new york city
integrative rehabilitation group

Extracorporeal Shockwave Therapy

A New York, winner of the Patients' Choice Awards.
Verified by .Opencare.com

Conventional medical approaches to musculoskeletal pain often fail to provide patients with long-term results, and surgical solutions pose significant risks, with no assurance of successful outcomes. Extracorporeal shockwave therapy (ESWT) is a non-invasive regenerative treatment that uses high-pressure acoustic waves to stimulate and accelerate tissue healing and repair.

When applied under ultrasound guidance, shockwaves trigger a cascade of biological reactions that promote tissue repair at the cellular level. Shockwave therapy is especially effective for healing avascular tissues like ligaments, tendons and fascia that are typically slow to heal. EPAT technology is often advertised as shockwave therapy, but it uses low energy waves that are not true shockwaves, and do not have regenerative effects.

In many cases, shockwave therapy is provided as a general pain treatment without a specific diagnosis or clear objective, and patients are often subjected to more treatment sessions than are recommended or warranted. When administered responsibly under ultrasound guidance, shockwave therapy is an evidence-based approach that requires only 5-6 sessions to stimulate tissue regeneration.

Why ESWT at NYCIRG is Superior to Shockwave
Therapy at Other Clinics

Dr. Lev Kalika

Dr. Lev Kalika has 20+ years of training and experience in extracorporeal shockwave therapy, and he is an esteemed member of the International Society for Medical Shockwave. Dr. Kalika is recognized as an international expert in musculoskeletal ultrasonography, and his scientific research has contributed substantially to the use of shockwave therapy in rehabilitative medicine.

The clinic at NYCIRG features the most advanced shockwave equipment available, enabling us to adjust the frequency, intensity, breadth and depth of tissue-specific shockwaves. Guidance with ultrasound imaging ensures that the shockwaves hit their mark, to produce optimal results.

Most injuries involve multiple tissue types, potentially affecting a combination of muscles, tendons, fascia, ligaments, bones, nerves and blood vessels. To target different tissue types, we combine four different types of shockwaves – focused, defocused, linear and radial – at no extra cost to the patient.

Our multi-modal approach to shockwave therapy allows us to vary the depth and width of penetration, zoom in to focus on specific tissues, and zoom out to cover larger areas. Research shows that combining focused electromagnetic and focused electrohydraulic waves produces superior results. All our shockwave sessions are supplemented with radial shockwave for fascia, to achieve holistic results.

SoftWave – a groundbreaking regenerative mechanotransduction technology – is the latest addition to our shockwave family. It delivers defocused and linear focused shockwaves to damaged tissues, recruiting maximum stem cells to the treatment site. SoftWave’s wider and deeper penetration using defocused energy is a preferred treatment option for a broad spectrum of conditions, ranging from orthopedic injuries to pelvic health.

High-Resolution Ultrasound Ensures Accuracy

Imaging approaches like Xray and MRI can help your doctor visualize your site of injury, but that often entails a trip to the lab, followed by days of waiting for results, seriously delaying your treatment and recovery. Moreover, those imaging modalities expose patients to dangerous radiation, and are inappropriate for certain populations.

At NYCIRG, we use the most advanced high-resolution ultrasound equipment for on-site imaging, giving us a clear picture of your injury on your very first visit. Dynamic ultrasound imaging is far superior to outdated imaging technologies like MRI that only provide static images of limited areas.

Advantages of ultrasound over MRI include:

Superior diagnostic tool, with 100x higher resolution over MRI for soft tissue imaging
Dramatically enhances the accuracy of shockwave therapy and orthobiologic procedures
Can clearly visualize long structures like muscles, bones and nerves along their entire path
Allows for dynamic imaging of the body’s structures in motion as they interact
Gives us crystal-clear images of fascial planes, densifications and ruptures
Lets us visualize muscle firing patterns during contraction
Allows us to compare injured tissues with undamaged tissues on the other side of the body
Allows for tissue analysis using sonoelastography and superb microvascular imaging
Multiple areas of the body can be scanned and analyzed in the same session, without harmful radiation
Fast, accurate and cost-effective diagnosis and treatment

High-Resolution Ultrasound Ensures Accuracy

In addition to being an invaluable diagnostic tool, high-resolution ultrasound
guidance enhances the accuracy and effectiveness of various treatments
and therapies such as:

Focal shockwave therapy
Orthobiologic injection therapies
Nerve hydrodissection

Myofascial release therapy
Trigger point dry needling

Our Technologies

In recent decades, technology has impacted almost every aspect of our lives, for better or worse. In the realm of rehabilitative medicine, technology has been an enormous boon for precise diagnosis and quantitative analysis, and provides multiple tools for tracking and measuring patient progress. Artificial intelligence and virtual reality augment interactive feedback training that restores functional pain-free movement.

