Non Surgical Treatments
Many conditions do not need surgery as a first resort. The most experienced surgeons will look for the safest and most effective treatments before considering surgery.
Shockwave therapy is a new treatment for chronic tendonopathy conditions affecting the human body. The theory behind the technique is to treat the chronic non-healing condition by creating a new injury using the Shockwave machine, but at a microscopic level. This injury sets up a new healing, inflammatory response in the cells around the old injury that allows the body to treat itself.
The big advantage of this technique is that it stimulates completely natural healing in the body without need for drugs, injections, scalpels etc. It has no complications apart from a tiny risk of causing bruising. There are a few reasons why some patients can not have Shockwave and it can not be used in children before bone growth has stopped.
The treatment consists of 3 sessions during which 2500 shockwave impulses are applied directly to the affected area. This is initially painful but a low force is used at the start. The force is turned up during the treatment to the maximum tolerated. Each session only takes a few minutes and the affected part initially feels almost pain free at the end.
It is important to keep on doing any stretching exercises that you have been shown. Also ice packs should not be applied the area to reduce swelling and you should not take ant anti-inflammatory medication. Both of these can potentially block the inflammatory reaction that we want to occur.
Some patients get rapid resolution of symptoms, but in other cases it may take 6 weeks to get the maximum benefit. Cure rates of 80% have been reported with this treatment, and I am usually finding this to be true making Shockwave a very effective option. If it does not work then all the other methods of treatment can still be used such as steroid and bone marrow injections, and even surgery in the worst cases.
Shockwave can be used for
I have developed the use of the Exogen Bone Healing Stimulation Device for treatment of fractures that fail to heal in my Trauma Practice at Poole Hospital. I have also used the device to boost healing in some fresh fractures where healing may be a problem and in patients who have had Orthopaedic procedures such as osteotomies and fusions, where again the bones have failed to heal after the normal expected time.
This device is approximately 80% effective and has saved many patients in my care with healing problems from the need for further surgery. I am one of only a few Orthopaedic Surgeons in the UK who have experience of this device and understand when it can be used successfully and when it is unlikely to be successful.
Many foot and ankle conditions are made worse by stiff joints and tight tendons. After surgery correct mobilisation is important to regain full function. I regularly send patients for physiotherapy as part of both pre and post-operative treatment.
Many foot deformities and arthritis can be managed by correctly moulded insoles in the shoes. I do not make these myself and usually recommend you see a Biomechanical Podiatrist who can assess your foot and get appropriate insoles made. There are many excellent Podiatrists in this area so I usually recommend you see one near your home or place of work for convenience.