聚焦式衝擊波治療

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一般醫療人員或媒介提及的聚焦式衝擊波治療是指『體外衝擊波治療』(Extra-Corporeal Shock Wave Therapy 或簡稱 ESWT)。

此治療科技源自衝擊波碎腎石的科技;近年來醫療科技界做了大量的研究,發現應用此科技於治療人類和動物如馬匹或狗隻等肌肉骨骼系統的慢性痛症和炎症時,效果非常理想。

其治療作用在於利用體外衝擊波去刺激骨骼、筋腱以及其附近組織的復原過程,以達到治療的目的。

衝擊波治療的優點在於相對便宜、療效快且好、非入侵性且沒有嚴重的副作用。

更多聚焦式衝擊波治療相關內容

衝擊波的適應症

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衝擊波治療的適應症

足底筋膜炎

足底筋膜慢性炎症,導致下床站起時、久坐後站起時或步行時腳跟痛,有些患者在腳弓部位亦有痛。

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跟腱炎

腳跟後的筋腱炎症,步行、跑步或該筋腱受壓時痛。

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膝蓋腱炎

膝蓋對下的筋腱炎症,患者尤其在上落樓梯或斜路時痛。

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肩周炎

肩關節痛,活動受限,尤其穿衣或提起上肢時痛。

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肘痛(網球肘或高爾夫球肘)

肘的外側或內側痛,尤其在取物或運動時痛。

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其他慢性的筋腱或韌帶勞損

圍繞肩、肘、腕、髖、膝或踝關節等的筋腱或韌帶因拉傷或勞損引致的痛症。

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其他慢性的肌肉痛症或勞損

肌肉的拉傷或激發點(Trigger points)引致的痛症。

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常見問題

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聚焦式衝擊波治療的常見問題

衝擊波的治療原理是甚麼?

衝擊波是一種高能量的聲波,可以透過破壞患處發炎的軟組織,從而刺激新血管生長,加速血液循環及喚醒細胞的自我修復功能。此外,衝擊波的高能量也能大量刺激痛覺神經受體,達到即時止痛的效果。

聚焦式衝擊波有甚麼特別?

正統的衝擊波都是聚焦式的,如用來碎腎石的衝擊波就是聚焦式的。相對於散發式的壓力波,聚焦式衝擊波將能量聚於一點,能準確直達致痛之源。由於可聚焦於不同的深度,對患處可作針對性的治療。

聚焦式衝擊波對那些肌肉筋腱或軟組織問題有用?

研究顯示,衝擊波對多方面的肌肉、筋腱或軟組織痛症炎症有顯著的療效,詳情請參看衝擊波的適應症

接受聚焦式衝擊波治療的過程及感覺是怎樣?

假設您是適合接受此治療的患者,我們的治療師會首先為您作一個詳細的評估。跟據患處的位置,治療師可能需要在患處皮膚上用筆作一些記號,然後在患處塗上水劑的o者o厘讓衝擊波能進入患處。由於聚焦式衝激波最大的能量在聚焦的位置,當聚焦於非患處時患者沒有甚麼特別不適的感覺。但當聚焦於患處時,患處會有酸麻脹痛的感覺,這種感覺有時會放射至患處附近,甚至較遠的位置。治療師會於此點給予治療;治療一會後患處的酸麻脹痛感覺會降低。視乎患處範圍的大小,這些點可能會不止一處。治療師會與患者配合,移向另一些類似的點給予治療。

每次治療需時多久?

這要視乎患處有多少個,以及每個患處的大小。第一次治療可能需時較多,因治療師需為患者作詳細的評估。以每一患處來說,衝擊波治療需時約15分鐘。

大概需要多少次治療才能復原?

這要視乎痛症炎症的嚴重程度。一般情況下,患者接受治療2-3次後會見到明顯的療效。

那些人不適合接受衝擊波治療?

孕婦,痛症位置附近有腫瘤或裝有心臟起搏器的人,患出血性疾病者,痛處皮膚表層有傷口或有細菌感染者都不適合接受衝擊波治療。

衝擊波治療會否帶來甚麼不良的副作用?

衝擊波治療沒有長遠的副作用。少部份患者在治療後皮膚表層有機會出現輕微瘀血或紅腫等徵狀,兩三天後會自然散去。

更多聚焦式衝擊波治療相關內容

有關研究

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衝擊波的應用範圍廣泛,以下我們搜集了一些研究的摘要,只屬肌肉骨骼系統的研究。這些文章,在國際上重要的學術會議上曾發表過。我們會將文章分類並簡介研究的出處及其結果。您可點擊來閱讀簡介和原文摘要。為求準確,我們只能以原來的英文版本刊出摘要。

足底筋膜炎

台灣長庚醫院的研究

台灣長庚醫院對衝擊波治療足底筋膜炎的長期效果研究。
研究結果:衝擊波治療有效及安全、長期效果良好。

Title:
Long-term Results of Extracorporeal Shockwave Treatment for Plantar Fasciitis

Author:
Ching-Jen Wang, *Feng-Sheng Wang, *Kuender D. Yang, Lin-Hsiu Weng, Jih-Yang Ko

Institution:
From the Department of Orthopedic Surgery and *the Department of Medical Research, Chang Gung Memorial Hospital at Kaohsiung, Kaohsiung, Taiwan

Background:
Extracorporeal shockwave treatment has shown mixed short-term results for plantar fasciitis. However, the long-term results are not available.

Hypothesis:
Long-term results of shockwave treatment are comparable with short-term results.

Study Design:
Randomized controlled clinical trial; Level of evidence, 1.

Methods:
This prospective study consisted of 149 patients (168 heels) with an established diagnosis of chronic plantar fasciitis, including 79 patients (85 heels) in the shockwave treatment group and 70 patients (83 heels) in the control group. In the shockwave group, patients received 1,500 shock wave impulses at 16 kV on the affected heel in a single session. Patients in the control group received conservative treatment consisting of nonsteroidal anti-inflammatory drugs, orthotics, physical therapy, an exercise program, and/or a local cortisone injection. Patients were evaluated at 60 to 72 months (shockwave group) or 34 to 64 months (control group) with a 100-point scoring system including 70 points for pain and 30 points for function. The clinical outcomes were rated as excellent, good, fair, or poor.

Results:
Before treatment, the groups showed no significant differences in the scores for pain and function. After treatment, the shockwave group showed significantly better pain and function scores as compared with the control group. The overall results were 69.1% excellent, 13.6% good, 6.2% fair, and 11.1% poor for the shockwave group; and 0% excellent, 55% good, 36% fair, and 9% poor for the control group (P < .001). The recurrence rate was 12% (9/81 heels) for the shockwave group versus 55% (43/78 heels) for the control group (P < .001). There were no systemic or local complications or device-related problems.

Conclusion:
Extracorporeal shockwave treatment is effective and safe for patients with plantar fasciitis, with good long-term results.

意大利Roma "La Sapienza"
大學的研究

意大利Roma "La Sapienza"大學對衝擊波治療足底筋膜炎的中期效果研究。
研究結果:衝擊波乃有效的治療。

Title:
Extracorporeal Shockwave Therapy (ESWT) in The Treatment of Plantar Fasciitis

Authors:
P.Papandrea MD, M. Ciurluini MD, A. Ferretti MD

Institution:
"Kirk Kilgour" Sports Injury Center, Department of Orthopaedic Surgery St. Andrea Hospital, University of Roma "La Sapienza", Italy

Objectives:
evaluate medium-term clinical results of symptomatic treatment of plantar fasciitis.

Methods and Measures:
From October 1998 to December 2004, 82 patients affected by plantar fasciitis, 14 of whom with a bilateral pathology, for a total of 96 cases, were treated with ESWT. On the basis of the inclusion criteria indicated by ISMST, 58 patients (67 cases) were included in the study.
44 patients (29 males and 15 females) aged between 21 and 77 years (average 56 year) were reviewed at 1 month, 4 month, 17-month follow up. 9 patients were affected by bilateral plantar fasciitis, for a total of 53 cases re-examined. 25 patients (30 cases) played sports activity. X-rays showed the presence of calcaneal spur in 34 patients.
In the pre-treatment phase, the symptomathology was classified into 5 stages according to the severity of pain and its effects on daily activities.
a) Stage 0: lack of pain;
b) Stage 1: pain only after intense physical activity or after playing sports;
c) Stage 2: pain and stiffness during intense physical activity or during sports;
d) Stage 3: pain during daily activities;
e) Stage 4: pain at rest and at night.
An average of four sessions (min 3, max 5) of shockwaves were administered (power from 0.04 to 0.250 mJ/mm2, 2000-2.500 impulses for each session). Clinical outcomes were evaluated according to the following criteria (based on the symptomathological classification mentioned above):
-Excellent: lack of pain (stage 0);
-Good: stage I with an improvement of at least two stages;
-Fair: improvement of one stage;
-Poor: no improvement.