The clinic at NYCIRG features some of the most advanced technologies available for musculoskeletal rehabilitation.

SoftWave Electro-Hydraulic Shockwave Therapy

SoftWave is a groundbreaking regenerative mechanotransduction technology that accelerates tissue healing. Its patented electro-hydraulic applicator delivers high-speed soundwaves that can penetrate up to six inches in depth. SoftWave’s defocused and linear focused shockwaves recruit maximum stem cells to the treatment site to promote healing. SoftWave’s wider and deeper penetration using defocused energy is a preferred treatment option for a broad spectrum of conditions, ranging from orthopedic injuries to pelvic health.

Extracorporeal Shockwave Therapy (ESWT)

Focused ESWT technology produces high frequency sound waves to stimulate the body’s own reparative mechanisms. ESWT helps to reduce pain and inflammation, increase circulation to targeted tissues, and stimulate the body’s innate healing mechanisms. Depending on the type, location and severity of damaged tissues, the effects of ESWT may be enhanced by other advanced technologies.

Extracorporeal Shockwave Therapy (ESWT)

Extracorporeal Magnetic Transduction Therapy (EMTT)

EMTT is a fairly new technology that transmits high energy magnetic pulses to targeted tissues. The magnetic waves synchronize with the body’s own magnetic fields, to trigger a reparative response. EMTT waves are able to target difficult-to-reach tendons, muscles, bones and nerves.

Myofascial Acoustic Compression Therapy (MyACT)

Our new PiezoWave shockwave machine features MyACT, a new type of focused shockwave technology that allows for deeper compression of the focused waves. Its higher frequency allows for precise neuro modulation under ultrasound guidance, with a special linear head for treating myofascial pain.
This innovative shockwave technology transforms the mechanical energy of shockwaves into biochemical signals that precisely target damaged tissues. Its versatile system of controls lets us fine-tune its output levels for precise and personalized patient care. With MyACT, we are able to repair and regenerate damaged tissues by stimulating the body’s own reparative mechanisms.

Myofascial Acoustic Compression Therapy (MyACT)

NESA Neuromodulation Therapy

The NESA device generates a biphasic low-frequency electrical current that travels through autonomic neural pathways, to restore optimal neural signaling to the brain.

Extracorporeal Pulse Activation Technology (EPAT)

EPAT, also known as defocused or radial shockwave therapy, uses acoustic pressure waves to enhance blood circulation to targeted tissues. Many practitioners use only radial shockwave therapy – aka EPAT – which is a pressure wave and not a true shockwave. EPAT does not have the same reparative potential as ESWT, and research shows that even focused shockwaves are less effective than ultrasound-guided ESWT.

Extracorporeal Pulse Activation Technology (EPAT)

High Energy Inductive Therapy (HEIT)

HEIT uses electromagnetic fields to penetrate cells, tissues, organs and bones, to reactivate optimal electrochemical function and stimulate healing of nerves, muscles and blood vessels.

INDIBA Radiofrequency Therapy

INDIBA technology converts electrical current into a stable frequency of 448 kHz, designed to increase the exchange of ions in damaged tissues and evoke a healing response.

INDIBA Radiofrequency Therapy

Localized Cryotherapy

Cold therapy has been used for centuries to treat soft tissue injuries, numb pain and reduce inflammation. Today, modern technology brings us a more efficient and effective means of leveraging cold therapy using nitrogen gas. When used with other therapies, localized cryotherapy helps to provide fast relief and speed recovery during the rehabilitation process.

Ultrasound Guided Therapies

We use ultrasound to guide many of our targeted therapies. Guidance with high resolution ultrasound ensures that our therapeutic techniques hit their mark, for maximum effectiveness.

Our Treatment Approach

Musculoskeletal pain and dysfunction are often diagnosed based on symptoms alone, and treatment zeros in on the locus of pain. This approach often fails, because the underlying cause of pain may originate elsewhere in the body. Nevertheless, insurance providers only compensate for location-specific treatment, tying the hands of providers, and relegating the patient to suboptimal results.

At NYCIRG, we take an integrative and holistic approach to patient care. Our goal is to identify the underlying cause(s) of your condition and resolve it. We treat the patient, not just the symptoms, with personalized treatment protocols and one-on-one therapy sessions geared to the individual. Our unique approach to rehabilitative medicine makes NYCIRG the clinic of choice for patients suffering from pain and disability in NYC.