Shock-wave therapy. Comparison of methods of treatment of a calcaneal spur and osteochondrosis.
Shock-wave therapy.
Comparison of methods of treatment of a calcaneal spur and osteochondrosis.
Diseases of the musculoskeletal device and peripheral nervous system are very widespread problem today. Contrary to ordinary opinion that these diseases are "age", a young face and working-age often have them. This pathology strongly worsens quality of the patient`s life. After all one of the most important functions of an organism – the movement is broken. Developing of these diseases is promoted by such factors as sedentary work (in particular, work at the computer), bad fitness, existence of injuries and overloads of the bone and muscular device, a psychoemotional stress.
Fortunately, it will be possible to avoid these problems, if you will lead a healthy way of life. Going in for sports and curative gymnastics, correct feed, proper selection of shoe, observance of the mode of labour and rest will allow to save health and mobility for long years. However that beautifully sounds in a theory, not always feasibly in practice.
The chronic lack of time, congestion working and household chores often doesn't leave opportunity to be engaged in any prevention. The bowl of scales "health- illness" favors the last and before the patient there are quite clear and logical questions:
Where to ask for the help?
What method of treatment to choose?
What to be guided: efficiency, safety, price?
On these questions isn't present and there can't be a definite answer. Everyone makes the decision, proceeding from a set of factors. In this review we will place emphasis on one, but very important aspect influencing a treatment method choice – economic. Commercial tendencies in modern medicine can't but be reflected on doctor`s and patient`s psychology.
First of all, the modern patient is the doctor`s client and the consumer of medical services. Respectively, he wants to achieve the fastest and highest efficiency of treatment for the most acceptable payment. After all today's realities are not correct, because neither the state, nor employers aren't interested in long-term treatment of sick workers. Therefore patients with installation on active social and private life are interested in the fastest recovery.
In this article we will consider such often widespread diseases as PLANTAR fastsiit (in the people – a calcaneal spur) and the osteochondrosis of a backbone cervical department which is followed by a pain syndrome. Despite seeming "harmlessness" of these diseases, they bring a lot of troubles upon doctors and patients. In turn, and costs of their treatment are also high.
In this article we will consider such often widespread diseases as PLANTAR fastsiit (in the people – a calcaneal spur) and the osteochondrosis of a backbone cervical department which is followed by a pain syndrome. Despite seeming "harmlessness" of these diseases, they bring a lot of troubles upon doctors and patients. In turn, and costs of their treatment are also high.
Estimation of MEDICATED therapy cost included the medicines which are most often appointed by general practitioners and neurologists. The average prices on drugstores of Kiev both on preparations of foreign producers, and on preparations of domestic analogs as of July, 2015 (www.tabletki.ua) were considered.
The prices received from the Internet on the Kiev private clinics chosen in a random way were taken as a estimation basis of cost of non-drug methods of treatment. Features of application of each technique are described taking into account literary data and own supervision. In a case with a calcaneal spur we didn't include the cost of orthopedic insoles as it pays off individually in each case in the table.
Cervical osteochondrosis
| Medical treatment | Nondrug treatment | ||||||||||||||||||||||||||||||||||||||||
| Courses of drugs | Blockades with using local anesthetic and GKS | Shock-wave therapy | Acupuncture | Massage | Manual therapy | Physiotherapy methods | |||||||||||||||||||||||||||||||||||
| course duration | 7-14 days for the stationary treatment;1-1,5 monthes for the ambulatory treatment | 3-5 days | 1-1,5 monthes | 10-12 days | 10-14 days | From several weeks to 2-3 monthes | 10-15 days | ||||||||||||||||||||||||||||||||||
| Periodicity of repetition | 2 times a year | While exacerbation(2 times per year and more) | 1-2 times a year | 2 times a year | 2 times a year | 1-2 courses a year, depends on the individual necessity | 2-3 times a year | ||||||||||||||||||||||||||||||||||
| Phase of the effect | 3-4 monthes | Individual | From average to expressed | Average | From weak to average | Average | From weak to expressed | ||||||||||||||||||||||||||||||||||
| Advance of the effect | During the course of treatment | After 1-2 blockades | After 1-2 sessions | After 2-3 sessions | After 4-5 sessions | After 4-5 sessions | After 1-3 sessions | ||||||||||||||||||||||||||||||||||
| Slight side effects | From moderate to expressed: pathology of alimentary canal (risk of gastritis, alimentary bleeding and perforation, ulcerous disease of stomach and duodenum), violation of blooding and increasing of arterial pressure, toxic effect for liver and reins, allergic reactions and other. After some time the effect of the treatment may bring down. | Temperate:toxic and allergic reactions, prick of the body cavity and spinal cord shells, damaging of vesssels and nerves with an needle, inflammatory local reactions, oscillation of arterial pressure, tachycardia | Practically absent | Seldom: infectious and inflammatory changes of skin in the field of introduction of a needle, a change or a curvature of a needle with damaging of adjacent fabrics, it is very rare: vegetative reactions (dizziness, perspiration, nausea, fluctuations of a vascular tone and faints) at strong influence | Practically absent | Infrequently: rupture of sheaves and muscles, blocking or shift of vertebras, development of a hyper backbone mobility of, infringement of a hernia nuclei pulposi, fractures of edges, shoots of vertebras, ischemic stroke. The probability of development of side effects very strongly depends on qualification of the manual therapist. | Practically absent | ||||||||||||||||||||||||||||||||||
