Shock Wave Therapy May Ease CPPS

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Atari
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Re: Shock Wave Therapy May Ease CPPS

Post by Atari »

billy79 wrote:Interesting..Is it possible to get a bit more info on Who/where this is located in Sweden?
after all its my neighbour country;)
Please send a mail to [email protected] and I will give you the address. Not sure if you are allowed to get this treatment because of it is a part of county council primary health care.

You should be able to get this treatment from a naprapath in your home country. At least for your external triggerpoints, many naprapath clinics in Sweden gives this treatment. I have myself booked me up four new treatment sessions for external triggerpoints from a private clinic here in Sweden.

http://www.youtube.com/watch?v=4AFuOmEUSoY
Age: 35 | Onset Age: 34 | Symptoms: | Helped By: SWT, trigger point therapy from a qualified naprapath, Tryptizol, squatting, yoga stretching. | Worsened By: Stress, not sleeping enough, sitting all day, hard workout, eating sugar and carbs in general. I'm now about 70% better with a LCHF-diet!
Atari
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Re: Shock Wave Therapy May Ease CPPS

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Here is a better link on how this is performed for pain in groin area:

http://www.youtube.com/watch?v=I5PUe_OOFrQ
Age: 35 | Onset Age: 34 | Symptoms: | Helped By: SWT, trigger point therapy from a qualified naprapath, Tryptizol, squatting, yoga stretching. | Worsened By: Stress, not sleeping enough, sitting all day, hard workout, eating sugar and carbs in general. I'm now about 70% better with a LCHF-diet!
captainJ
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Re: Shock Wave Therapy May Ease CPPS

Post by captainJ »

I also would like to know the clinic name as I am studying this method as a patient.
Atari
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Re: Shock Wave Therapy May Ease CPPS

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Hello CaptainJ, from what area in the world are you from? This treatment is given as a part of the county council medical treatment in Sweden against CPPS/Prostatitis. It’s a private clinic, but they operate on a mandate from the county council medical treatment in their area. Travelling from far away for a maximum 15-20 minutes of treatment per session doesn’t make any sense, it's desperate. I have also received 5 sessions of this method from the naprapath clinic around the corner from my job. Any naprapath clinic that has an SWT-machine can perform this treatment. I could even easily perform it on my self. My suggestion if you are not from Sweden is to check around you area for a clinic that have an SWT-machine and perform this treatment.
Age: 35 | Onset Age: 34 | Symptoms: | Helped By: SWT, trigger point therapy from a qualified naprapath, Tryptizol, squatting, yoga stretching. | Worsened By: Stress, not sleeping enough, sitting all day, hard workout, eating sugar and carbs in general. I'm now about 70% better with a LCHF-diet!
kls269
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Re: Shock Wave Therapy May Ease CPPS

Post by kls269 »

Atari do you have any update on the efficacy of this therapy? thanks.
26 yo. Pain since 11/2009. Doing much, much better than the initial few months where I was in EXCRUCIATING pain 24-7. Still have irritation, burning, tingling, and/or pain in pelvis and feet.

Things that help: yoga/stretching, internal trigger point stretches, good posture, thinking positively/not obsessing, amitriptyline (maybe), warm baths (sometimes), and literally doing everything possible to live normally and productively. I also think a night of drinking can relax the body and provide a nice temporary escape.
Things that don't help: obsessing, catastrophic thinking, most doctors, antibiotics
Things I find irrelevant (for me): food/drink, antibiotics, deep breathing.
critthinker
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Re: Shock Wave Therapy May Ease CPPS

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I second KLS' question. Would love to hear more.
Age: 27 | Onset Age: 26 | Symptoms: Pelvic pain (began w/ introduction into bladder/prostate of highly resistant strain of bacteria that was acquired via a Botox injection intended to treat levator ani syndrome) | Helped By: Paxil for anxiety, Trigger point release and trigger point injections, stretches, hot baths, Prosta-Q | Worsened By: Stress/anxiety, Sitting down for long periods,
Atari
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Re: Shock Wave Therapy May Ease CPPS

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Hello everyone!