Results:
At 1 month follow-up, 49% of patients reported satisfactory results (excellent and good results), at 4 months follow-up the percentage increased to 68%, at 17 month follow-up to were 81%. At 40 month f. up it was possible to review 15 patients (19 cases), satisfactory results were 84%. Regarding the 34 patients affected by plantar fasciitis in association with calcaneal spur, at 17 month follow-up satisfactory results were 73%, no radiological evidence of disappearing of the spur was obtained.
Among the 25 sport players (30 cases) satisfactory results were 57% at 1 month, 80% at 4 month, 90% at 17 month follow-up.

Conclusion:
shockwave therapy represents a valid, non-invasive symptomatic treatment for patients with plantar fasciitis.

德國Johannes Gutenberg
大學的研究

德國Johannes Gutenberg大學醫學院對衝擊波治療競跑運動員足底筋膜炎的研究。
研究結果:衝擊波治療安全及有效。

Title:
Shockwave Application for Chronic Plantar Fasciitis in Running Athletes. A Prospective, Randomised, Placebo-Controlled, Double-Blinded Trial.

Authors:
Jan D. Rompe, Jens Decking, Carsten Schulner, Bernhard Nafe

Institution:
Department of Orthopaedic Surgery, Johannes Gutenberg University School of Medicine, Mainz, Germany

AIM:
To assess the efficacy of repeated low-energy shock wave application for chronic fasciitis in runners.

MATERIALS AND METHODS:
Forty-five running athletes with intractable plantar heel pain were enrolled in a randomized single-blind trial with a parallel-group design and blinded independent observer, to evaluate the efficacy of three applications of 2100 impulses of low-energy shock waves (Group I) compared with placebo treatment (Group II). Followup examinations were done at six months, and at one year after extracorporeal shock wave application. Symptoms had been present from one year to six years. Each patient satisfied numerous inclusion and exclusion criteria before he or she was accepted into this study. The primary efficacy endpoint was reduction of subjects self-assessment of pain on first walking in the morning on a visual analog scale (range, 0 - 10 points) at six months after shock wave application.

RESULTS:
After six months self-assessment of pain on first walking in the morning showed a significant reduction from an average seven to 2.1 points in Group I, and from an average seven to 4.7 points in Group II on the visual analog scale. The difference of 2.6 points between both groups was significant six months after the intervention (p= 0.0004, 95% CI: 1.9 - 3.3 points; power > 0.9). Twelve of nineteen patients (63%) of the treatment group versus six of twenty patients (30%) of the sham group reported a >50% improvement. After twelve months 81% of the patients of the treatment group versus 37% of the patients of the placebo group rated accordingly. Co-interventions remained on a comparable, low level in both groups.

CONCLUSION:
The current study showed that three treatments with 2100 impulses of low-energy shock waves were a safe and effective nonsurgical method for treating chronic plantar fasciitis in runners.

跟腱炎

意大利Universita degli
Studi di Milano大學的研究

意大利Universita degli Studi di Milano大學對衝擊波治療跟腱炎的研究。
研究結果:衝擊波治療對跟腱炎是一個有效及安全的治療工具。

Title:
Overuse Achilles tendinopathy: ESWT vs placebo. An 18 months follow up study

Authors:
F. Astore, V. Sansone, L. Spotorno

Institution:
Departement of Orthopaedics, Universita degli Studi di Milano, IRCCS Humanitas, Rozzano (Milan), Italy

The purpose of this study is to evaluate if Extracorporeal Shock Wave Therapy (ESWT) be considered potentially useful for overuse Achilles tendinopathy resistant to prolonged conventional non-operative treatment.

METHODS
A prospective, double-blind clinical trial was performed to compare the outcomes of a standard treatment with ESWT with 2000 impulses of ESWT with energy flux density of 0.25 mJ/mm2 in the painful segment of the Achilles tendon, at weekly intervals for 3 weeks and placebo in subjects dedicated to sport and affected by non-insertional Achilles tendinopathy which failed to improve after current conservative treatments. The comparison was submitted to the chi-square test for a significance level of 95%. Of a total of 102 patients, affected by intractable Achilles tendinopathy, 51 received ESWT and 51 received Placebo. The main outcome measurement were Visual Analogical Scale and 60-point scoring system.

RESULTS
87 patients concluded the study (44 ESWT and 43 Placebo). At 18 months follow-up: in the ESWT group 10 (22.8%) good, 23 (52.2%) fair and 11 (25.0%) poor; in the Placebo group 5 (11.6%) good, 12 (27.9%) fair and 26 (60.5%) poor.

DISCUSSION
The management of Achilles tendinopathy is usually conservative and few therapeutic measures can be considered effective. Sometimes a slow spontaneous recovery is present. Surgery is indicated after exhausting periods of conservative treatment, but the results are controversial and frequently not satisfactory. The good results obtained with ESWT without significant risks and the controversial results of operative treatment of tendon disorders in athletes prompted us to consider ESWT for those sportsmen affected by non-insertional chronic tendinopathy of Achilles who failed to improve significantly after conventional conservative treatment.

CONCLUSION
In conclusion ESWT confirmed to be an effective and safe therapeutic tool for Achilles tendinopathy resistant to conventional non-surgical management.

美國Bucknell大學
的研究

美國Bucknell大學對衝擊波治療跟腱炎的研究。

研究結果:衝擊波治療對慢性跟腱炎是一個安全及有效的治療。

Title:
ESWT as a treatment for chronic insertional Achilles tendinosis

Authors:
J Furia

Institution:
Bucknell University, SUN Orthopedics and Sports Medicine Lewisburg, PA USA

Purpose:
The purpose of this study was to determine the efficacy of high energy extracorporeal shockwave therapy (ESWT) for the treatment of adults with chronic insertional Achilles tendinosis and to determine if use of a local anaesthesia field block has an adverse effect on outcome.

Type of Study:
Retrospective case-control.

Methods:
Between June 1 2003 and January 31 2004, 68 patients with chronic insertional Achilles tendinosis were enrolled in this study. Each patient had failed to respond to a minimum of six months of traditional non-operative treatments. Thirty-five patients were treated with a single dose of high energy shock wave therapy (ESWT group). Thirty-three patients were treated with additional forms of traditional non-operative measures (control group). All procedures were performed by a physician using either a local anaesthesia field block (12 patients) or an anesthesia other than local (23 patients). Each of the ESWT patients received a total of 3000 shocks for a total energy flux density of 604mJ/mm2. T-tests and analysis of variance (ANOVA) were used to test for differences in visual analog scores (VAS) between the ESWT and control groups.

Results:
Four weeks post treatment, the mean visual analog score (VAS) for the control and ESWT groups were 8.2 (range, 6-10; SD=1.1) and 4.2 (range, 1-10; SD=2.4) respectively (t=8.7, P < .001). Twelve weeks post treatment, the mean VAS for the control and ESWT groups were 7.2 (range, 5-9; SD=1.3) and 2.9 (range, 1-10; SD=2.1) respectively (t=10.1, P < .001). Fifty-two weeks post treatment, the mean VAS for the control and ESWT groups were 7.0 (range, 4-9; SD=1.2) and 2.8 (range, 1-10; SD=2.2) respectively (t=9.7, P < .001). Using the Roles and Maudsley scale, 2 of the control patients (6.1%) and 6 of the ESWT patients (17.1%) were assigned an excellent result and 11 of the control patients (33.3%) and 23 of the ESWT patients (65.7%) had a good result at the final endpoint. ANOVA testing at 52 weeks post treatment revealed that the mean improvement in VAS score for the local anaesthesia subgroup was significantly less than the corresponding gain in the anaesthesia other than local subgroup ( F=16.77 verses F=53.95, P<.001). There were no significant complications.

Conclusions:
ESWT is a safe and effective treatment for chronic insertional Achilles tendinosis. Local field block anaesthesia appears to decrease the effectiveness of this procedure.

膝蓋腱炎

意大利Roma "La Sapienza"
大學的研究

意大利Roma "La Sapienza"大學對衝擊波治療膝蓋腱炎的研究。(文中Jumper's Knee即膝蓋腱炎)
研究結果:衝擊波對膝蓋腱炎是一有效的療法。

Title:
Treatment of Jumper's Knee with Extracorporeal Shock Wave Therapy

Author:
M.C. Vulpiani, D. Trischitta, M. Vetrano, V. Savoia, E.Di Pangrazio, A. Ferretti

Institution:
St. Andrea Hospital, University "La Sapienza" Rome, Italy

Jumper’s knee affects mostly individuals who play sports particularly jumping athletes. In this study we have included 73 sports patients, 54 male and 19 female, age range between 15 and 69 (mean age: 32). Since 10 patients were affected by bilateral tendinopathy, a total of 83 tendons were treated. All patients underwent clinical and instrumental diagnosis in order to recognize the presence, the location and the seriousness of the specific tendinopathy associated or not with calcific areas of metaplasia in the tendon to be diagnosed. The pain symptomathology was classified using VAS and according to a 5 stage clinical evaluation range. The treatment was performed using 2 different devices, produced by STORZ, both equipped with electromagnetic generators with cylindrical coil and providing ultrasonography capability. The protocol, identical for both generators, called for an average of 4 sessions (min. 3 - max. 5), administered in 2 to 7-day time intervals with 1,500-2,500 shocks applied with an EDF between 0.08 and 0.44 mJ/mm2.
The evaluation of the post-treatment results was assessed on the basis of the average VAS score and on the subjective clinical evaluation range.

