Swiss DolorClast ® Brochure - Ortho Providers

EXTRA-
CORPOREAL
SHOCKWAVE
THERAPY

Swiss DolorClast ® - FDA Class III Approved.

Swiss DolorClast ® - FDA Class III Approved.

Substance P plays a central role as a pain-mediator and growth factor.
> Shockwaves lead to depletion of substance P out of its storing vesicles.
> This molecular mechanism explains the long lasting analgesic effect of shockwaves.
Furthermore, substance P has been shown to dilate blood vessels, stimulate neovascularization
and contribute to new bone formation.
> Shock waves stimulate the early expression of angiogenesis related growth factors including
eNOS (endothelial nitric oxide synthase), VEGF (vessel endothelial growth factor) and PCNA
(proliferating cell nuclear antigen). This promotes neovascularisation that improves blood supply
and increases cell proliferation and tissue regeneration to repair tendon or bone tissues.
> Scientific studies show that shockwaves, and the overstimulating of small nerve fibers, block an
increase in pain stimuli and thus intensify the analgesic effect (Melzak and Wall, Gate Control Theory).
Scientific Background
1. Hausdorf J, Schmitz C, Averbeck B, Maier M. - Molecular basis for pain mediating properties of extracorporeal shock waves
Schmerz. 2004 Dec;18(6):492-7. German.
2. Maier M, Averbeck B, Milz S, Refior HJ, Schmitz C. - Substance P and prostaglandin E2 release after shock wave application to the rabbit femur.
Clin Orthop Relat Res. 2003 Jan;(406):237-45.
3. Wang CJ. - An overview of shock wave therapy in musculoskeletal disorders.
Chang Gung Med J. 2003 Apr;26(4):220-32. Review.

Substance P plays a central role as a pain-mediator and growth factor.
> Shockwaves lead to depletion of substance P out of its storing vesicles.
> This molecular mechanism explains the long lasting analgesic effect of shockwaves.
Furthermore, substance P has been shown to dilate blood vessels, stimulate neovascularization
and contribute to new bone formation.
> Shock waves stimulate the early expression of angiogenesis related growth factors including
eNOS (endothelial nitric oxide synthase), VEGF (vessel endothelial growth factor) and PCNA
(proliferating cell nuclear antigen). This promotes neovascularisation that improves blood supply
and increases cell proliferation and tissue regeneration to repair tendon or bone tissues.
> Scientific studies show that shockwaves, and the overstimulating of small nerve fibers, block an
increase in pain stimuli and thus intensify the analgesic effect (Melzak and Wall, Gate Control Theory).
Scientific Background
1. Hausdorf J, Schmitz C, Averbeck B, Maier M. - Molecular basis for pain mediating properties of extracorporeal shock waves
Schmerz. 2004 Dec;18(6):492-7. German.
2. Maier M, Averbeck B, Milz S, Refior HJ, Schmitz C. - Substance P and prostaglandin E2 release after shock wave application to the rabbit femur.
Clin Orthop Relat Res. 2003 Jan;(406):237-45.
3. Wang CJ. - An overview of shock wave therapy in musculoskeletal disorders.
Chang Gung Med J. 2003 Apr;26(4):220-32. Review.

Kinetic energy is converted into impact energy,
as illustrated by Newton’s Cradle.

The advantage of extracorporeal shockwaves is that
they produce an analgesic effect on the treated area.
The unfocused propagation of the shockwaves extends
to the entire area where pain occurs.

The advantage of extracorporeal shockwaves is that
they produce an analgesic effect on the treated area.
The unfocused propagation of the shockwaves extends
to the entire area where pain occurs.

1. Locating the area of pain by palpation 2. Marking the treatment area
3. Applying the contact gel 4. Delivering the shockwaves

1. Locating the area of pain by palpation 2. Marking the treatment area
3. Applying the contact gel 4. Delivering the shockwaves

