Dr. Chin Discusses A Regenerative Treatment Approach That Successfully Combines EPAT and Amniotics
For many physicians, EPAT (Extracorporeal Pulse Activation Technology), often referred to as ESWT or shockwave therapy, has proven to be a highly effective method for treating acute and chronic musculoskeletal pain. A growing number of doctors are seeing even better outcomes when combining EPAT/ESWT with biologic solutions that help repair and rebuild soft tissue.
For Dr. Michael Chin, renowned DPM and Founder of The Running Institute in Chicago, this type of “combined” approach involves both radial and focused EPAT treatment along with amniotics. To learn more, we sat down with Dr. Chin to discuss his experience.
Q: Which solutions have you integrated into your practice and for how long have you been using them?
A: For shockwave, I first connected with CuraMedix in 2012 when I incorporated radial shockwave and most recently added focused shockwave – both STORZ Medical devices. We then added amniotics (Amniox) about four years ago.
Q: For which medical conditions do you typically use this approach?
A: I’ve seen the best results in patients with chronic fasciopathy or chronic tendinosis along with an interstitial tear. These conditions are usually identified on either an MRI or via ultrasound – and both conditions can be picked up pretty easily though imaging systems. All in all, I’ve seen exceptional results for nearly 60 patients with these conditions: 2/3 of them were for plantar fasciitis, and 1/3 for Achilles tendinosis.
Q: How important are imaging systems?
A: Extremely important! Especially in the diagnostics phase. Many patients come to us for a second or third opinion after seeing other physicians with no clear diagnosis or treatment plan. For my practice, high-resolution imaging really helps narrow down and identify what it is truly causing a problem. From there, I can direct treatment far more effectively as opposed to just guessing.
Q: Can you discuss the main benefit of using both focused and radial shockwave?
A: The huge benefit of using both is the increased angiogenic response – the patient is getting more vascular flow to the area, in addition to the mechanical changes that occur in the soft tissue. Basically, we see a breakdown of the scar tissue. This allows the pain receptors to respond in a favorable way while getting the tissue to remodel.
Q: And what’s the main advantage of using amniotics?
A: With an amniotic injection, the stem cell activators within the adult stem cells in the tissue create the tissue backbone. There’s basically a cascade of elements that kickstart that healing process. One analogy of the combined approach is that it’s like a garden – with EPAT, you’re watering the ground for the plants to grow, then with amnio, you’re adding the fertilizer.
Q: How have you seen this approach impact patient outcomes?
A: In the cases where the fascial tears were more chronic, there has been significant improvement for these patients when we combined the two – I would say close to a 95% success rate.
Q: Can you describe what a typical treatment protocol might look like?
A: It’s based on the patient’s pain scale, but is typically about a 4-week treatment plan. In week one, I would apply both radial and focused shock wave to the affected area – about 2,000 pulses using focused shock wave to treat the point of most pain and then 2,000 pulses to treat the surrounding tissue. In week two, I might increase the intensity of treatment, using ultrasound to target the amnio treatment to the point of interest, followed with a boot immobilizer. The third week would be a repeat of week one, with a final EPAT/ESWT treatment one week later and follow-ups as needed.
Q: What do you think is the biggest benefit to your patients?
A: Expedited healing. This treatment approach speeds up the process and patients can avoid surgery – and avoid the expensive tab that often comes with surgery. Not only that, but this treatment method actually repairs and rebuilds the tissue for longer lasting healing.
Want to Learn More About EPAT/ESWT?
EPAT/ESWT is today’s most advanced, non-invasive technology for treating pain. It is evidence-based and clinically proven. Learn more when you download our white paper, The Art of Shockwave.