In conclusion, we obtained satisfactory results in 73.5% of cases (Excellent in 54.2% and Good in 19.3%). The successful treatment in performing athletes (16 tendons) was satisfactory in 87.5% with an average time of resuming sport at approximately 6 weeks. In our opinion, shock waves are a valid conservative therapy for the treatment of jumper’s knee, in accordance with what is found in literature.

肩周炎

德國Technical University of
Munich大學的研究

德國Technical University of Munich大學對衝擊波治療肩鈣化性筋腱炎的研究。
研究結果:衝擊波對肩鈣化性筋腱炎是最佳的療法。

Title:
The Effectiveness of Extracorporal Shock Wave Therapy on Tendinitis of the Shoulder

Author:
L. Gerdesmeyer, S. Wagenpfeil, G. Handle, M. Loew, K. Lehmkuhler, S.Gassel, R. Seil

Institution:
Dept of Orthopaedic Surgery and Sportstraumatology, Technical University of Munich, Germany

Calcified lesions of the shoulder of the rotator cuff are a common problem in orthopaedic practice. The incidence vary from 2.5% to 20% in patients with asymptomatic shoulders and as much as 54% in patients with shoulder pain. The lesions are mostly located in the supraspinatus tendon close to the insertion area in the critical zone. Patients with calcifying tendinosis were usually treated conservatively ( physiotherapy, analgesics, subacromial injection, ...). Uthoff described the circle of the desease which is mostly self-limiting and at least 10% of patients may require open or arthroscopic surgery.

Extracorporeal shock wave therapy ( ESWT ) in treatment of these calcified lesions was first described by Dahmen in Germany. Two different shock wave therapy techniques were know. The low energy one with a mean energy flux density lower than 0.08 mJ/mm2 and the high energy one with energy levels of more than 0.28 mJ/mm2 . Dahmen first used the low energy shock wave and described an analgetic effect. Loew used the high energy level and found a pain relief and also changings of the lesions in most cases. There is an increasing number of clinical trials showing a success in 60% to 80% of patients. Mostly these trial were uncontrolled prospective designed. A better trial was published by Loew et al. They reported there results and stated the high energy ESWT is effective. But a least there is no trial with a design in accordance to the ICH/GCP guidelines. Only these trials have the statistical power and evidence to show the efficacy of a treatment method.

Haake at al showed that the application of ESWT must be controlled to verify the position of the ESWT focus. Treatment techniques without control mechanism showed a worther outcome than techniques with an exact fluoroscopic controlled focussing application.

Materials and methods:
First we completed a feasibility study to find out the treatment effect size and calculate the sample size. A prospective randomized placebo controlled study in accordance to the ICH and GCP guidelines was designed based on the results of the feasibility trial. We treated 48 patients in low energetic, high energetic and control group each to have the right statistic power. One treatment group received 2 x 1500 high energetic shock waves with mean energy flux density of 0,32 mJ/mm2 and the other one got 2 x 6000 low energetic shock waves with mean energy flux density of 0,08 mJ/mm2 , 48 patients of the blinded placebo group receiced a sham therapy. We used the same device in all patients so we could exclude device related effects. The device we used called EPOS FLUOROR, manufactured by DORNIER MED TECHR. The primary criteria was the Constant-Murley-Score, second criterias the visuell analogue scale and changings of deposit size in x-ray examination. The ESWT was indicated after failed complete conservative therapies. Between the two application setting we have an time interval of two weeks. In all sessions the patients could get an analgosedation if the pain was uncomfortable. An air chambered foil inhibits the transmission of the shock waves from ESWT emmitter into the shoulder in the controlgroupe.

The clinical and radiological examinations were done by a blinded observer, during the hole trial phase an independed monitor guaranteed that the protocol was followed by the coworkers. The statistic evaluations, data monitoring and auditing were done independently from applicator and blinded observer. The patients were randomized after they have fullfill the inclusion and exclusion criterias and after they have given a writen informed consent to get the ESWT and to take part of the trial.

Comparative analyses were done on an intention-to-treat basis. No prospective cessation rules were defined and no interim analysis was planned. The study protocol was approved of by the ethics committee at the authors’ institution.

Results:
24 weeks after ESWT the patients treated with high and low energetic ESWT have a significant better outcome as the shame group by scoring the Constant-Murley-Score ( p<0.001 ). The second-criterias as the visuell analogue scale and the morphological appearence of the deposits changed with high statistical difference ( p<0.001 ). No severe side effects caused by shock waves were observed. In some cases we observed a transient reddening and small cutaneous petechial bleeding but all of them disappeared within 6 weeks when the patients came to the first follow up visit. The comparison between high and low energetic ESWT showed significant better outcome after high energetic ESWT.

Discussion:
The exact mechanisms of the therapeutic effect of extracorporeal shock wave therapy for treatment of calcified lesions of the shoulder are still uncertain. Although some investigations show a direct mechanical effect that leads to a mechanical disintegrating effect on the deposit. Other authors prefer a long-lasting hyperstimulation analgesia. The shock waves iniciate an increase of blood flow with increasing oxygen supply of the critical zone. That can induce the further ongoing of the natural selfhealing cycle. In chronic calcified tendinitis of the rotator cuff, the cycle, described by Uthoff rests in the calcific stage. The application of extracorporal shock waves pushs the cycle further to the postcalcific stage that leads to a complete restitutio. Because of the natural history and the normally self limiting deasease of the tendinosis, the shock waves treatment should not used in acute patients. Most of these patients with an acute tendinitis still move from the calcific stage to the postcalcific stage and should only be treated in a symptomatic analgetic of antiphlogistic way. Compared to other published data regarding calcific tendinitis of the shoulder, no study fulfils the requirements of GCP guidelines to show efficacy.

Conclusion:
The high energetic shock wave therapy is the best evidence based treatment in calcified lesions of the shoulder and must be indicated before operative intervention.

意大利Universita egli studi
del Piemonte Orientale大學的研究

意大利Universita egli studi del Piemonte Orientale大學對衝擊波治療肩鈣化性筋腱炎的研究。
研究結果:衝擊波對肩鈣化性筋腱炎是有效的療法。

Title:
ESWT Treatment in Calcific Tendinitis of the Shoulder

Author:
D. Rozzati, A. Littera, E. Cignini, S. Festari, G. Sessa , A. Carriero

Institution:
Universita egli studi del Piemonte Orientale “A.Avogadro” SCDU Radiodiagnostica A.O. Maggiore della Carita Novara - Corso Mazzini 18 28100 NOVARA - Italy

The objective of our study was to evaluate the effectiveness of ESWT treatment for symptomatic calcific tendonitis of the shoulder.
Our 2 years experience lasted from Jan. 2004 to Jan. 2006. We treated 110 patients, 44 males and 66 females, (age ranging from 32 to 83 years) with painful shoulder calcific tendinitis who were unresponsive to other conservative therapies. We used a REFLECTRON - HMT ESWT System using a protocol which consisted in one treatment of 500 shocks (frequency 240 shocks/min) each week for three weeks. The treatment was successful in 83 patients with symptomatic resolution. In 21 patients we observed at the post-treatment X-Ray control the complete vanishing of periarticular calcifications. In 39 patients there was a volumetric reduction of the calcifications. 20 patients experienced no change. 1 patient presented a volumetric increase of the calcification. 2 patients showed a symptomatic improvement.

Conclusions:
In our experience ESWT can be accepted as a valid conservative treatment in calcific tendinitis of the shoulder leading to a symptomatic, functional and radiological improvement.

意大利University of Rome
"La Sapienza"大學的研究

意大利University of Rome "La Sapienza"大學對衝擊波治療肩Impingement Syndrome的研究。
研究結果:衝擊波對肩Impingement Syndrome是有價值的療法。

Title:
Extracorporeal Shockwave Therapy (ESWT) in Impingement Syndrome. Medium and Long-Term Results.

Authors:
P. Papandrea, MC Vulpiani, M Ciurluini, E Monaco, A Ferretti

Institution:
University of Rome "La Sapienza" Italy

Purpose of this study was to evaluate efficacy of low-energy shockwave therapy in Impingement Syndrome of the shoulder.

MATERIALS AND METHODS:
From December 1997 until December 2001, 247 patients (263 shoulders) affected by this painful syndrome of the shoulder were treated.

One hundred and twenty-eight of the patients were females and one hundred and nineteen were males. The patient's range in age was from 16 years to 84 years, with a mean age of 54. All the shoulders were classified, according to clinical evaluation and "imaging" data (X-rays, Ultrasound and MRI) in the three Neer stages (Stage I: inflammation, degeneration; Stage II: partial rotator cuff tear; Stage III: complete rotator cuff tear).

X-ray examination was used to document calcified areas in the shoulders.

The patients underwent an average of four sessions (Min 3-Max 5), once a week, and received 2500 impulses of the energy density 0,04 - 0,07 mmJ/mm2; in the calcifying tendinitis the energy used was from 0,07 to 0,17 mmJ/mm2. Follow up was at 1 year, 2 years and 3 years post treatment. All of the patients were evaluated pre- and post- ESWT according to Constant score.