Heel pain is a “catch-all term” for any condition that can occur around the heel. The most common
of these conditions is known as PLANTAR FASCIITIS. The plantar fascia (PF) is a strong ligament (tensile
strength of 4000 lbs/sq. inch) that is located along the under surface of the foot, extending from the base of
the toes to the heel bone (calcaneus). The PF is almost as wide as the foot and plays an important role in
support of the foot as well as function.
> When the plantar fascia is strained due to overuse, improper shoes, or abnormal foot structure, it can
initially become irritated and painful. As we get older, tissues become less flexible and the PF can become
strained from something as simple as walking a full day in Disneyworld with non supporting, flat shoes.
Although most people have heel pain that lasts only a couple of days, many have repeated episodes of PF
strain leading to the development of scar tissue in the plantar fascia. It is thought that this scar tissue is the
cause of chronic heel pain also known as plantar fasciosis. Although heel spurs (a small forward projection
of bone under the heel) are related to plantar fasciitis, research has shown that permanent elimination of
heel pain caused by plantar fascioses does NOT require the removal of the heel spur.
> Plantar fasciitis is diagnosed with the classic symptoms of pain well localized over the heel area of the
bottom of the foot. Often the pain from plantar fasciitis is most severe when you first stand on your feet in
the morning. Pain often subsides quite quickly, but then returns after prolonged standing or walking.
> Plantar fasciitis is most often seen in middle-aged men and women, but can be found in all age
groups. The condition can be seen in people with high arches, normal arches, and flatfeet. Activities that
seem to initiate PF are people who change their heel height on shoes from normal to flat heels; walking or
running on a soft surface with non supporting shoes; taking on an exercise program and doing too much,
too fast, and standing for long periods of time on a hard surface.
> Plantar fasciitis is sometimes, but not always, associated with overweight people. It is sometimes seen
in recreational athletes, especially runners. In these athletes, it is thought that the repetitive nature of the
sport causes damage to the tissue at the attachment of the PF to the heel.
> Symptoms of plantar fasciitis are typically worsened early in the morning after sleep. At that time, the
arch tissue is tight and simple movements stretch the contracted tissue. As you begin to loosen the foot, the
pain usually subsides, but often returns with prolonged standing or walking.

“
The Weil Foot & Ankle Institute has been involved with Extracorporeal
Shockwave Therapy (ESWT) since 2000 and was the first group in the USA
to publish the results of this treatment for plantar fasciosis. Since that time,
I have been the principal investigator on three FDA studies using different
ESWT technologies (electrohydraulic, piezoelectric, and pneumatic technology
– Swiss DolorClast ® ). Much to our surprise, the double blinded results of the Swiss
DolorClast ® superseded the results of the other two technologies while offering
a tolerable treatment, over three sessions, without the use of sedation or even local anesthetic.
We believe that ESWT with the Swiss DolorClast ® will be an important addition to treatment
of the podiatric, orthopaedic, and sports medicine patients. ”
“
We had excellent experiences with the Swiss DolorClast ® , and I can fully recommend it. It is a
valuable part of a modern treatment concept. Through(out) our international network, we have treated
many professional athletes, and in no time they were all back in the game thanks to this non-invasive and
gentle treatment.
The medical community has only just begun to discover the possibilities of this treatment. ”
“
The Institute of Biomechanics and Orthopaedics of the German Sport
University Cologne has been working with Extracorporeal Shockwaves Therapy
(ESWT) for several years, with respect to clinical applications as well as basic
research concerning its effects on a cellular level.
During my personal experience with the Swiss DolorClast ® as the attending
medical professional of ATP tennis players, I have observed an increased relevance
of this therapy in the field of sports medicine and in the care of professional athletes.
Based on our clinical application and various experimental research projects, extracorporeal
shockwaves seem to be a successful and simple form of therapy for orthopaedic disorders. ”

“
The OrthoTrauma Clinic has investigated safety and effectiveness of
repetitive low-energy shock wave treatment without local anaesthesia for patients
with chronic plantar fasciopathy (plantar heel pain).
ESWT with the Swiss DolorClast ® device was effective in about 60%
of cases. No rupture of the plantar fascia occurred, no side effects with the
exception of bruising were recorded.
Extracorporeal Shockwave Therapy (ESWT) is an important addition to
treatment options for patients with recalcitrant plantar fasciopathy. ”
“
Heel pain can become a “chronic disease” which has a negative effect on a
patient’s quality of life. Since the results of surgery are not guaranteed, extracorporeal
shockwave therapy with the Swiss DolorClast ® provides an attractive alternative for
the treatment of chronic heel pain syndrome. I am impressed by the high success rate
and lack of complications in our study patients. ”
“
Swiss DolorClast ® is our permanent companion on ATP’s tennis tournaments and has become
increasingly popular with players. ”
“
For plantar fasciitis the dolorclast system is incredibly convenient for doctor
and patient. No need for anesthesia. “On the spot” in office delivery of therapeutic
shockwaves. Safe, effective and well tolerated.
Everyone should have one! ”

