What is EPAT®?

EPAT® stands for Extracorporeal Pulse Activation Technology.  EPAT® is a form of ESWT (Extracorporeal Shock Wave Therapy) which is an evidence-based, emerging, proven treatment option for patients suffering from both acute and chronic musculoskeletal injuries. This technology was developed in Europe and is considered a standard of care in most of the world for treating chronic musculoskeletal conditions.  If you are tired of being in pain and not able to participate in activities you love, EPAT could be right for you.

How does EPAT® work?

EPAT® uses acoustic pressure waves to safely increase metabolism and blood flow, stimulating or enhancing healing of the injury.  The microtrauma induced, triggers a cascade of inflammatory factors such as cytokines and chemokines that help regenerate the damaged tissue.  These inflammatory factors are essential for healing and are present at high levels in acute injuries, but diminish or cease to exist over time in chronic injuries.  Think of EPAT® as a way of pushing the reset button on healing.

Examples of conditions treated with EPAT®:

• Plantar Fasciitis  
• Achilles Tendonitis  
• Posterior Tibial Tendonitis
• Anterior Tibial Tendonitis
• Plantar Plate Injuries
• Peroneal Tendonitis
• Interdigital Neuromas

Who is a candidate for EPAT® technology?

We recommend EPAT® for acute injuries as part of first line therapy, since it will allow for a faster recovery, so that you can return to the activities you love. It is also recommended for patients coming to us with chronic injuries who have failed to respond to other therapies. EPAT® allows our patients to avoid major downtime during treatment.

How do I prepare for a EPAT® procedure?

We recommend patients discontinue all anti inflammatories at least 1 week prior to the procedure.  This includes Ibuprofen (Advil), Aleve and all prescription anti inflammatories. Since EPAT® produces an inflammatory response, it is important to taking avoid anti-inflammatory medications, since they will inhibit this inflammatory response. Tylenol is allowed since it is not an anti inflammatory.

What should I expect from EPAT®?

Treatment is performed in the office and usually consists of 3 sessions on a weekly basis.  Patients with more chronic injuries may require a 4th or 5th treatment. EPAT is usually well tolerated and does not usually require the uses of any use of anesthesia or nerve block.  A hand held applicator along with coupling gel is applied to the skin over each of the injured areas. Patients will then be exposed to a series of pulses, which will slowly be increased as tolerated to a therapeutic level during the session.  Expect each session lasts 10-15 minutes. Most patients will leave the office with a temporary reduction in pain.  Patients are able to walk out of the office and resume normal weight bearing activities.

Are there any risks to EPAT®?

EPAT® is FDA cleared for the treatment of acute and chronic musculoskeletal pain and connective tissue disorders; there are no known risks or complications.

When will I see improvement from EPAT®?

Patients may begin to see improvement 4 weeks after their last treatment.  More significant improvement often occurs 8-12 weeks after the last treatment.

What are the success rates of EPAT®?

Over 80% of patients see significant or complete resolution of symptoms.  

Are there any contraindications with EPAT®?

EPAT® is not recommended for patients on blood thinners, those with malignancies and those who are pregnant.

Is EPAT® covered by insurance?

EPAT® is an elective pay modality and is not covered by insurance.