SHORT WAVE IN THE TREATMENT OF BURSITIS WITH CALCIFICATION"
ABRAHAM J. GINSBERG, M.D.
Presented at the 36th Annual Meeting of the
CONGRESS OF PHYSICAL MEDICINE AND REHABILITATION
Philadephia, Pa., August 24-29, 1958
electrical energy in the treatment of disease has been with us
in many forms for more than two decades. Most modalities involve
continuous excitation of tissue for the duration of treatment at
energy transfer rates which produce pyrexia—to the extent that
heating was at one time considered the source of benefit to
patients. This regime was named diathermy.
1935 the technique of pulsed short wave therapy, which does not
produce pyrexia, has rather radically changed (1) our
physiological explanations. 2 our regimes, (3) the syndromes
which indicate short wave therapy, and (4) our clinical
effectiveness. Original experimentation with laboratory animals,
and extensive clinical experience, confirm the relative safety
and efficacy of this new approach. In addition new applications
of electrotherapy are made possible.
data given here relates to subdeltoid bursitis with associated
calcification in 94 patients as treated by me over a period of 1
5 years with pulsed short wave therapy.
that 1 used for treatment delivered short bursts of power at the
usual and assigned medical frequencies. Each burst persisted
only 50 microseconds, but at the high instantaneous power level
of 1300 watts. Two operating settings were used. one at 400
pulses per second and the other at 600 pulses per second. Thus
the period of emanation of energy was only 1/50th or 1/33rd of
the elapsed time, and average level power delivery to patient
less than 18 or 25 watts.
treatment could be administered for indefinite periods without
measurable pyrexia (as indeed it has been on laboratory
animals), the procedure followed here in treating the 94
calcified bursitis cases was uniform as follows: 10 minutes of
irradiation at 600 pulses per second and maximum setting of 6 on
the penetration dial over the affected area (right or left
deltoid), plus 10 minutes each of irradiation at 400 pulses per
second and a setting of 4 on the penetration dial over both the
liver and the adrenals.
not disrobe. The treatment head of the unit ( 10 ) inches in
diameter was as placed against the patient. Treatments were
given at frequencies varying from a day to twice a week, and the
average was three times a week.
The exposure of
the liver and the adrenals in addition to conviction and long
experience that the centers of the host defense mechanism are as
important to treat as the affected area. Mounting clinical
evidence and current basic research lend encouragement to the
procedures I have followed since 1 935.
exhibited by patients before treatments started varied from mild
to excruciating pain accompanied by limitation of motion. Some
patients said they came for treatment immediately after feeling
the first symptoms, while others said they were seeking ielief
after months and even years of intermittent pain.
More than half
of the 94 patients claimed to have received one or more other
forms of treatment including aspiration of the bursa, diathermy,
immobilization, Vitamin B injections, local anesthesia, massage,
novocaine injections, surgery, osteopathic manipulations and
All 94 of the
bursitis cases reported here were X-rayed prior to treatment to
demon- strate the presence of calcium. Since many of the
patients were referred by other physicians. it was not possible
to insist that they continue treatment after pain and symptoms
were relieved. Since the period of treatment required to show
evidence of decalcification is three or four times as long as
the period required to restore mobility and comfort, only 46 of
my patients continued treatment to the point at which final
investigation with X-ray of decalcification could be made.
In these 46
cases, Thefore and after" shoulder X-rays are available for
comparative study together with the case history file cards. The
average number of treatments per patient for these 46 cases, was
thirty over periods of ten to twelve weeks. Symptoms were
relieved after 6 to 8 treatments during the first two or three
weeks of therapy.
I summarizes the symptomatic relief, and Table H the calcium
absorption ap- parent on X-rays, in all of the cases.
before beginning treatment *
before and after treatment
Patients discontinued after symptomatic relief; i.e., after only
ABSORPTION APPARENT ON X-RAYS
the table shows 91 % efficacy in reducing calcification ( 52%
complete) and 96% efficacy in relieving
symptoms when treatment is protracted to 30 or 35 irradiations
(10 minutes over the deltoid, 10 over the liver and 10
adrenals each time) within 15 weeks. It also shows 87% efficacy
in relief of symptoms after the first 2 or 3 weeks of treatment.
use of pulsed short wave for treatment, without
drugs or other thera- peutic modalities,
produces impressive clinical results in calcified bursitis.
1. Pulsed short
wave shows an effectiveness of 87.5% in
relieving symptoms, even after an
incomplete course of treatment lasting 2-3 weeks.
2. Pulsed short wave shows a 91.3% effectiveness in
relieving symptoms after a complete course of treatment
lasting 10-12 weeks.
3. Most important of all, pulsed short wave shows
a 91.3% efficacy in reducing calcification
with 52.1 % complete absorption of calcium
GINSBERG, A. J.: A
description of my athermic
shortwave apparatus with clinical applications.
Paper presented at the New York Academy
“Fortnight on Infections,” October 14-25,
2. HALSEY, H. R.: Communication to the author.
December 15, 1940.
3. HALSEY, H. R.: Communication to the author.
October 6, 1941
4. DECAMP, C. E.: New type of diathermy in
small-animal practice: preliminary report. North Am.
5. GOLDMAN, H.: Report.
Transactions of the Thirty-fifth Annual Session of the American
6. GOODCHILD. F. M.: Affidavit. June 3. 1941.
7. SHIFFMAN, M., and SAFFORD, F. K. Jr.:
Pulsating high voltage short wave: a preliminary clinical
Physiotherapy Review 23:6 (Nov.-Dec.)
8. BRUCKHEIMER. R. M.: Communication to the
author. December 26, 1944.
9. KNAUF, G. M.: Communication to the author. April 17,
10. GRAD, I.: Report to author. November 1 2. 1957.