“
The OrthoTrauma Clinic has investigated safety and effectiveness of
repetitive low-energy shock wave treatment without local anaesthesia for patients
with chronic plantar fasciopathy (plantar heel pain).
ESWT with the Swiss DolorClast ® device was effective in about 60%
of cases. No rupture of the plantar fascia occurred, no side effects with the
exception of bruising were recorded.
Extracorporeal Shockwave Therapy (ESWT) is an important addition to
treatment options for patients with recalcitrant plantar fasciopathy. ”
“
Heel pain can become a “chronic disease” which has a negative effect on a
patient’s quality of life. Since the results of surgery are not guaranteed, extracorporeal
shockwave therapy with the Swiss DolorClast ® provides an attractive alternative for
the treatment of chronic heel pain syndrome. I am impressed by the high success rate
and lack of complications in our study patients. ”
“
Swiss DolorClast ® is our permanent companion on ATP’s tennis tournaments and has become
increasingly popular with players. ”
“
For plantar fasciitis the dolorclast system is incredibly convenient for doctor
and patient. No need for anesthesia. “On the spot” in office delivery of therapeutic
shockwaves. Safe, effective and well tolerated.
Everyone should have one! ”

“
The OrthoTrauma Clinic has investigated safety and effectiveness of
repetitive low-energy shock wave treatment without local anaesthesia for patients
with chronic plantar fasciopathy (plantar heel pain).
ESWT with the Swiss DolorClast ® device was effective in about 60%
of cases. No rupture of the plantar fascia occurred, no side effects with the
exception of bruising were recorded.
Extracorporeal Shockwave Therapy (ESWT) is an important addition to
treatment options for patients with recalcitrant plantar fasciopathy. ”
“
Heel pain can become a “chronic disease” which has a negative effect on a
patient’s quality of life. Since the results of surgery are not guaranteed, extracorporeal
shockwave therapy with the Swiss DolorClast ® provides an attractive alternative for
the treatment of chronic heel pain syndrome. I am impressed by the high success rate
and lack of complications in our study patients. ”
“
Swiss DolorClast ® is our permanent companion on ATP’s tennis tournaments and has become
increasingly popular with players. ”
“
For plantar fasciitis the dolorclast system is incredibly convenient for doctor
and patient. No need for anesthesia. “On the spot” in office delivery of therapeutic
shockwaves. Safe, effective and well tolerated.
Everyone should have one! ”

“
The OrthoTrauma Clinic has investigated safety and effectiveness of
repetitive low-energy shock wave treatment without local anaesthesia for patients
with chronic plantar fasciopathy (plantar heel pain).
ESWT with the Swiss DolorClast ® device was effective in about 60%
of cases. No rupture of the plantar fascia occurred, no side effects with the
exception of bruising were recorded.
Extracorporeal Shockwave Therapy (ESWT) is an important addition to
treatment options for patients with recalcitrant plantar fasciopathy. ”
“
Heel pain can become a “chronic disease” which has a negative effect on a
patient’s quality of life. Since the results of surgery are not guaranteed, extracorporeal
shockwave therapy with the Swiss DolorClast ® provides an attractive alternative for
the treatment of chronic heel pain syndrome. I am impressed by the high success rate
and lack of complications in our study patients. ”
“
Swiss DolorClast ® is our permanent companion on ATP’s tennis tournaments and has become
increasingly popular with players. ”
“
For plantar fasciitis the dolorclast system is incredibly convenient for doctor
and patient. No need for anesthesia. “On the spot” in office delivery of therapeutic
shockwaves. Safe, effective and well tolerated.
Everyone should have one! ”