I am have noticed that I am checking in to the forum less more and more. I am doing fine. On a good day I am 90% better from the pain. And about 80% better from all other symptoms. Sometimes I am even forgetting that I have this disease. I have taken up dating and my career, seeing friends a lot more than before. I can sleep less and still wake up rested in the morning.

I don’t think SWT did it. I think it’s my change of diet, reducing stress, accepting that I am ill and will be so for a very long time. Seeing a PT from whom I have received a home training program has helped a lot. My PT has found TP all over my body; guess I have caught a general pain syndrome. And my PT can feel that the trigger points are getting less and less tender. That feels very good. I'm soon going back for a new session of SWT. I hope that it will kill some more of my TPs. In all this misery, the pain has been the worst to handle. As soon as the pain started to disappear, I have started to feel better and better. I can go out with my friends and drink and smoke. I eat no sugar, drink no beer, no sodas, no pasta, no rice, no chips etc. I only eat extremely healthy food. I’m taking Quercetin, Bromelain, bee pollen, extreme high dosage of D-vitamins, Omega-3 and Elavi. But the first SWT session was the start for my change.
Age: 35 | Onset Age: 34 | Symptoms: | Helped By: SWT, trigger point therapy from a qualified naprapath, Tryptizol, squatting, yoga stretching. | Worsened By: Stress, not sleeping enough, sitting all day, hard workout, eating sugar and carbs in general. I'm now about 70% better with a LCHF-diet!
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Re: Shock Wave Therapy May Ease CPPS

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Not sure if anyone noticed but the one-year follow-up results were available in April 2010 from www.urosource.com.
Extracorporeal Shock Wave Therapy for CPPS is an economic treatment option

Sunday, 18 April 2010- There is an increasing incidence of chronic pelvic pain syndrome (CPPS) at least in the Western world, and the vast majority of male patients suffer from the abacterial form of chronic prostatitis or CPPS.

"Recently, an incidence of almost 14% was found among more than 5,000 male urological outpatients. For instance, in the US millions of patients visit their physicians due to CPPS-related complaints. The disease reveals substantial morbidity comparable to that of Angina pectoris, Morbus Crohn or the status after heart attack," said Dr. Reinhold Zimmermann who presented the study "Extracorporeal Shock Wave Therapy (ESWT) for Chronic Pelvic Pain Syndrome," during the Oral Poster Session held today at the 25th Anniversary EAU Congress in Barcelona, Spain.

Disease-typical complaints are pain sensations most commonly in the prostate, testes, groin, back, pelvic floor and supra-pubic region. Disturbances of micturition and erectile function can have a crucial diminishing effect on quality of life which may be even greater than the pain itself. Quality of life can be markedly restricted. The illness might influence social contacts and is probably linked to psychosomatic aspects.

No causal or standardised treatment is available at present. Various agents such as analgesics, antiphlogistics, antibiotics, a-receptor blockers and 5-a-reductase inhibitors are used individually and in various combinations. A certain group of patients may mostly benefit from alpha-blockers, whilst there is no rational basis for the widespread use of antibiotics. The lack of evidence or objective measurement of effectiveness for each of these treatments has to be emphasised. Side effects may predominate over possible treatment effects.

Physiotherapy, trigger point massage, electromagnetic treatment and acupuncture have already been used for CPPS. Based on orthopaedic pain syndromes, fractures, wound healing disorders and even cellulite which are successfully treated by low-energy Extracorporeal Shock Wave Therapy (ESWT), this therapy was also introduced in CPPS treatment. Additional arguments were that SWs could reduce passive muscle tone in stroke patients and induce reperfusion in ischemic dysfunctional myocardial areas.

In a feasibility study, Zimmerman and colleagues showed that SWs are easily applicable by perineal approach without side effects, achieving significant improvement of CPPS-related symptoms, in particular with respect to pain.

Beforehand, prostate specific antigen (PSA) testing, digital rectal examination (DRE) and transrectal ultrasound (TRUS) of the prostate have been performed prior to study enrolment in order to rule out other pathologies. Side effects were very thoroughly investigated when commencing ESWT to pelvic floor, and were definitely excluded by a large variety of highly reliable clinical and imaging methods (lab analysis, TRUS, MRI).