RESULTS:
The patients treated with ESWT have clinically and statistically significant improvement in function and an important reduction of pain.

At 1 year follow-up 80% of patients had excellent and good results: at 2 years follow-up the results excellent and good were 74%. At 3 years follow-up they were 67%. No complications were noted in this study.

CONCLUSIONS:
The results of this study show that ESWT is a valuable option for Subacromial Impingement Syndrome patients, when other conservative treatment options have failed, also versus surgical treatment.

網球肘

台灣長庚醫院的研究

台灣長庚醫院對衝擊波治療網球肘的研究。
研究結果:衝擊波治療網球肘是安全和有效的療法。

Title:
Shockwave Therapy for Patients with Lateral Epicondylitis of the Elbow: a One to Two Years Follow-Up Study

Authors:
Ching-Jen Wang, Han-Shiang Chen*

Institution:
Department of Orthopedic Surgery and Department of Surgery *, Chang Gung Memorial Hospital / Kaohsiung Medical Center, Taiwan

The effect of shock wave therapy was investigated in 57 patients (58 elbows) with lateral epicondylitis of the elbow. Forty-three patients (44 elbows) with one to two years follow-up were included in this study. In addition, 6 patients (6 elbows) were treated as control study. This series included 24 men and 19 women with an average age of 46 (range 33-66) years. One patient was treated for bilateral elbows. The right elbow was affected in 28 cases and left elbow 16. Each patient was treated with 1000 impulses of shock wave at 14 kV to the affected elbow. A 100-point scoring system was used for evaluation including 40 points for pain, 30 points for function, 20 points for strength and 10 points for elbow motion. The intensity of pain was based on a visual analogue scale from 0 to 10. The average follow-up time was 17.4 (range 12, 26) months.

The overall results were complaints free in 27 (61.4)%, significantly better in 13 (29.5)%, slightly better in 3 (6.8%) and unchanged ! in 1 (2.3%). Recurrent pain of lesser degree was noted in 3 patients (6.8%) including 1 at 12 months after one treatment, and 2 at 24 months after two treatments. In the control group, however, the results were unchanged in all 6 patients. There was no device-related problems, systemic or local complications.

Shock wave therapy is a safe and effective modality in the treatment of patients with lateral epicondylitis of the elbow.

加拿大University of
British Columbia大學的研究

加拿大University of British Columbia大學對衝擊波治療工作引起的網球肘的研究。
研究結果:衝擊波治療網球肘是有效的療法。

Title:
Clinical Focusing and Low Energy ESWT in the Treatment of Work-Induced Chronic Lateral Epicondylitis

Author:
Brian Day MD FRCS (C)

Institution:
Associate Professor, Department of Orthopaedics, University of British Columbia, Canada

Methods:
41 patients with work-related lateral epicondylitis of over 6 months duration, who had been referred for consideration of surgery because of failed conservative treatment (rest, bracing, anti-inflammatory agents, physiotherapy and steroid injections) were included in the ESWT study group. Five once-weekly treatments of low energy shock wave therapy were applied using the Siemens Basic Sonocur. The technique emphasized the role of clinical focusing with shock waves being targeted at the point of maximal tenderness with direct patient feedback. The analgesic affect allows the energy level to be slowly increased and focusing is rechecked every 200-400 impulses. A total of 2000 impulses were applied in each treatment session. Imaging and local anaesthesia were not used. The control group, who had similar inclusion and exclusion criteria, underwent surgical treatment. The primary outcome measurement was return to work status and secondary outcomes assessed were changes in pain, function and overall patient satisfaction. Three and 6 month post-treatment assessments were performed.

Results:
76% of those in the ESWT treatment group returned to work, compared to only 30% after surgery. Furthermore, of those, 83% of the ESWT group returned to full-time work compared with 43% in the surgery group. Patient satisfaction in the ESWT group was 81%. There were no complications in either group.

It is concluded that low dose ESWT using a clinical focusing technique is an effective non-invasive method for the treatment of chronic refractory lateral epicondylitis in workers and appears to have results that are superior to surgery.

韓國Hallym University
Sacred Heart Hospital醫院的研究

韓國Hallym University Sacred Heart Hospital醫院對衝擊波治療網球肘的研究。
研究結果:衝擊波治療網球肘是有效的療法。

Title:
A Preliminary Study on Clinical Outcomes of Lateral Epicondylitis after ESWT: Importance of Radiologically Detectable Calcification in Extensor Tendons

Authors:
Seok-Beom Lee, Duck-Joo Kwon, Jong-Cheol Jung, Yong-Joon Song, Sung-Kyu Cha, Kee-Byung Lee

Institution:
Department of Orthopaedic Surgery, Hallym University Sacred Heart Hospital, Pyungchon, Korea

PURPOSES:
This study was to investigate the effects of ESWT on lateral epicondylitis and to elucidate the importance of calcification in extensor tendons detectable by plane film and/or ultrasonography in clinical outcomes.

MATERIAL AND METHODS:
24 subjects with refractory lateral epicondylitis were treated with 1000 impulses of shockwaves at 14 Kv using an OssaTron orthotriptor (High Medical Technology, Kreuzlingen, Switzerland). Average age being 45 (range: 33-57). Eighteen subjects were female and 6 were male. Duration of symptom was 2.1 years on average (range: 1 month ?4 years). All the subjects had steroid injections before shockwave therapy. The subjects were evaluated by Simple Elbow Test (SET) questionnaire of the University of Washington and Visual Analogue Scale (VAS) analysis before and after ESWT. Comparison of clinical outcomes for the subjects with and without calcification in the extensor tendon detectable by plane film and/or ultrasonography was tried to determine if this could be a possible prognostic factor in clinical settings. Follow up was carried out at 6 and 12 months after ESWT.

RESULTS:
Significant improvement of symptoms were observed in 20 (83 %) patients at 6 and 12 months follow up. 4 (17%) patients did not respond to treatment. Average SET and VAS scores were substantially improved after ESWT. Calcification deposits of varying sizes were documented in 12 patients (50%) by plane film and/or ultrasonography. Ultrasonography could also show swelling of tendons and fluid accumulation about lateral epicondyle as well as tiny calcifications that could not be found on plane film. The subjects with calcification in the extensor tendons improved significantly better, when compared to the subjects without calcification at follow-up.

CONCLUSIONS:
This study suggests that shockwave therapy could be considered an effective noninvasive treatment modality for refractory lateral epicondylitis of the elbow. The shockwave treatment seemed to be more successful for patients with calcific deposits in extensor tendons, which were detected by plane film and/or ultrasonography.

肌肉激發點

德國Orthopadische Privatpraxis
Dr.med. Hannes Muller-Ehrenberg的研究

德國Orthopadische Privatpraxis Dr.med. Hannes Muller-Ehrenberg對衝擊波治療肌肉激發點的研究。
研究結果:衝擊波能成功治療肌肉激發點的痛症。

Title:
Extracorporeal Shockwave Therapy In Myofascial Pain Syndrome

Authors:
H. Muller-Ehrenberg, MD

Institution:
Orthopadische Privatpraxis Dr.med. Hannes Muller-Ehrenberg Tibusplatz 6 48143 Munster, Germany

Myofascial Pain Syndrome is one of the most common causes of acute and chronic pain of the musculoskeletal system. It is characterized by myofascial trigger points (MTrPs), which are hyperirritable spots in a palpable tense band of skeletal muscle. MTrPs are caused by a dysfunction from involved motor endplates, which is followed by a segmental shortening of groups of sarcomeres.
Diagnostic approach is based on the criteria defined by J.Travell and D.Simons: while palpating the hyperirretable MTrP a characteristic referred pain and familiar pain (recognition) is elicited. Effective diagnosis and treatment requires clinical experience and diagnostic skill, especially palpation ability. Exact pressure or impulse with minimum irritation or even damage of the collateral tissue is needed to identify and release MTrPs. The focussed extracorporeal shockwave therapy (ESWT) is, on the contrary to the radial ESWT, able to apply an exact mechanical impulse on a small spot to release MTrPs.
Moreover the focussed ESWT was also able to reproduce, while treating a MTrP, the referred and also the familiar pain of the patient.
In a pilot study 40 patients with various musculoskeletal pain have been examined and treated by an experienced medical doctor (Triggerpunkt-Therapeut -IMTTR) and identified MTrPs were treated by focussed ESWT (Piezoson 100 plus, Fa. Wolf). In more than 90% of the cases the characteristic referred pain and familiar pain (recognition) has been elicited by the focussed ESWT, when precisely the MTrP was hit by the exact impulse. This study revealed that the focussed ESWT is able to improve the diagnosis of MTrPs and also to treat musculoskeletal pain successfully.

CONCLUSION:
In clinical routine there was so far no imaging method or laboratory test of MTrPs. Diagnosis depended entirely on history and physical examination. The use of the focussed ESWT detects MTrps accurately and will lead us more often to recognize muscle-tissue being the cause of most of musculoskeletal pain.