“
The OrthoTrauma Clinic has investigated safety and effectiveness of
repetitive low-energy shock wave treatment without local anaesthesia for patients
with chronic plantar fasciopathy (plantar heel pain).
ESWT with the Swiss DolorClast ® device was effective in about 60%
of cases. No rupture of the plantar fascia occurred, no side effects with the
exception of bruising were recorded.
Extracorporeal Shockwave Therapy (ESWT) is an important addition to
treatment options for patients with recalcitrant plantar fasciopathy. ”
“
Heel pain can become a “chronic disease” which has a negative effect on a
patient’s quality of life. Since the results of surgery are not guaranteed, extracorporeal
shockwave therapy with the Swiss DolorClast ® provides an attractive alternative for
the treatment of chronic heel pain syndrome. I am impressed by the high success rate
and lack of complications in our study patients. ”
“
Swiss DolorClast ® is our permanent companion on ATP’s tennis tournaments and has become
increasingly popular with players. ”
“
For plantar fasciitis the dolorclast system is incredibly convenient for doctor
and patient. No need for anesthesia. “On the spot” in office delivery of therapeutic
shockwaves. Safe, effective and well tolerated.
Everyone should have one! ”

“
The OrthoTrauma Clinic has investigated safety and effectiveness of
repetitive low-energy shock wave treatment without local anaesthesia for patients
with chronic plantar fasciopathy (plantar heel pain).
ESWT with the Swiss DolorClast ® device was effective in about 60%
of cases. No rupture of the plantar fascia occurred, no side effects with the
exception of bruising were recorded.
Extracorporeal Shockwave Therapy (ESWT) is an important addition to
treatment options for patients with recalcitrant plantar fasciopathy. ”
“
Heel pain can become a “chronic disease” which has a negative effect on a
patient’s quality of life. Since the results of surgery are not guaranteed, extracorporeal
shockwave therapy with the Swiss DolorClast ® provides an attractive alternative for
the treatment of chronic heel pain syndrome. I am impressed by the high success rate
and lack of complications in our study patients. ”
“
Swiss DolorClast ® is our permanent companion on ATP’s tennis tournaments and has become
increasingly popular with players. ”
“
For plantar fasciitis the dolorclast system is incredibly convenient for doctor
and patient. No need for anesthesia. “On the spot” in office delivery of therapeutic
shockwaves. Safe, effective and well tolerated.
Everyone should have one! ”

*
> The number of potential patients is very high.
> Anyone who suffers from chronic heel pain may be treated with the Swiss DolorClast ® method.
> It is a proven alternative to surgery.
> It offers a new and promising alternative to patients who are surgery candidates or are resigned to
their condition and no longer seek therapy.
> Today, many more patients are able to afford Extracorporeal Shockwave Therapy because compared
to other methods the Swiss DolorClast ® method is much more economical.
Patients per month
x
Applications per patient
Total applications
x
Charge per application
Monthly revenue

Display desired impulse count per treatment
Display current impulse count
Display operating frequency
Increase impulse count per treatment
Reduce impulse count per treatment
Increase operating frequency
Reduce operating frequency
On/Off with indicator light
Handpiece connection
“Select” to activate change in preset impulse count
“Validate” to confirm setting
Single-impulse operation
Continuous impulse operation
Manometer for operating pressure
Operating pressure regulator
Handpiece
Cable holder
Bottle holder (gel)
Drawer
Compressor compartment

Electro Medical Systems (EMS) has been setting standards in the development and production of medical
devices since 1981. Each product is individually produced and tested in Switzerland – with Swiss precision.
> EMS is one of the world’s leading manufacturers of prophylactic dental devices.
> With over 8,000 Swiss LithoClast ® devices in daily use, EMS is the world’s largest supplier
of intracorporeal shockwave lithotriptors for the treatment of kidney, ureteric and bladder stones.
> With its patented Swiss DolorClast ® , EMS offers products that benefit from the expertise and EMS
offers a product defined experience with pneumatically generated shockwaves. Since its market introduction
in 1999, Swiss DolorClast ® has been the reference for successful pain therapy and has made EMS the number
one in Shockwave Therapy.
> Like all EMS products, Swiss DolorClast ® meets the highest European and international
quality standards.
> Product certification: FDA Class III Medical Device, ISO 9001, ISO 13485 (Medical Devices),
and CE Mark.
> EMS is a promoting member of the ISMST (International Society for Musculoskeletal Shockwave
Therapy), an official member of DIGEST (German and International Society for Extracorporeal Shockwave
Therapy) and supports ATRAD (Association for Radial Pain Therapy).

CAUTION! Federal law restricts this device to sale by or on the order of a physician.