| |
Bursitis of the Shoulder
Prior
to any Sonocur treatment, care must be taken to be certain that the
patient meets the treatment criteria, has no treatment contraindications,
has had the necessary pre-treatment imaging studies, and has read and
signed the proper informed consent.
 |
|
click
to enlarge
|
|
 |
|
click
to enlarge
|
|
PROCEDURE
TECHNIQUE
- Place patient on
treatment table in supine position.
- Place and support
the arm of the affected side alongside the body with the palm of the
hand facing upward.
- Identify trigger
point (sore area near or over the shoulder) by palpation and mark with
pen if necessary.
- Apply transmission
gel over trigger point.
- Swing Sonocur
shock head into place and position over identified trigger point.
- Apply shock waves
initially at lowest energy level (level 1) at 4Hz.
- Move shock head
or shoulder in small increments until patient reports maximal reproduction
of discomfort.
- Accomplish fine
adjustment of shock wave penetration depth by adjusting amount of fluid
in bellows, again with patient feedback to identify maximal trigger
point stimulation.
- Great care must
be taken to precisely identify the exact area of pain. It may require
the use of several shocks (eg.100) to identify this site.
- Depending upon
patient tolerance, gradually increase energy levels to the highest level
that can be maximally tolerated. For shoulder bursitis, this is generally
level two (2) or occasionally level three (3). Shoulder bursitis is
generally very sensitive to treatment. Be certain that the patient does
not become too uncomfortable. It is more important to deliver all the
shock waves to the correct area at a lower energy level than miss the
mark with higher levels because the patient is too uncomfortable.
- Readjust the shock
head position after every 200-400 shocks to precisely treat the maximal
area of tenderness. Cover the entire area well with applied shock waves.
- Deliver a total
of 2000 shocks to the affected site after it has been identified.
- Remove shock head
from shoulder and observe the site of application.
- Wipe away the
gel.
- Supply patient
with post treatment instructions and return appointment for additional
treatment or physician visit.
HELPFUL HINTS
- If the patient
is exquisitely tender or has significant discomfort, it may be helpful
to initiate treatment more slightly away from the point of maximal tenderness.
After 100-200 shocks, slowly readjust the shock head so that the shock
waves are focused more progressively toward area of maximal tenderness.
Slowly advance to the maximal trigger point and complete the treatment.
In rare cases, the painful site may be large or have more than one exquisitely
painful area. In these cases, both areas should receive 2000 shocks
each.
- Inform the patient
that it is usual to have soreness after treatment and that often the
pain will be worse for a few days until healing begins. Explain that
if multiple treatments are necessary, that subsequent treatments can
sometimes be more uncomfortable than the initial treatment. In addition,
emphasize that healing may take several weeks to occur and that one
should not expect maximal improvement until 12 weeks after the last
treatment.
Sonorex Sonocur
Treatment Protocols are copyright protected.
© 2012 Sonorex. All rights reserved.
The Sonocur® Orthopedic Extracorporeal Shockwave system is available in Canada and other countries where regulatory approval has been obtained. The Sonocur® Basic is FDA approved in the United States for the treatment of chronic lateral epicondylitis (tennis elbow).
© 2012 Sonorex. All rights reserved. By using this service, you accept the terms of our Visitor Agreement. Please read it. The material sonorex.ca is for informational purposes only and is not a substitute for medical advice or treatment for any medical conditions. You should promptly seek professional medical care if you have any concern about your health, and you should always consult your physician before starting a fitness regimen.
|
|