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衝擊波治療的病人經驗分享

足底筋膜炎和跟腱炎

足底筋膜炎:Terry Lam 的分享

起初感覺腳底很痛,特別早上起床落地,如腳底出了問題,又不知去那裡看醫生和什麼葯膏,很好的是在網上找到物理治療師余先生的沖衝波治療。在他的網頁內看到其他腳底也有問題的人,他們分享腳底問題,感覺和他們在外浪費很多時間找如何醫治方法。所以我看了這些分享後便找了余先生。第一次去到他診所,他很細心告知每個細節,只做了一次治療便有好的效果,第二早上落床便沒有痛的感覺。

治療過程有點正常痛,但真的很有效,治療過程時間短,又不用食葯和打針,見效時間又快。

Terry Lam
2017年2月

足底筋膜炎:Lee Suet Ying 的分享

我喜歡跑步行山,因工作關係要常穿平底鞋。直至年多前,右腳底開始有點像抽筋的痛。初時只是很輕微,並沒有理會它,照常去跑步行山以及穿平底鞋。後來痛楚增加,早上起床,更覺痛楚。由於自己正在看腰的物理治療,故此先詢問治療師,他告訴我是足底筋膜炎,要去看骨科醫生。

看後醫生開了消炎止痛藥,以及一些止痛藥膏。但是藥力過後仍然痛。同時間,亦進行物理治療,包括: 拔罐、超聲波、激光等,亦會做一些對腳底有幫助的運動,但是痛症反覆。

後來,從網上看到Back Clinic對衝擊波的介紹,再找了一些資料後,知道衝擊波對治療足底筋膜炎很有效,於是致電 Back Clinic預約治療。

第一次治療時感覺很難受,患處很痛很痛,後來按治療師的指示,每天以冰加水浸患處,之後的治療,一次較一次改善,經過5-6次衝擊波治療後,感覺已經痊癒7,8成。

現在已經做了3,4個月左右,治療時由最初很痛很痛,到現在有些位置已經變得不痛了;由最初一星期2次治療, 到慢慢地變了一星期一次,兩星期一次,現在也差不多可以一個月一次了。成效真的在我身上體驗到時,我也想真心地告訴大家,衝擊波治療真的很有效,有時亦會想,如果早點知道有衝擊波治療,就不用繞這麼多路。

謝謝治療師令我的痛楚逐漸痊癒!

Lee Suet Ying
Feb 2012

足底筋膜炎:鄺啟華先生的分享

本人熱愛長跑運動,兩年內每天練跑平地五公里,週末加強上山訓練。直至完成二零一零渣打馬拉松全馬賽事。其後每天早上雙足腳跟劇痛無比。求醫証實患上常見的“足底筋膜炎”,於是馬上暫停訓練。經十多節超聲波治療後痛楚減輕,以為痊癒。休養期間再次感覺痛楚。數月後再進行一段同樣的療程,病程反覆,未有大幅進展,枉費時間和錢財。前後經歷一年,缺乏運動,不能久行,信心受創,更連行街購物、旅行、抱孩子玩耍也大受影響。熱愛運動者一定明白這種無奈和困擾。直至親身接受過“衝擊波治療”,相當嚴重的痛症在首數次的治療得以舒緩。其後繼續接受十多次治療,反覆好轉已至八、九成。實証“衝擊波”加上治療師的臨床經驗,良好溝通,是顯著有效的醫治。最後忠告讀者盡早醫治,跟隨治療師的指示,少行多休,勿做以為小事其實傷腳的動作,定必快見痊癒。在此祝你早日康復!

鄺啟華
2011年3月

足底筋膜炎:Agnes Poon 的分享

我喜歡行山,週末假日很多時都會跟一班行山朋友去行山。有一段時間,我只穿平底鞋﹝鞋底很薄、鞋跟很矮那種﹞,至幾個月前,右足腳底開始有點痛。初時只是很輕微,並沒有理會它,照常去行山,照穿平底鞋。後來痛楚加大,早上起床,腳板落地一刻尤覺痛楚,於是求醫。首先看西醫,被診斷為足底筋膜炎,要服用消炎止痛藥,但是藥力過後仍然痛。接著改以物理治療,包括: 針炙、超聲波等,但也是無甚效果,之後再試中醫跌打,結果因為師傅太用力按壓而弄到腳跟也腫起來。

後來朋友告知,在報紙專欄中看到衝擊波對治療足底筋膜炎很有效,於是上網搜查有關資料,找到了Back Clinic立刻預約治療。第一次治療時感覺很難受,感到患處又麻、又痺、又酸,後來按治療師的指示配合每天以冰+水浸患處,往後的治療,一次較一次有改善,經過7次衝擊波治療後,現已痊癒八九成。

如果早點知道有衝擊波治療,就不用繞這麼多無效果的路了。現在我常常主動向身邊的朋友,尤其喜歡行山、跑步的朋友﹝比較容易患症﹞推介衝擊波治療。

Agnes Poon
2010年7月

足底筋膜炎:韓文偉先生的分享

本人是一位運動愛好者,足球及長跑最為喜愛,平均每星期有兩日踢波及兩日跑步,但經過多年的運動就發現左足腳底下發生了毛病。每當早上起床時左腳一觸地,腳跟部位便很痛,甚至行走也有困難,有時連坐著工作也隱隱作痛。於是便去求醫,亦證實了是足底筋膜炎。在此期間試過不同治療,例如、跌打、物理治療和服食消炎藥等,但都沒有明顯進展。在今年三月本人在報章及互聯網得知有一種名為"衝擊波治療"對足底筋膜炎有效,於是便嘗試接受衝擊波治療。經過治療師診斷及第一次的治療後,痛楚已有明顯好轉,到第二次的治療後,早上落床觸地已沒有太大痛楚,到第三次的治療後治療師向我說已康復了九成,衝擊波治療明顯給我有對症下藥的感覺,是有效和針對性的。我的腳跟痛現已痊癒了九成多了。

韓文偉
2010年4月

足底筋膜炎:陳少英女士的分享

本人患了足底筋膜炎煩擾超過大半年,走路時都痛,連shopping也沒有興趣。我已嘗試過針灸、超聲波、電療、雷射機等等,但全部治療都沒有效。唐先生是我的同事,他亦曾患過足底筋膜炎,聽他說在香港腰脊物理治療中心做衝擊波治療,大約治療十多次已完全痊癒。本人抱著嘗試的心態去接觸衝擊波治療,治療十多次後,感覺好轉了八九成,痛症已經大大改善了。

陳少英
2009年9月

足底筋膜炎:周德豐先生的分享

本人是一位運動愛好者,而且是接近瘋狂的那一類,經常在零晨時份還在街上跑步。每個月也會參加最少一個公開賽,維持了大約兩年多了。直至2008年渣打馬拉松之後,就發現左足腳底下發生了毛病。每當早上起床時左腳一觸地,腳跟部位便很痛,甚至行走也有困難。在工作上影響甚巨,因本人是一位汽車維修從業員,要經常站立或蹲低作業。於是便去求醫,亦證實了是足底筋膜炎。在此期間試過不同治療,例如針灸、跌打、物理治療和服食消炎藥等,但都沒有明顯進展。在今年五月尾,本人太太手部亦因工作關係,出現痛症。經朋友介紹,接受衝擊波治療,經過三、四次的治療後已經有良好的進展。我便抱著嘗試態度一試。當初,治療師就著我的工作環境以及痛症已困擾了我約一年時間之久,作了一個判斷,認為可能需要較長時間去治療。果然在最初的幾次治療,進展明顯不大。七月中的時候,就有大幅的進步。前後約有十數次的治療,雖然過程不太快,但就給我有對症下藥的感覺,明顯是有效和針對性的。我的腳跟痛現已覺痊癒了九成多了。

周德豐
2009年8月

足底筋膜炎:Ray Chan 的分享

腳跟痛﹝足底筋膜炎﹞令我走路時痛及早上起床時不能站立,炎症困擾我約大半年。都試過四五個月跌打治療和服食消炎藥,都沒有明顯進展。一次在互聯網上尋找資料時,發現『衝擊波』能治療足底筋膜炎,便在互聯網搜查更多這方面資料。發現香港腰脊物理治療中心有衝擊波治療,當天便到中心首次接觸衝擊波治療。治療時的感覺一陣陣刺痛刺入患處,但在七八次治療後我的炎症情況明顯反覆改善。現在治療十多次後炎症已有九成痊癒。本人體驗到衝擊波治療足底筋膜炎是最直接治療。

Ray Chan
2009年8月

肩周炎和足底筋膜炎:衛伊雯女士的分享

我向來熱愛運動,尤其喜歡羽毛球。知道患上肩周炎和腳底筋膜炎後,既感困擾,亦因不了解療方成效而茫無頭緒。我嘗試針灸、拔罐和跌打治療,但效用不明顯、進展緩慢。偶然聽到電台一節健康講座,醫生詳細介紹「衝擊波」治療。我立即在互聯網上尋找這方面資料,欲試新療法。後來到香港腰脊物理治療中心首次接觸「衝擊波」,確有「既愛又恨」的體驗,因這種療法能直達痛楚根源,治標亦治本,只是過程中給我稍微疼痛之感,但尚可忍受。約三至四次治療後我的炎症情況明顯改善,痛楚大大減輕。至今我接受「衝擊波」治療十多次,頑症已九成治好,十足痊癒指日可待。現在我可如常拿起球拍在羽毛球場上跳躍擋殺、大顯身手,確要歸因於「衝擊波」治療的奇效。

