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International Journal of Anesthesiology & Pain Medicine
ISSN: 2471-982X
Volume 4
March 26-28, 2018
Vienna, Austria
Pain Management 2018
Internal Medicine 2018
Page 21
JOINT EVENT
7 t h E d i t i o n o f I n t e r n a t i o n a l C o n f e r e n c e o n
Internal Medicine and Patient Care
&
6 t h E d i t i o n o f I n t e r n a t i o n a l C o n f e r e n c e o n
Pain Management
Rehabilitation management of musculoskeletal pain
conditions are challenges. Most patients developed chronic
pain conditions since inadequate management during acute
pain phase. Currently, extracorporeal shock wave therapy
(ESWT) and Class IV lasers or high-power laser therapy are novel
therapy for these conditions. Interestingly that both therapies
with different actions and mechanisms have same benefits on
musculoskeletal pain conditions and considered as regenerative
medicine therapies. The evidences of safety, efficacy and
good patient compliance made both therapies to be increasing
popular in the worldwide. ESWT has become one of the best
investigated treatment modalities for various conditions of the
musculoskeletal system such as myofascial pain syndrome,
tendinopathies and osteoarthritis, etc. An optimum treatment
protocol for ESWT appears to be three treatment sessions at
one-week intervals, with 2000 impulses per session and the
highest energy flux density that can be applied. The proposed
mechanisms for the benefit of ESWT on musculoskeletal
tissue include direct effects on tissue calcification, alteration
of cell activity through cavitation, acoustic micro streaming,
hyper vascularity and blood flow increment, alteration of cell
membrane permeability and effects on nociceptors through
hyper stimulation, blocking the gate control mechanism. Class
IV lasers or high-power laser therapy offers better therapeutic
outcome compared to Class III lasers as follows: (1) larger
dosages of therapeutic energy. (2) deeper penetration into the
body. (3) larger treatment surface area. This is important when
treating large regions, such as the lumbar spine, quadriceps or
hips. (4) greater power density. (5) continuous power supply.
(6) superior fiber optic cables: Fiber optic cables transmit laser
energy from the laser to the treatment probe (wand) at the end
of the cable. The beneficial effects of ESWT and high-power
laser therapy on musculoskeletal tissues are anti-Inflammation,
analgesic, accelerated tissue repair and cell growth, improve
vascular activity, release trigger points and desensitization,
reduce fibrous tissue formation. In conclusion, ESWT has been
proven for more than 20 years as effective and safe noninvasive
treatment option for tendon and other pathologies of the
musculoskeletal system in a multitude of high-quality RCTs.
High power laser therapy is by far the most exciting new clinical
treatment to advance physical medicine in the 21st century anti-
inflammatory and analgesic effects. It offers better therapeutic
outcome compared to Class III lasers which has been used for
a long period of time with little impressive outcome. High power
laser therapy is newer therapy with increasing evidences.
Biography
Areerat Suputtitada MD is a Professor of Rehabilitation Medicine from Ch-
ulalongkorn University and King Chulalongkorn Memorial Hospital, Bang-
kok, Thailand. She is the Director of Excellent Center for Gait and Motion at
King Chualongkorn Memorial Hospital and Chairperson of Neurorehabil-
itation Research Unit of Chulalongkorn University. She has been involved
in education, residency training, research, and clinical treatment related to
rehabilitation medicine for more than 20 years. She was invited as interna-
tional speaker more than 80 times around the world. She received 18 na-
tional and international awards, and published more than 60 national and
international articles in several areas of Rehabilitation Medicine including
Neurological Rehabilitation, Spasticity and Dystonia, Pain, Gait and Motion,
and Sport and Exercise Medicine. She has been elected and appointed to
important positions in the ISPRMsuch as the Chairperson of ISPRMWom-
en and Health Task Force and ISPRM International Exchange Committee.
Novel of extracorporeal shockwave
therapy and high-power laser therapy in
musculoskeletal pain conditions
Areerat Suputtitada
Chulalongkorn University & King Chulalongkorn Memorial Hospital, Thailand
Areerat Suputtitada, Int J Anesth Pain Med 2018, Volume 4
DOI: 10.21767/2471-982X-C1-001