| Risk for the patient | Average | Average | Minimum | Minimum | Minimum | Average | Minimum | ||||||||||||||||||||||||||||||||||
| Expenditure of time | Temporary disability in the case of stationary treatment | If the treatment is ambulatory, the patient is employable, one blockade takes nearly ten minutes | 10-15 minutes for a session per week, the patient leads the usual way of life | From 30 minutes till several hours, depending of the method | 20-30 minutes for a session. A patient has it every day or every other day | 15-20 minutes with a break for 48 hours between sessions | 10-15 minutes for a session for the majority of the methods | ||||||||||||||||||||||||||||||||||
| Full cost of the course(approximate prices) | 700-3000 uah +additional 1500 uah for hondroprotector and symptomatic therapy | Price for 5 blockades: 250-500 uah and 100-1000 uah and more for drugs | 1000-2800 uah | 1000-2800 uah | 1200-2500 uah | 1500-4000 uah | 500-2000 uah | ||||||||||||||||||||||||||||||||||
| Cost of the course(average) | 1850 uah(without hondroprotector cost) | 1000 uah | 1900 uah | 1900 uah | 1850 uah | 2750 uah | 1250 uah | ||||||||||||||||||||||||||||||||||
| Annual cost of the treatment | 3700 uah(without hondroprotector cost) | 2000(treatment of escalation two times a year) | 2800 uah | 3800 uah | 3700 uah | 4100 uah | 2500 uah | ||||||||||||||||||||||||||||||||||
Сalcar caicaneum
| Medical treatment | Nondrug treatment | ||||||||
| Courses of drugs | Blockades with local anesthetic, lidasa and GKS | Shock-wave therapy | Physiotherapy methods | Massage | |||||
| Duration of the course | 7-14 days ( for the injections), several weeks ( for the pills and gels) | From 3 weeks to 1,5 monthes | 1-2 monthes | 10 days | 10-14 days | ||||
| Periodicity of repetition | 2 times for a year and more | 2 times for a year and more | 1-2 times for a year | 1-2 times for a year | 2 times for a year | ||||
| Expressing of the effect | Low | Normal | Expressed | Normal | From weak to normal | ||||
| Duration of the effect | Momentary, less than several weeks | Individual, high frequency of relapse | From 6 monthes | 3-4 monthes | 2-3 monthes | ||||
| Attack of the effect | Individual, quite often after 5-7 injections of NPWS | After 2-4 injections | After 1-2 sessions | Individual, after 3-4 sessions | After 4-5 sessions | ||||
| Side effects | From moderated to the expressed: digestive tract pathology (risk of gastritis, gastrointestinal bleedings and perforation, stomach ulcer of a stomach and a 12-perstny gut), blood formation violations, increasing of arterial pressure, toxic effect for a liver and kidneys | The expressed: destruction of a calcaneal bone and soft foot fabrics , GKS have a harmful effect on a mucous membrane of a digestive tract | Absent | Practically absent | Practically absent | ||||
| Risk for the patient | Moderate | Moderate | Minimal | Minimal | Minimal | ||||
| Expenditure of time | If the treatment is ambulatory, the patient is employable (14 days) | 3-5 injections with the break for one time a week | 10-15 minutes for 1 session per week | 10-15 minutes for 1 sessionfor most of methods | 10-30 minutes for 1 session every day or every other day | ||||
| Full price of the course (approximate prices) | 700-3000 uah +nearly 1000 uah for the symptomatic therapy | Price for 5 blockades:250-500 uah :100-1000 uah and more for the drugs | 1000-2500 uah | 500-2000 uah | 500-1500 uah | ||||
| Price of the course (average) | 1850 uah | 1500 uah | 1750 uah | 1250 uah | 1000 uah | ||||
| Annual cost of the treatment | 3700 uah | 3000 uah (treatment of escalation two times a year) | 2625 uah | 2500 uah | 2000 uah | ||||
In summary it should be noted that this review doesn't apply for comprehensive illumination of the medical services features market at all. The data, which was provided in tables are indicative. We sincerely hope that having weighed cost factors, and also safety, reliability and efficiency of each technique, both patients, and doctors will be able to make a right choice.
Article is intended also for those patients, who have troubles in orientation in various medical approaches of a calcaneal spur and cervical osteochondrosis treatment. It is necessary to remember that the main factors at the head of any method of treatment – efficiency and safety (lack of side effects).
Taking into account transition of medicine to market living conditions economic validity of the patient `s expenses also matters. The «Awatage» clinic will carry out further analysis of treatment methods of other diseases not as advertising, and with the educational purpose of those who needs it. The main argument as the proof of our objective approach in supply of material is that fact that specialists of the SWT medical center «Awatage» always refer to authoritative scientific researches of both domestic, and foreign doctors – at the end of each article the big list of the used literature is provided.
Read, think, analyze, make a right choice … And be healthy..
Author: Kutz KV Clinic neurologist Avatage