衛伊雯
2008年12月

跟腱炎:楊汗強先生的分享

本人患足跟痛有兩年多,鍾意跑步和行山的我,十分煩擾。每次運動前的熱身拉筋等動作我一定做足不會馬虎,但仍然無法減少跑步後的痛楚。推拿、針炙、跌打和物理治療都醫過。有一次上網發現『聚焦式衝搫波治療』對治療筋腱等軟組織發炎效果非常理想,最重要是療效快和非入侵性,而且沒有嚴重的副作用,我的好奇心推動下到香港腰脊物理治療中心接受治療。

笫一次到中心時我行每步都腳痛,物理治療師為我評估後說是足跟筋腱炎,與劉翔一樣,當然我的問題輕微很多,我聽後安心很多,因劉翔休息半年多又可以比賽,我相信我都可以。第一次治療時,如治療師所說,足跟有發炎的位置會感到非常痛而沒有發炎的位置無痛的感覺。頭兩三次治療後,感覺有少少改善,完成了十次治療,痛楚明顯好了七八成,日常步行已完全無痛,但坐得耐起身和做跑步測試時有拉緊。我相信在今年十二月可以參加樂善行和2011年馬拉松全馬賽事。在此多謝余先生細心治療和香港腰脊物理治療中心姑娘。祝中心人員身體安康!

楊汗強
2010年7月

肌肉創傷

肩膊肌肉拉傷:鍾浩笙先生的分享

本人姓鍾,43歳,男仕,瘦身材,不高....有做開少量運動(打高爾夫球),原欲練一身橫身材,就上網看視頻教程(練大隻個D),在家中舉啞鈴(重要係5磅一隻個種咁輕)打算練胸肌,點知左手拉一拉...拉開咗....x~x

過咗兩天肩膊位置一帶非常痛....自己也找遍全家什麼什麼十全百全個D鉄打丫銅打酒咁,係咁擦...什麼標膏藥丫係咁貼...但都係好痛...痛到返工在公司時,直頭想壯士斷臂...免受痛苦個種....(回想起來都有D寒寒地...) 當日已經不理三七廿一上網立即找最近嘅跌打丫針灸丫診所,希望可以立即止痛及醫好...

去到中醫診所把有關事情說了一遍給....醫師聽(個個穿白袍,所以我稱為醫師,至於是不是我也冇問了)醫師幫我推拿按摩貼藥後就說我應該係左肩韌帶撕裂....我當時真的嚇了一跳(那我以後如何打高爾夫....)醫師還說如果晚上仍痛明天就要進行針灸治療....我記得當晩簡直生不如死......痛到瞓唔到...翌日一早呢間診所都未開門我已經在門口等.....見到醫師(同一個人)後, 他在我嘅左手施展我國有幾千年嘅醫學歷史嘅針灸,還加上現代化的微電流(當時我問做了會唔會唔痛及好,他當時答一定好!)我吉了大約十三四針(由肩膊到手指)再加埋電(早餐都未食呢)....心想電完唔痛就得啦.....眼看每支針在我麒麟臂上的穴位震盪時(有些痛)真的有點後悔......

如事者過了三十分鐘后...心想終於有救了...誰不知拆針後痛的地方仍然痛....連舉手也舉不過腰(其實未看中醫時已經不舉了....)之後個醫師看見我情況后還用針吉我穴位話放出瘀血...那可以行氣活血....吉下吉下我手㬹及肩膊位已經出現了瘀青....結果還是一樣冇變過(痛).....那時我開始害怕了... (以上我是無心說中醫治療方法有問題或醫療人員有問題...只是我寫我個人感受而已)

之後我再上網查韌帶撕裂應如何處理及治療....好彩俾我見到余先生的網站(衝擊波)我看了一看幾遍網站內評論...心想要抱著什麼都要一試嘅心態去試試,因為真的好痛..........所以才按網站上資料打電話去booking 及問了價錢...

當我上到去...入到房間內看見幾台類似健身俱樂部內嘅儀器設備時我心立即想離開...心想不是打算用呢D來治療丫嘛....說好了的衝擊波呢?唉!既然來到就看看吧(反正電話booking 時也問了價錢...相比針灸還平)

坐下看見余先生...(因為他冇穿白袍所以我冇叫他做醫師或醫生)他用了望,聞,問,切這種方式了解我左手肩膊的痛由....他當時同我講我的患處一定不會是韌帶撕裂...因為我痛的位置根本就冇韌帶.....嘩...我當時不知如何是好,信還是不信...明明中醫師說的跟余先生說的完全兩碼子事...之後余先生用掛在牆上的人體結構圖解釋一次我患處的地方...(其實我當時唔知佢講乜,我只知我手好痛...有料就快D...唔好講咁多...)之後余先生好詳細的說明衝撃波治療的方式及相關嘅應對後我開始了第一次奇妙的治療(之後才知道奇妙)「衝擊波」

治療大约十分鐘后(詳細經過我不在這裏說...我只說結果吧)...只是感覺麻痺及酸....但痛好似減少了(減了多少我也很難形容)...但當晚比之前已經可以容易入睡(但我仍然不敢亂動,上班也只用右手打電郵.....)過了兩天再到余先生診所覆診.....(過了兩天痛楚已經比之前好了有一半)余先生叫我舉起左手....我不敢舉因為之前舉過真的好痛...,但冇法子也嘗試舉吧....點知我之前說的奇妙就在這一刻發生了.....我左手竟然可以在冇痛的情況下輕鬆舉起(但仍然有些酸痺感覺)還不用腰力舉起.....哈哈哈,當時我眼睛已經有涙光(當然余先生看不到的啦...男人不易掉眼淚的嘛)真的真的十分十分興奮...這種衝撃波竟然咁厲害....

由那刻起余先生所講的任何關於治療嘅說話,我每句都好用心聽.....我全部療程只做了三次就已經完全冇事了...(其實第二次做完已經好了九成)不過余先生診所好得意係第二次起覆診及之後既診金還比第一次便宜百分之三十...所以才去第三㳄......hehe ...

雖然我至今仍然不知道衝擊波是什麼原理令我不痛及痊癒,但我相信這種衝擊波在余先生的運用下會發揮出令患者有好轉及痊癒的結果....

最近家父因為搬東西弄到腰痛我也第一時間帶家父去找余先生....結果我也不用說了...

但在這,我必須申報我與余先生之前並不認識的,寫這篇評論也是想有缘人可以選對治療人選及方法,其他人會否與我一樣三,兩次痊癒我也不敢說...

回說到余先生,他人外形似隱世名醫...健談風趣....様貌跟我差不多俊吧!(哈哈哈)

最後祝願余先生及護士小姐,身體健康,生活愉快,做福人羣....

謝謝!

鍾浩笙
2017年7月

臀腿肌肉拉傷:Flora Chung 的分享

每當飽受身體受煎熬的時候,我除了向神禱告祈求舒緩痛楚外,就是向神尋求可信賴的醫師根治我的病患。我遇上余治療師也是在上主引領的情況下發生的。兩星期前我的腰部疼痛,以致大腿發麻,臀部痺痛得像下肢癱瘓。在沒有朋友介紹合適醫生的情況下,我只好在搜尋器上打上自己的病徵,以求與我同病相憐的網友能推介有醫德的醫師。

在劇痛得無法多走幾步的大前提下,我以地點方便為大前提,揀選了香港腰脊物理治療中心。在接受治療前,余先生為我做了詳細的評估和檢查,然後就替我進行衝擊波治療,治療期間,受傷部份是額外痛楚的,幸好得到余先生的耐心治療和周姑娘的體貼照顧,進行了約20分鐘治療後,我的臀部及大腿痺痛已經減輕不少。起初我以為這種舒緩只是暫時性的,但神奇的是我在接受療程後的36小時,只剩餘約10%的酸痛。在接受療程約3次後,我感到自己已完全康復了!

