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By Andrew Gorosko



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By Andrew Gorosko

A local podiatrist is now using an advanced form of noninvasive, electronic treatment intended to relieve the pain of patients who have medical conditions including Achilles tendinitis, heel spurs, and plantar fasciitis.

The nondescript appearance of the portable treatment device, which is housed in a beige case with an extendable boom, belies the complexity of the medical mechanism functioning within.

Known as “extracorporeal shock wave therapy,” the treatment approach employs an electromagnetic/acoustic shock wave generator. The generated shock waves move through a water-filled vessel and into an acoustic lens. The acoustic lens focuses the pulsating shock waves for the treatment of foot/ankle maladies.

Joel S. Segalman, MD, who has medical offices in Newtown and Waterbury, said the shock wave treatment intentionally causes an inflammation of the bodily tissue toward which the shock waves are aimed. After the inflammation subsides, a “revascularization” occurs, improving blood flow in the area, thus fostering healing, the doctor explained.

Patients treated with shock wave therapy typically are those who have not had success with other treatment methods, Dr Segalman said. The doctor began working with the technique in August 2003. Patients who have been treated with shock waves have reported a high success rate, he said. Many of the patients whom Dr Segalman treats have sports-related injuries.

Shock wave treatment offers the prospect of successful healing for patients for whom other treatments have failed, Dr Segalman said.

Typically, patients receive three well-spaced shock wave therapy sessions. Although the therapy may induce some patient discomfort, there are virtually no adverse side effects caused by the use of low-energy shock wave therapy, Dr Segalman said. Each treatment session lasts between 11 and 15 minutes.

Shock wave treatment offers patients definite medical results, akin to those that are produced by surgery, but without the need to undergo the complexities of surgery, the doctor said. In that sense, shock wave treatment is better than surgery, he said.

The shock wave modality is becoming a more popular form of treatment in western Connecticut, Dr Segalman said. Besides foot and ankle problems, shock wave equipment may be used by other doctors to treat elbow, arm, shoulder, wrist, pelvis, hip, groin, and knee problems.

Because the equipment is quite expensive, the portable shock wave generator used in the treatment is transported to various doctors’ offices, where it is used on a rotating basis.

Dr Segalman estimates that about 40 of his patients have received shock wave treatments since he began using the equipment last August. Of that number, approximately 85 percent of the patients treated have experienced good results, he said.

Other treatments for patients with Achilles tendintis, heel spurs, and plantar fasciitis include cortisone injections, physical therapy, and surgery, plus the use of orthotics, anti-inflammatory drugs, and night splints.

Dr Segalman said he expects that the relatively high cost of shock wave treatment will decline as it becomes a more popular therapy. The doctor said that as shock wave treatment becomes a preferred form of therapy for foot/ankle disorders, he hopes that its use will become more widely reimbursable by medical insurance firms.

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