High energy laser therapy

High-energy laser therapy has anti-inflammatory and analgesic effects. In addition to the pain-relieving effect, bio-stimulation causes rapid tissue regeneration and dissolution of bruises (hematomas).
High-energy, focused laser light stimulates blood flow in the treated tissue and improves metabolism. The cells stimulated in this way increase their metabolism and cell regeneration is stimulated. Inflammatory products and fluid accumulation are eliminated more quickly and healing processes are accelerated by increasing lymphatic and venous microcirculation.

Furthermore, stimulation of endorphin release can be observed, which makes the laser highly suitable as a pain therapy for the treatment of inflammatory and traumatic changes of the musculoskeletal system, as they occur especially after operations or accidents. Especially after surgical interventions, the use of a high-energy laser leads to faster hematoma resolution and tissue regeneration, as well as pain reduction.

Extracorporeal shock wave therapy

Shock waves are high-energy mechanical waves whose effect can be focused precisely on the damaged tissue. Molecular medicine studies have shown that shock waves change the environment of the treated tissue, dissolve calcium, inflamed degenerative tissue dies and thus a repair process is initiated. In addition, shock waves promote the release of growth factors and stem cells that boost tissue regeneration. An additional effect is the pain reduction of shock wave therapy, which is caused by the blocking of pain receptors or changes in the cell membrane, so that the pain transmission is stopped.

There are 2 types of extracorporeal shock wave therapy:

  • High-energy focused shock wave therapy, which is used primarily for deep tissue inflammation. Using ultrasound, the area to be treated is localized and, if necessary, anesthetized with local anesthetic, since the shock wave develops a high intensity. Permanent healing can be achieved after only 3 – 6 sessions.
  • Radial shock wave therapy, which is used primarily to treat muscular trigger points. Trigger points or also called myogeloses are the most common and also the most misunderstood cause of musculoskeletal pain. These are so-called contraction nodes of the muscles, so that the muscle fibers can no longer slide apart. You can palpate these points very well and often they also lead to transmitted pain syndromes, such as tendonitis. Radial shock wave therapy is good at softening muscles and breaking up trigger points.

Areas of application of shock wave therapy are:

  • acute and chronic pain in the cervical, thoracic and lumbar spine
  • Herniated disc
  • degenerative changes in the vertebral joints
  • Sciatic pain
  • Low back pain
  • Muscle pain
  • Shoulder pain
  • Calcifications in the shoulder
  • Rotator cuff Inflammation
  • Tennis elbow
  • Rizarthrosis, pain in the metacarpophalangeal joint of the thumb
  • degenerative changes in the wrist
  • Sports injuries to tendons and joints and the spine, bone bruise, bone edema
  • Osteoarthritis in hip and knee joints with soft tissue pain
  • Soft tissue pain in the hip region
  • Patellar tendinitis, jumper‘s knee, runner’s knee
  • Acute and chronic Achilles tendinitis
  • Achilles tendon rupture, Achilles tendon swelling
  • Heel pain due to lower or upper heel spur, plantar fasciitis
  • Hallux pain, metatarsalgia
  • Morton’s disease
  • Spontaneous fractures

Trigger Punt Therapy

If a muscle has to work at 50% of its maximum force for a longer period of time, this leads to a usually painful undersupply of blood in individual fiber bundles. Thus, permanently stressed muscles shorten and especially one-sided activities (sitting, assembly line work, VDU work, sports) lead to the development of certain tension patterns (myofascial pain syndromes). These are caused by the formation of these myogeloses or trigger points. In addition to the application of radial shock wave therapy, an extremely successful treatment of these so-called myofascial pain syndromes or trigger points is the so-called “needling”. This involves locating the trigger point and then pricking it with a thin needle. Ideally, the muscles twitch and relax, breaking up the myogelosis. Preferably, a local anesthetic is injected into the muscles at the same time, so that the pain memory is erased, muscle metabolism normalizes and the muscles can therefore relax and regenerate. This results in a permanent elimination of muscular or tendon complaints.

Manual medicine

Another way to identify and treat pathological joint structures and joint dysfunctions, as well as functional disorders of the spine, is manual medicine (chiropractic).

Here, the functionally disturbed movement segment is examined in its entirety and repaired.

Due to blocks caused by incorrect loading, reflexive processes as in myofascial pain syndromes and structural joint changes, the functional unit of controlling nervous system and musculature and joint is disturbed.

Effects include mechanical sequelae with limited mobility, pain and dysfunction, as well as remote effects on the musculoskeletal system, including internal organs.

In manual medicine, the disturbed movement segment is mobilized and brought to the tension of the end of movement. In the next step, manipulation, the set tension is held as a preload, the motion segment is locked and mobilized on a trial basis and pushed or pulled in the planned treatment direction. This deblocks the motion segment again, which is usually noticeable as a “cracking” sound.



Injections into joints, spine, tendons, ligaments and muscles can achieve great success for pain symptoms in the musculoskeletal system and also facilitate manual therapy. There are several techniques to make the structures painless. Whereby the large and small joints – after appropriate hygienic disinfection and using sterile syringes and needles – can be made painless with the infiltration technique.

In most cases, a drug is used that has an anesthetic, i.e. pain-reducing, effect (e.g. xyloneural). It is important not only to infiltrate the joint, but also to treat the skin, the tissue under the skin, the capsule of the joint and the joint itself.

At the spine, there are various superficial techniques (e.g., wheal, deep subcutaneous or muscular infiltrations), as well as deep infiltrations that can be approached up to the vertebral joint and the nerve exit site coming from the spinal cord. A special form is the so-called epidural infiltration, where in the sense of neural therapy, the spinal canal is flooded with local anesthetic, inflammation is inhibited and thus the nerves of the spinal cord are reprogrammed and can recover.

The goal of infiltration treatment, as in manual medicine, is pain reduction and restoration of disturbed functions.


Especially when it comes to infiltrating joints, tendons or even the spine, it is highly recommended to perform this with the help of an imaging procedure to guarantee the correct fit of the needle and not to injure surrounding structures. Injection monitoring by ultrasound has now become the gold standard due to its excellent resolution and patient convenience. In my practice, all structures are infiltrated only under ultrasound control to ensure the best possible result.