EXTRACORPOREAL SHOCK WAVE THERAPY (ESWT) CONTRAINDICATIONS
There are relatively few reasons why an individual might not qualify for an ESWT treatment but the following will exclude a potential patient from treatment:- Poorly localized or non palpable area of pain.
- No recent X-ray, CT scan or MRI of the area
- Patients who have had previous surgery for lateral epicondylitis
- Pregnancy
- A bleeding disorder such as hemophilia or an acquired bleeding disorder
- Patients with thrombopathy, infection, tumor, cervical compression syndrome (a nerve in the upper neck is compressed causing pain similar to tennis elbow), cervical or upper extremity arthritis, local arthrosis, neurologic abnormality, or radial nerve entrapment (the nerve, passing the elbow, is compressed causing pain similar to tennis elbow)
- Blood dyscrasia or other disorder with platelet count less than 50,000
- Patients who suffer from severe systemic diseases that may lead to sensory changes or nerve related pain. For example, this may include diseases such as gout, brittle diabetes mellitus, rheumatoid arthritis.
- An open wound over the site to be treated
- Patients with cardiac pacemaker
- Redness, swelling, fever, or other evidence of infection or acute inflammation at the site to be treated
- Uncooperative patient or one who cannot follow directions (Alzheimer's disease, senile dementia, organic brain syndrome, etc.)
- Patients younger than 18 years of age.
MEDICATIONS AND ALLERGIES
- Patients should take their regular medications during their series of treatments.
- Patients on Coumadin (Wafarin) or other anti-coagulants should discontinue their medication prior to treatment. Patients taking aspirin should discontinue this medication one week prior to treatment.
- Latex hypersensitivity is not a contraindication to therapy.
IMPORTANT
In addition to imaging studies, all patients selected for ESWT should have palpable, localized, areas of pain. If these criteria are not met, the treatment should not be done.
It cannot be overstated how important this selection criteria is. Patients with diffuse, non-localized pain should not be treated. If a patient is not appropriate for ESWT treatment, his or her referring physician will be notified by a CROM physician.
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