余先生的收費雖然頗貴,但能在最短的時間以有效的方法治療我的病情,以達至早日康復也是值得的。 感謝余先生的醫德,也感激周姑娘提供的心理輔導和貼心照顧,這是一間很專業、很有心的物理治療中心。

Flora Chung
2013年7月

臀部和大腿肌肉創傷:戚維宗先生的分享

本人因為拉傷大脾連patpat肌肉,所以係朋友介紹下,搵物理治療師余先生接受治療。本身係11月頭,打完籃球後,發現大脾同patpat位有d痛,但都覺得係運動後既問題,過1、2日會無事。咁過左2日後,真係無事,完全無再痛。

點知係第3日,個日下雨,出街時跌左把雨傘係地,我屈低身去執把雨傘時,即時出事,條筋好似被火燒咁,又痛又熱。之後根本企唔到直,行都行唔到。要停左係度一陣,慢慢先拐住黎行。當晚根本訓唔到,一壓住佢就痛。之後即問朋友有無介紹,就搵到物理治療師余先生。

出事後2日,去睇第一次。睇之前,我係唔可以單腳企。接受左第一次治療後,可以單腳企番,雖然個時仲有d痛,但一定比未睇余先生前好好多。之後接受約5次治療,情況都慢慢改善。而家都好得8-9成,行路都可以好似之前咁快。係間唔中仲有1、2下痛。但都比我預期中快,去多1、2次應該會好哂。

呢個衝擊波治療真係又快又有用,日後touch wood又再出事,都會搵番余先生醫。

真係感謝余先生的治療與姑娘細心的協助。

戚維宗
2011年11月

大腿肌肉創傷:Ray Lam 的分享

近年來,我因為急於減肥而瘋狂的跑步。但沒有穿著跑鞋又沒有熱身,姿勢又不正確,在持續過火的運動量下,終於弄傷了腳。

2011年四月,那天我與朋友踏單車。踏了一整天後,那一晚我的左腳突然劇痛,痛得有如肌肉被活生生撕開一樣,幾個小時後,我終於耐不住要去看急症。急症室的醫師判定我肌肉發炎,為我打了止痛針之後,便要我離開。

雖然一針之後,再沒有痛劇出現,但走起路來依然不自然,要說跑步更沒可能,因為走得路多,坐得久或跑步便又會很痛。於是四個月來我不斷求醫,跌打、中式骨醫、中式針炙、西式脊醫、物理治療,花了很多錢與時間,病情像是反覆地有起色,但不知怎的疼痛依然未退,總覺得康復無望。廿多歲從未試過如此地深受傷患纏繞,令到身心疲憊,痛苦難當,直至遇見物理治療師余先生。

第一次見治療師是八月,我大致向他說了近幾個月的經歷與痛楚位置、程度,他便仔細的為我反覆檢查,這幾個月為我看過病的醫師都未如此細心過。檢查以後,他便解釋我得到的是甚麼傷,原來我左腳的膕繩肌腱深層發炎(Hamstring Injury)。Hamstring是大腿的主要肌腱,日常生活無論走路跑步都會用到它。

當斷症後,他便為我運用衝擊波治療。開始前,他為我解釋衝擊波是怎樣運作與療程是怎樣的,我覺得這樣的解說很認真與細心。治療開始,不知怎的總找不到正確患處,他換上不同的治療接頭反覆找尋,但都未能順利擊中患處。於是他便叫我換姿勢,原因是把軟組織拉開,進而令衝擊波可擊中深層的肌肉。

這回終於找到。當衝擊波掃過真正的患處時,我感到痛苦難耐,有如被刀刺一樣,但當過了十多秒,便會慢慢適應,如是者,會不斷的在患處四周進行治療。

三星期內,我進行了四次衝擊波治療,現在已差不多完全康復。特別在此感謝余先生仁心仁術的治療與姑娘細心的協助,並分享一下自己的經歷,希望可以幫助同樣有如此傷患的人。就這次傷患,衝擊波治療可以令我完全康復。

Ray Lam
2011年9月

肌肉及韌帶創傷:趙皓雋先生的分享

本人是學校田徑隊隊員,熱愛跨欄,早前因應付比賽而操練過度,導致右腳韌帶和大腿肌肉拉傷,右腳踏地便感劇痛,每踏一步,右腳踝都痛得像刀刺,可說是每步為艱。本人曾經接受西醫診治,冰療和服食消炎止痛藥後皆不見效果。

其後,經朋友介紹,接受香港腰脊物理治療中心的衝擊波治療。治療時的感覺有如刀刺,一小下、一小下的刺入患處,患處的周邊亦感痺痛。第一次治療後,我感到已經有百分之七十的痊癒了,可以以正常的速度行走而不感到任何痛楚,只有按壓患處時仍有少許痛;第二次治療後,我已經徹底地痊癒,可以繼續參與田徑隊練習了。

直至現在,已經兩個多月了,韌帶和大腿肌肉的痛楚沒有再出現,我在此再次感謝治療師,使本人得以徹底地康復了。

趙皓雋
2009年3月

膝關節痛

膝蓋腱炎:Brian Tang 的分享

本人從事倉務低收入工作,因每日長時間步行及不斷重複性動作,膝蓋不斷感到強烈痺痛和刺痛感覺,令本人睡覺及步行都艱難。半年前找骨科醫生,發現左腳膝蓋筋腱發炎及韌帶微裂。本人四處尋找骨科醫生及物理治療師,都只普通開出消炎止痛藥、冰療,就連解釋膝蓋傷痛位置在哪裡都沒有講過。

其後,本人從醫院物理治療師得知這個衝擊波治療能對膝蓋筋腱發炎有效,從互聯網見到其他同類病例的病人經驗分享,於是向治療中心預約。治療師余先生向本人做不同測試及查問有關受傷原因,後來余先生一一解釋受傷問題、傷痛位置、治療時會有什麼感覺,治療回家後會有什麼感覺出現等,連本人工作上如何令到膝蓋韌帶微裂都專業地解釋出來。

本人第一次接受衝擊波治療時發炎位置感到強烈痛楚,但治療完後痛楚比平日減輕很多。個半月內已完成了九次治療,本人已康復七成,現在能輕鬆地步行及上落樓梯。聚焦式衝擊波治療對本人康復極大幫助,我會繼續去治療令傷患痊癒。很感謝余先生熱心及嚴謹地為我治療及多謝診所姑娘對傷患者熱誠的照顧!

Brian Tang
2012年4月

膝關節筋腱及韌帶創傷:許俊泓先生的分享

本人是籃球的愛好者,經常和朋友打籃球。兩年前在一次比賽中,被對手撞傷膝蓋。受傷以後膝蓋感覺乏力,無法跳動,跑動也有困難。兩年為此不停尋訪醫生,針灸、跌打、物理治療、脊醫等等都試過,但也無法使受傷的膝蓋痊癒。直到一次認識衝擊波治療及此物理治療中心,經過一些研究,認為此治療可以一試,便到來接受治療。

第一次接受衝擊波及手法治療感到十分痛楚,但治療後膝蓋已開始有力。經過第二和第三次的治療後,本人已經可以跑動,而且膝蓋乏力的感覺也消失。

我認為此治療對治療我的傷患有很大的幫助。我會繼續接受治療,相信不久便可以痊癒並繼續打籃球。

許俊泓
2009年2月

足踝創傷

足踝韌帶創傷:Wendy Li 的分享

本人兩年前在公司樓下梯級扭傷左腳足踝,當時疼得無法行走,需Call救護車到醫院治理。醫生照X光後診斷是內側韌帶創傷,但醫生只給我一支冬青膏及止疼藥。之後足踝在走路及上落樓梯都十分疼楚,一年多來一直都沒有好轉,試過跌打、超聲波、磁療、針灸、推拿等等治療,但也無法使受傷的內側韌帶好轉。因無法找到醫治方法及方向,故今年初我已經放棄醫治。直至今年4月中,無意中在互聯網上看到衝擊波治療信息,及從香港腰脊物理治療中心網頁看到病人治療分享,決定到治療中心試一試。

四月中旬第一次到中心,治療師余先生細心查看受傷位置,了解受傷情況及之前所接受的治療後,他說衝擊波治療一定可以幫你康復,余生肯定的回復,給了我很大的信心。之後開始了治療,當衝擊波打落受傷位置感到猶如針刺,患處的周邊亦感到十分痺痛,但經過幾次的治療後,痛楚已經明顯減輕了六、七成。

至今已接受了十二次治療,已康復至九成。衝擊波治療對我的傷患有很大的幫助。感謝余生的細心治療及給予我康復的信心,我會繼續接受治療,相信不久便可以完全痊癒。

Wendy K.S Li
2010年6月

足踝韌帶創傷:王斐小姐的分享

本人是學校籃球隊隊員,熱愛各項體育運動,早前因在友誼賽中拗柴而令到右腳足踝韌帶受傷。本來先接受中醫治療,但康復進展緩慢且因中藥令皮膚敏感而不能再接受治療。

其後,媽媽帶我到香港腰脊物理治療中心接受治療。想不到第一次接受物理治療,就讓我有幸使用到「衝擊波」這種高科技的治療方法。雖然在治療時有一點點痛楚,患處附近亦感到痺痛,但在完成第一次治療之後,我的患處即刻變得十分舒服。經過四至五次的治療後,我已經由一個走路也不能快的患者變成一個有能力繼續參與球隊訓練的運動員。

現在我能再次在球場上殺敵,利用各種方式入球、接受體能訓練,確是因為「衝擊波」治療的果效,在此感謝治療師,使本人能再次做運動。

王斐
2010年4月

足踝韌帶受傷:鄧裕霖小朋友的分享

我是鄧裕霖,今年11歲,讀小學6年級。

有一次,上體育課時,我們要練習跑步,我跑了一會兒,不小心扭傷了自己的腳。最初只有少少痛,放學回家後痛了很多,媽媽帶我去看了跌打醫生,看了三次跌打,終於比以前好了很多了,不痛了。所以,我可以繼續上體育堂。開始跑步了一會兒,腳又痛,還比以前痛了很多,放學時,一跛一跛,我很怕會成為跛子。

這次,媽媽帶我看了物理治療。治療師叔叔說是足踝韌帶撕裂,他對媽媽說:『一般會用『衝擊波』治療,很快復原,不過治療時會痛,他年紀小,可以選擇用其他治療方法,不過復原時間要較長。』我對媽媽說:『我不怕痛!』

做『衝擊波』真的很痛,比跌打還要痛,但是我很喜歡它,因為回家時沒有一跛一跛了。第二次已經痛少了很多,第三次只有少少痛,走路已經沒有痛了。第二天,上體育堂時,練習跑步沒有痛了。

我很開心,我可以上體育課了!還可以參加運動會的跑步比賽!

