Axomera: neuromodulative signal therapy in Hamburg

What is Axomera?

Axomera is a neuromodulative, locally applied therapy. Weak electrical signals are sent to pain-relevant nerves or irritated tissue (e.g. tendon attachments) via fine probes/electrodes. The impulses are designed to modulate the activity of pain fibers and inflammatory mediators and thus reduce symptoms. It is not an operation or an injection of medication; the treatment takes place on an outpatient basis.

• Goal: Influencing pain and inflammatory processes (neuromodulation)
• Outpatient, minimally invasive, usually without anesthesia
• Complements conservative measures such as physiotherapy, load management and training build-up

Active principle: Bioelectric neuromodulation

Axomera signals address neural and cellular mechanisms involved in pain, overstimulation and healing. Through targeted impulse protocols, nociceptive (pain-conducting) signals can be weakened and local regulatory processes in tendons, ligaments and soft tissues can be positively influenced. In practice, the probe is guided to the anatomically relevant point; The signals have a local effect; systemic effects are not to be expected.

• Modulation of peripheral nerves and pain-conducting C and Aδ fibers
• Influence on neurogenic inflammation and tissue homeostasis
• No pharmacological substance administration, therefore low systemic side effects

Indications: For which complaints can Axomera be considered?

Axomera is primarily considered for chronic, therapy-resistant complaints - especially when guideline conservative measures (load adjustment, physiotherapy, possibly shock waves or infiltrations) have been exhausted. The decision must be made individually and after examination.

• Tendon insertion problems (tendinopathies): tennis elbow, golfer's elbow, Achilles tendon, patellar tendon
• Irritation of the plantar fascia/heel spur (plantar fasciopathy)
• Painful nerve congestion or irritation (e.g. Morton's neuralgia)
• Muscular myofascial trigger points and chronic soft tissue pain
• Osteoarthritis-related pain in early to middle stages (multimodal concept)
• Postoperative or posttraumatic pain persistence (after structural causes have been clarified)

Not all ailments are suitable for Axomera. If there is significant structural damage, unstable conditions or advanced osteoarthritis, other procedures come to the fore.

Process of treatment in our practice

• Treatment duration per session: usually 15-30 minutes
• Number of sessions: individual; often 1-4 applications
• Sport/everyday life: dosed return-to-work recommendations based on findings

Evidence: What is proven and what is not?

Axomera is one of the newer neuromodulatory procedures. There are positive reports and growing clinical data for selected indications, particularly tendinopathic pain and certain nerve-related pain syndromes. Randomized, high-quality studies are partly available, but the overall evidence is still limited compared to established standard procedures.

• We only use Axomera after careful indications and as part of a conservative overall concept.
• Success cannot be guaranteed; individual response rates vary.
• We provide transparent information about the data situation, possible alternatives and costs.

Opportunities and limits

• Potential advantages: Gentle, locally effective, can be combined with training therapy and physiotherapy.
• Target group: Patients with persistent symptoms despite standard therapy.
• Limitations: Structural defects (e.g. complete tendon rupture) cannot be corrected with this.
• Realistic expectations: Symptom relief and functional gain are possible, but cannot be predicted with certainty.

Risks, side effects and contraindications

Overall, the treatment is considered to be well tolerated. As with all minimally invasive procedures, undesirable effects are possible, usually temporary.

• Common: short-term irritation, feeling of pressure, temporary increase in pain
• Rare: small hematomas, local skin irritations
• Very rare: infection at the bite site

Contraindications and caution:

• Active local infection
• Severe coagulation disorders/anticoagulation (individual assessment)
• Do not use implanted pacemakers/defibrillators without cardiological consultation
• Pregnancy: generally cautious indications
• Lack of diagnostic clarification or unclear cause of pain

Preparation and aftercare

• Preparation: Please bring any existing findings/images with you; inform about blood thinning medications.
• On the day of treatment: Comfortable clothing; light meal is possible.
• Aftercare: Short-term protection; Gradual increase in load according to plan.
• Physiotherapy: Accompanying training/eccentricity in tendinopathies increases the effectiveness of conservative concepts.
• Warning signs: Increasing redness, swelling, fever - please contact us immediately.

Costs and reimbursement

Axomera is not a standard benefit component of statutory health insurance in Germany. Billing is usually carried out as an individual health service (IGeL) according to GOÄ. Private insurers or aid can reimburse depending on the contract; prior clarification is recommended.

• Transparent cost estimate before you start
• Number of sessions depends on the findings and progress
• Reimbursement: Please check your tariff or speak to your insurer

Alternatives and sensible combinations

The basis remains conservative: load management, targeted training, physiotherapy/manual therapy. Depending on the indication, shock wave therapy, taping/orthosis, infiltrations (e.g. local anesthetic), drug pain therapy or regenerative procedures can also be considered.

• Physiotherapy and exercise programs (eccentric tendon training)
• Shock wave therapy for tendinopathies/plantar fasciitis (evidence-based option)
• PRP neuromodulation as a regenerative adjunct in selected cases
• Transcranial pulse stimulation (neuromodulative, for certain pain and neuro issues)
• Orthotic concepts/insoles and load control
• Surgical procedures only if there is a clear indication after conservative options have been exhausted

Who is Axomera suitable for – and who is it not suitable for?

• Suitable: People with chronic, circumscribed complaints despite conservative therapy who would like a non-surgical option.
• Less suitable: In the case of advanced osteoarthritis, gross instabilities or complete ruptures - other strategies take priority here.
• Required: Clear diagnosis, realistic goals and willingness to actively participate (training/physio).

Your way to us in Hamburg

Our orthopedic practice is located at Dorotheenstraße 48, 22301 Hamburg. We take the time for a careful examination, focus on the diagnosis and discuss whether Axomera makes sense in your case or whether other conservative measures promise greater benefit.

• Make an appointment easily online via Doctolib
• Alternatively, contact us by email – we will get back to you as soon as possible
• Easily accessible in the heart of Hamburg

Further topics and combinable procedures

You can find more detailed information about complementary therapies in our advice pages. Depending on the findings, a regenerative supplement such as PRP neuromodulation or central neuromodulation such as transcranial pulse stimulation may be an option. Classic conservative procedures also remain central.

• PRP neuromodulation – regenerative supplement in selected cases
• Transcranial pulse stimulation – neuromodulatory for certain indications
• Conservative orthopedics – diagnostics, training and therapy concepts
• Shock wave therapy – option for tendon and fascia problems