Following these first encouraging results a placebo-controlled double-blinded randomised trial including 60 patients (30 each group verum/placebo) could be successfully performed. According to the study protocol no other treatments were permitted during study and follow up (FU) period.

All patients were randomised prior to treatment. The verum patients received 1 perineally applied ESWT treatment weekly (3000 impulses each, maximum total energy flow density 0.25 mJ/mm2, frequency 4 Hz) for 4 weeks.

The device used for the study was a standard electromagnetic shock wave unit, DUOLITH SD1, with a focused shock wave source. The position of the shock wave transducer was changed after every 500 impulses in order to scan virtually the entire prostatic and pelvic floor region. The focus geometry of the transducer ensured that prostatic region could not be failed to strike when placing the transducer perineally.

For placebo treatment spreading of SW was stopped definitely within the transducer by an integrated membrane.

The follow-up (FU) included clinical examinations and the questionnaire-based re-evalution of quality of life and complaints. Recently, the one-year FU could be completed showing extremely encouraging results. In this context it has to be noted that only a small minority of investigations on CPPS extend to this FU duration.

The now available long term FU verifies impressively the value of ESWT for treating CPPS. Very few investigations on this topic have comparable FU and results data. ESWT may in particular be interesting due to easy and inexpensive application, very little need of staff and the possibility for repeating the treatment at any time.

In terms of healthcare costs, ESWT could be extraordinarily attractive because patients can receive it 'by the way' – meaning there is no need for interruption of employment or hospitalisation. Effects of ESWT are limited, at least with the current application schemes. But one has to pay attention to the fact that modifications of application, which have only not been realised in order to maintain the study protocol, could potentially extend the effects on tissue and therewith the duration of pain soothing for an 'unlimited' period of time.

Source: R. Zimmermann, "Extracorporeal Shock Wave Therapy (ESWT) for Chronic Pelvic Pain Syndrome," Oral –Poster Session 40, 18 April 2010, 25th Anniversary EAU Congress, Barcelona, Spain.
Age: 27 | Onset Age: 26 | Symptoms: Pelvic pain (began w/ introduction into bladder/prostate of highly resistant strain of bacteria that was acquired via a Botox injection intended to treat levator ani syndrome) | Helped By: Paxil for anxiety, Trigger point release and trigger point injections, stretches, hot baths, Prosta-Q | Worsened By: Stress/anxiety, Sitting down for long periods,
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Re: Shock Wave Therapy May Ease CPPS

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Not yet available on Pubmed, but can be seen here.
eswt.png
eswt.png (61.21 KiB) Viewed 580 times
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critthinker
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Re: Shock Wave Therapy May Ease CPPS

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Found this after a Google search. It's the another study done in China:

Chan Lung W, Tsang L, Hong Heng C.
Extracorporeal shock wave therapy for chronic pelvic pain syndrome
3rd Asia-Pacific Forum on Andrology (Nanjing, China: October 10, 2009)
Background: Prostatitis is one of the most common urological diseases. Chronic pelvic pain syndrome (CPPS) has an incidence of 1.5%-10% among male populations all over the world. It is accompanied by many symptoms like voiding disorders and pains in perineum, testis, penis, bladder and the back. Quality of life of the affected men is often poor. NIH classification holds that many prostate affections, especially those in which no infection can be detected, are associated with patho-physiological processes outside the prostate (neurological, neuromuscular, perineal or intrapelvic causes). The origin of CPPS is still unknown and an efficient therapy for it is still missing. Shock wave has been widely used in ESWL. Shortly after its establishment in urology, ESWL was modified and also applied as extracorporeal shock wave therapy (ESWT) with weaker energy sources in orthopaedics for the treatment of degenerative and painful arthropathies and chronic pain in soft tissue. Good results were achieved especially in the treatment of pain. Otorhinolaryngology has discovered ESWT for the treatment of sialolithiais. The applicability of ESWT was also postulated for the treatment of Peyronie's disease. ESWT should reduce the degree of deviation and the pain of erection. Furthermore, there is clinical evidence that shock wave can relax muscles with chronic hypertension.
Aim: To investigate whether ESWT is an effective therapy for CPPS.
Methods: A total of 186 patients (age 16-45, mean 26.4) with CPPS for a minimum of 6 months (average duration of CPPS complaints 21.2 months [7-143 months]) without inflammation signs in urine or seminal fluid or clinical evidence of prostate cancer were included into the study. The patient is positioned on his back and the therapy head is coupled on the perineum. At each session, 3 000 pulses of focused SW are applied at a frequency of 3.5 Hz. The treatment is effected at an energy level of 0.25 mJ per mm2. The time between individual treatments is one week. A total of four sessions in the course of four weeks is planned. Follow up was performed after 4 weeks. Specific complaints including the average urinary symptoms score, the average pain score, and the average score of quality of life were investigated by NIH-CPSI before and after the treatment. All patients completed the treatment course and were followed up.
Results: The duration of ESWT was each 13 min. No side effects occurred. NIH-CPSI improved markedly. The average NIH-CPSI score was 34.1 before treatment and 17.9 after ESWT. The average pain score of 15.8 was reduced to 8.2 after treatment. The average urinary symptoms score was 7.2 down to 3.8. The average score of quality of life was increased by 46.8%, i.e. 11.1 down to 5.9 after ESWT.
Conclusion: ESWT in the prostate region can be a safe and effective treatment chronic pelvic pain syndrome. It was an easily performable treatment showing no side effects at all. ESWT achieved a reduction of CPPS related pain and complaints followed by better quality of life.
Author Affiliation: University Hospital of Macau Chong Hong Heng, Satish Shrestha Urology Care of Hong Kong, Hong Kong and University Hospital, Macau University of Science and Technology, Avenida Wai Long, Macau, China
Age: 27 | Onset Age: 26 | Symptoms: Pelvic pain (began w/ introduction into bladder/prostate of highly resistant strain of bacteria that was acquired via a Botox injection intended to treat levator ani syndrome) | Helped By: Paxil for anxiety, Trigger point release and trigger point injections, stretches, hot baths, Prosta-Q | Worsened By: Stress/anxiety, Sitting down for long periods,
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Re: Shock Wave Therapy May Ease CPPS

Post by Sevaem2256 »

Is this kind of treatment available in the US?
Age:20 | Onset Age:15 | Symptoms: Constant urethral pain, post-ejaculatory pain, post-defecation pain, painful urination, IBS | Helped By: The rare use of Azo | Worsened By: Alcohol
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Re: Shock Wave Therapy May Ease CPPS

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I don't know of any specific doctors/clinics who are using it, but it seems like it wouldn't be too difficult to use existing ESWT machines for this purpose.

I know the actual machine used in the Austrian study is not FDA approved. I wonder how similar this machine is to other shock wave devices that ARE FDA approved (for other indications, of course).
Age: 27 | Onset Age: 26 | Symptoms: Pelvic pain (began w/ introduction into bladder/prostate of highly resistant strain of bacteria that was acquired via a Botox injection intended to treat levator ani syndrome) | Helped By: Paxil for anxiety, Trigger point release and trigger point injections, stretches, hot baths, Prosta-Q | Worsened By: Stress/anxiety, Sitting down for long periods,
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Re: Shock Wave Therapy May Ease CPPS

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I found this chiropractor in Canada who seems to offer shock wave treatment.

https://sites.google.com/site/drkirkand ... s-protocol
Age: 27 | Onset Age: 26 | Symptoms: Pelvic pain (began w/ introduction into bladder/prostate of highly resistant strain of bacteria that was acquired via a Botox injection intended to treat levator ani syndrome) | Helped By: Paxil for anxiety, Trigger point release and trigger point injections, stretches, hot baths, Prosta-Q | Worsened By: Stress/anxiety, Sitting down for long periods,
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Re: Shock Wave Therapy May Ease CPPS

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Re: Shock Wave Therapy May Ease CPPS

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ESWT therapy not supported in long term followup
http://pubmed.ncbi.nlm.nih.gov/25097599
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