鄧裕霖

肩頸背痛

肩周炎:賴家軒先生的分享

自從2008年,我因為工作太忙,在打羽毛球的時候很多時都沒有做好熱身,終於在12月有一次扣殺後肩膀非常的痛。開始時我不了了之,以為只是一般的拉傷,可是痛了大概一個月都沒有好轉,於是找尋些專門醫治肩膀的地方求醫,證實了是肩周炎。試了很多方法,針灸、拔罐、推拿等等,不能說完全無效,但是感覺到那些治療方法 "不到位",好像找不出我的真正患處,一直到6月中的時候仍然感覺不到有康復的跡象。但是接受衝擊波治療之後就不同了,6月尾的時候做了2次治療,感覺是對症下藥,找到痛點的位置在進行治療,只做了2次就明顯覺得好轉了,以前我把右臂水平的提起經已覺得疼痛,2次之後疼痛消失,不過我的患處範圍比較廣,所以一直到8月初我自己覺得完全不痛,康復了,而我介紹的朋友去做衝擊波治療只3次就完全康復。衝擊波給我的感覺是快速、有效和針對性的,一個星期的治療就解決了困擾我5個多月的病情,當然亦和余先生的經驗有相當大的關係,他會以不同的方法不同的姿勢去找出患者的痛點進行治療。現在我已經能做一些復健運動,在此分享自己的經驗並非常感謝余先生治好我的肩患,曾經我一度認為自己不能再打羽毛球了,是余先生給了我希望,真的非常感謝,相信很快我就能回到球場大展身手了。

賴家軒
2009年8月

肩頸背痛:陸美顏女士的分享

肩頸背病已困擾我約五年多,但近兩年感到病情日漸加深,令我整日都極為辛苦,更影響睡眠。其間不斷求醫!西醫、跌打、針灸、脊醫、物理治療等等,甚至傻到求診於神醫,但沒有解決病情,還浪費金錢及時間。偶然間在報刊上見到介紹衝擊波治療法,便到互聯網搜查這方面資料,首次到香港腰脊物理治療中心接觸衝擊波。經過治療師詳細和耐心評估後,認為我是頸椎移位及肩背肌肉嚴重勞損,所以令我有極疼痛的原因。用衝擊波治療神奇之處,是能直達到發炎患處,治療四、五次後,炎症有明顯改善,疼痛也減輕很多。至於頸患,在治療師專業手法治療和復位運動下,頸椎復位也明顯改善!現在心情也輕鬆不少,非常感恩遇到衝擊波和好的治療師。

陸美顏
2009年4月

肩頸痛:黎志豪先生的分享

平生第一次接受物理治療,就讓我認識到『衝擊波』這種新科技。

相信很多人都和我一樣有肩頸痛的問題,幸運地,我有一位護士太太為我提供照顧和治療,所以一直以來的問題不太大。不過,我終於第一次嘗到疼痛帶來的煎熬!

日間工作和晚上溫習、做功課,每天都要花十幾個小時使用電腦,進入冬季後,肩頸痛一直持續,雖然太太已很悉心地為我舒緩不適,但疼痛時緩時劇,頭痛和整個上背部不適的出現,令我要依賴止痛藥才能應付日間的工作,因工作太忙和為免太太擔心,所以一直死忍,但是,連續四個晚上因疼痛而影響睡眠,終於被太太揭發。翌日早上,就為我約診物理治療。

經過治療師詳細評估後,認為我的頸胸椎無大問題,但頸肩間的軟組織出現很嚴重的炎症,最嚴重的部位像有『1/6個蛋黃』伏在肩背,按壓時疼痛非常,甚至感到頭痛,這些炎症是因長期勞損而產生,亦是令我出現嚴重疼痛的原因。

治療前,治療師已表示,因我的炎症嚴重,在接受『衝擊波』治療時,疼痛的感覺相對地較大,於是我咬緊牙關接受第一次治療。治療後,即時感到上背部輕鬆了,頭痛亦消失了,按壓發炎的軟組織時仍有痛,但已減輕了不少,一次的治療已令我的疼痛減輕了一半。三次治療後,我的炎症差不多已完全消退。

由於『衝擊波』在香港是一種新科技,我太太當然要充分了解後才安心讓我接受治療。在此,多謝治療師非常耐心地解答她的疑問。

黎志豪
2008年3月

網球肘、哥爾夫球肘

網球肘:蕭秋蓮女士的分享

本人右手肘在一月時開始酸痛無力,但因工作關係,這種情形以前也有發生,貼些止痛貼後會慢慢好轉,所以沒有太擔心。但這次不但沒有好,還越來越嚴重,曾經看過跌打、西醫、針灸等都沒有效。

幸好一次從網上看到「衝擊波治療」,令我記起以前也曾做過衝擊波治療足底筋膜炎而痊癒,於是便到香港腰脊物理治療中心一試。治療師檢查後說我的炎症嚴重,但接受十次治療後已好了七八成,再接受多幾次會完全醫好。

在此感謝治療師余先生的耐心治療!

蕭秋蓮
2012年3月31日

網球肘:陳美玲女士的分享

我的網球肘已經困擾了我很多年,時好時壞。幾年來,政府同私家物理治療都做過,針灸同跌打都做了好多個醫師,總之有人介紹話好都會去試,但是都無辦法斷尾,亦用了不少錢。近兩年我都開始放棄,後來個仔個女朋友介紹呢間物理治療中心做衝擊波,話新科技好有效。最初只為順下後生意思試下。

記得第一次做衝擊波已經覺得好神奇,如治療師所講,打落去有發炎的地方會痺痛,無發炎的地方會無反應,我做的時候除了痛連尾指都覺得痺,短短幾分鐘治療後,即時感覺做某些動作時,手痛減少了。做了四、五次治療後,已經好了很多,只是間中有些動作會覺得有少少痛,由於我是多年舊患,我好想完全醫好,所以都聽治療師意見,要耐心做多幾次治療。

我的網球肘已經醫好,差不多半年都無翻發,所以我好樂意接受治療師邀請,同大家分享我的治療經驗。

陳美玲
2009年1月

哥爾夫球肘:Philip Chan 的分享

由於我很喜歡羽毛球運動,幾年前打完球之後手肘內側筋非常緊和疼痛,之後越來越嚴重。曾經看過跌打、吃消炎藥、針灸等效果只是治標,疼痛反反覆覆,一次從報章看到「衝擊波」,對治療網球肘等痛症很有效,於是找到一間治療中心試一試。

第一次經過「衝擊波」治療,過程感覺很疼、痹,晚上感覺肘內側還是很疼有些失望,但第二天早起疼痛已好了很多。第二次治療時,同一疼點明顯好轉,做了幾次之後,感覺已好了八九成。以前扭毛巾都痛的患處,發力已感覺不到痛,因為我的痛症已好幾年了,所以聽從治療師的意見,等完全治好之後才開始運動。在此感激治療師的耐心治療,使我很快康復。

Philip Chan
2010年7月

手肘痛和腰痛:Jeff Cheng 的分享

本人手肘扭傷超過3年半,腰部跌傷接近20年,之前試過很多方法:跌打、脊醫、骨醫及物理治療等等,屢醫無效。手一用力就痛,腰部經常酸痛無力,自己都處於半放棄狀態,只是恐怕將來最終要做手術解決,十分擔心。但今年2月,偶然在電視介紹『衝擊波』治療,自己都想可以一試。第一次治療就被治療師的專業知識及細心所吸引,之後用『衝擊波』治療手肘2至3次,已經感覺明顯進展,最後接受8次治療,手肘明顯康復。之後自己更有信心治療腰患,治療師詳細評估後說我最主要是第五節腰椎的椎間盤移位,需要用復位運動及使附近肌肉練習得強壯以穩固腰椎,至今接受了13次治療,已完全康復。多謝治療師余先生的仁心仁術之餘,在此寫下這篇經驗分享。

Jeff Cheng
2011年5月21日

其他

面部肌肉創傷:陳澤仁先生的分享

我在半年前因意外撞了檯角位,以我印象中,也算是很大力,起初沒有留意它,沒有理會,以為它會自我痊癒。但過了大約半年,照鏡的時候,發現右邊面腫了。我一路也不知甚麼原因令它腫起,直至上網的時候,發現香港腰脊物理治療中心的衝擊波治療。當我見完治療師,才知道是弄傷了肌肉軟組織引至發炎。現在我用衝擊波治療了五次,治療師每次都很細心地問我康復的進展,事實上,我自己也覺得好了七至八成,我自己很開心,在此我也很感謝物理治療師余先生。

陳澤仁
2011年5月

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