene works with these patient advocates as well to provide a personalized pricing program. Some patients can use their employer’s “Qualiﬁed Health Savings Account” to cover these out-of-pocket expenses.
What if I have a special health condition?
The safety and effectiveness of the EPAT®/ESWT procedure has not been determined on people with malignancies at the treatment site, DVT (Deep Vein Thrombosis), or pregnancy. Dr. Stiene will provide you with information about how these and other conditions might affect the determination to perform the EPAT®/ESWT procedures.
Why consider non-invasive EPAT®/ESWT?
EPAT®/ESWT has a proven success rate that is equal to or greater than that of traditional treatment methods (including surgery) and without the risks, complications and lengthy recovery time. EPAT®/ESWT is performed in Dr. Stiene and Dr. Miller’s office/clinic, does not require anesthesia, or needles/injections, and requires a minimal amount of time. You can remain active, but not to the point where a given activity increases your pain, as the injury needs to be given time to fully heal. Certain activities may be restricted a bit longer depending on your situation.
What are the expected results?
The beneﬁcial effects of Extracorporeal Pulse Activation Technology (EPAT®), also known as ESWT or shock wave therapy, are often experienced after only 3 treatments. Some patients report immediate pain relief after the treatment, although it can take up to 4 weeks for pain relief to begin. The procedure eliminates pain and restores full mobility, thus improving your quality of life. Over 80% of patients treated report to be pain free and/or have signiﬁcant pain reduction.
Dr. Henry Stiene or Dr. Adam Miller are the best people to talk with if you have questions or concerns about the EPAT®/ESWT procedure. Both expert physicians have extensive knowledge and specialized training on all aspects of its use, safety and effectiveness.
You can also learn more about EPAT®/ESWT technology by visiting the CuraMedix website at www.curamedix.com.Book an Appointment