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Low Back Pain

LOW  BACK PAIN HELPED WITH EXTRACORPOREAL SHOCKWAVE THERAPY IN THE BAY AREA

Sacroiliac pain and facet joint pain can be greatly helped with ESWT.  Check out how..

LUMBAR FACET JOINT PAIN AND ESWT

Between each vertebra are 3 connection points.  There is the disc in the front (this is why when people have disc problems they have more symptoms bending forward) and there are two joints in the back.  These are called the facet joints (see diagram). When someone has facet joint pain they usually hurt when they arch their spine.  Facet joint pain accounts for ⅓ of chronic low back pain. Having a practice for over 20 years outside The Villages senior community in San Jose, we have seen a lot of degenerated facet joints on x-ray!

SOME SYMPTOMS OF FACET JOINT PAINESWT can help Lumbar Facet Joint Pain

  • Pain when leaning backward
  • Buttock pain
  • Leg pain to the knee
  • Pain standing for periods
  • Pain sitting 
  • Facet arthritis on x-ray
  • Low back muscle spasms

With ESWT sound waves are focused in and around the facet joints.  The sound waves break up adhesions, bring blood into the area and help the joint cartilage to regenerate.  This has been shown in controlled settings and outcomes in our Los Gatos office are very good.

ESWT used over lumbar facet joint pain

The Piezowave 2 wand placed over lumbar facet joints

When comparing ESWT to steroid injections for facet joint pain, ESWT showed better long-term results without the high cost and damaging side effects of injecting corticosteroids into the facet joints [1].

Another medical treatment for facet joint pain is a medial nerve branch block called radiofrequency neurotomy (RMBN).  Here, the nerves are, literally, killed.  This lasts for 1 to 2 years until the nerve grows back [1].  ESWT, coupled with proper spinal rehab, is a better option as it helps fix the problem rather than just getting rid of the symptom to wake up with a bigger problem down the road.  

ESWT will help with some desensitization of the pain [2,3,4] but that is just the beginning.  ESWT is approved as a noninvasive way to help regenerate tissue [11-14].  We are now moving into a new phase in healthcare toward regenerative medicine and away from cutting out parts and tissues of the body.

ESWT also plays a role as desensitization of the painful facet joints [2,3,4]. Extracorporeal Shock Wave Therapy (ESWT) can be nowadays approved as an effective, safe, noninvasive therapy for many musculoskeletal diseases and many conditions where regenerative effects are desirable. It is the novel therapy for applications in the fields of regenerative medicine, tissue engineering and cell therapies [3,4,5,6].

HOW DO EXTRACORPOREAL SHOCKWAVES AFFECT YOUR TISSUES:

  • Increased permeability of the cell membranes of the tissue
  • Increased circulation and metabolism of the cells
  • Breaking up of scar tissue (even within the facet joints)
  • Healing of collagen fibers by fibroblast stimulation [5,6]

I am thrilled to say that with ESWT and the extensive set of tools be have to help facet joint pain, you are likely to have the healing you are looking for in our office.  We look forward to serving you. (408) 274-2244

SACROILIAC JOINT PAIN AND ESWT

Before reading sacroiliac (SI) joint pain please read the information on facet joint pain as there is some crossover information.

Your sacroiliac joints are formed by the connection between the sacrum (the triangular shaped bone at the base of your spine) and your iliac bones (some would call them your hips).  So, the sacroiliac joints connect your pelvis to your spine.  There insn’t much movement in the SI joints but when they get locked up there can be pain and accelerated degeneration. Because your SI joints support the entire weight of your torso, they tend to get worn cartilage and arthritic.

POSSIBLE SYMPTOMS OF SACROILIAC JOINT DYSFUNCTIONPelvis showing SI Joint that can be helped with ESWT

  • Pain at the SI joint
  • Lower back pain
  • Pain in the back of the hips
  • Worse standing
  • Improved  with lying down
  • Gluteal muscle spasms

Usually, when there is SI joint dysfunction, it is a problem with too little movement rather than too much movement.  When SI joints become fixated they are more likely to hurt.  In general, movement feels good in the human body.  When a baby is crying you rock it, when you hit your hand with a hammer you shake it and when you want to soothe yourself you use a massage chair. We love movement and that goes for your SI joints as well.

Our extracorporeal shockwave therapy has focused sound waves that can go into the SI joints, break up scar tissue, bring nutrients via blood into the SI joints and help regenerate the collagen fibers within the joints.  Chiropractic is phenomenal for putting movement into the SI joints.  However, if the joints are dried up and arthritic, they will lock up again.

Necessary for any tissue repair process is the production of collagen.  ESWT advances procollagen synthesis and the new fibers have a better structure and denser and stiff.  So, we get more lubrication in the SI joint and more stability from the ligaments outside the SI joint.  Add to that an active muscular system and you have a sacroiliac joint complex that is ready to sit, stand, jump and dance for years to come.

Let us share this wonderful technology with you.  Come to either the San Jose or Los Gatos office for an evaluation but the Piezowave 2 is located in our Los Gatos office  (408) 274-2244

SI Joint Pain Helped with Extracorporeal Shockwave Therapy (ESWT)

Dr Fields of San Jose, CA demonstrating ESWT use over the SI Joint

  1. Nedelka T1, Nedelka J2, Schlenker J3, Hankins C4, Mazanec R1. Mechano-transduction effect of shockwaves in the treatment of lumbar facet joint pain: comparative effectiveness evaluation of shockwave therapy, steroid injections and radiofrequency medial branch neurotomy.Neuro Endocrinol Lett. 2014;35(5):393-7.
  2. Suputtitada A (2015) Spinal segmental sensitization and myofascial pain syndrome: Evidences and experiences. Int J Phys Med Rehabil 3:4.
  3. Saggini R,Di Stefano A,Saggini A,Bellomo RG (2014) Clinical application of shock wave therapy in musculoskeletal disorders: part II related tomyofascialand nerve apparatus. Eur J PhysRehabil Med 50:217-230.
  4. Suputtitada A, Schmitz C (2016) Extracorporeal Shock Wave Therapy (ESWT) in Musculoskeletal Disorders. ISPRM.
  5. Schmitz C, Nikolaus BM, Stefan M, Matthias S, Nicola M, et al. (2015) Efficacy and safety of extracorporeal shock wave therapy for orthopedic conditions: a systematic review on studies listed in the PEDro database. Br Med Bull 116: 115-138.
  6. Suputtitada A (2016) Extracorporeal Shock Wave Therapy (ESWT) in Physical Medicine and Rehabilitation conditions. ISPRM.