The objective of the study was to compare the effects of shockwave therapy and laser therapy on pain, neck functionality, and quality of life in patients with myofascial pain syndrome of the trapezius. 61 patients (> 18 years) were randomly allocated to two treatment groups: (1) 31 patients received soft laser therapy once daily in a 3-week period for a total of 15 sessions, (2) 30 patients received shockwave therapy once in a week for 3 weeks, totalling 3 treatments. Resting pain and pain tolerance were assessed by a 100 mm visual analogue scale; functional status and quality of life were measured by specific questionnaires (Neck Disability Index, SF-36) before and after the 3-week therapy and at the 15th week follow-up visit. All measured parameters improved significantly in both groups at week 3 and week 15. Comparing the two groups, patients receiving shockwave therapy demonstrated significantly better changes in pain tolerance (mean between-group differences at visit 1-0 = 14.911, 95% CI = 2.641-27.182, mean between-group differences at visit 2-0 = 17.190, 95% CI = 4.326-30.055 in the left trapezius), neck functionality (mean between-group differences at visit 1- 0 = 0.660, 95% CI = - 1.933 to 3.253, mean between-group differences at visit 2-0 = 1.072, 95% CI = - 2.110 to 4.254), and in all domains using SF-36 QoL questionnaire. The only parameter in which the laser group showed significantly higher benefits was at week 15 for resting pain (mean between-group differences at visit 2-0 = - 1.345, 95% CI = - 14.600 to 11.910). The results of our study point to a conclusion that both laser and shockwave therapy are effective in myofascial pain syndrome, though we found shockwave therapy to be somewhat more beneficial. Clinical trial registration number NCT03436459 ( https://clinicaltrials.gov/ct2/show/NCT03436459 ).

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HighlightsUnderwater ultrasound therapy is a useful procedure to treat inflammation in patients with RA.Underwater ultrasound therapy is suitable to treat irregular body parts, because the transmission coefficient is high and the reflection is low in water.The improvements were only observed in the short term (at the end of 2 weeks of treatment).

The aim of this non-inferiority study was to evaluate and compare the effects of Tiszasüly and Kolop mud pack therapy on pain, function and quality of life in patients with knee osteoarthritis. In this double-blind, randomised, follow-up study, 60 patients with knee osteoarthritis were treated with either Tiszasüly hot mud pack (group 1) or with Kolop hot mud pack (group 2) on 10 occasions for 2 weeks (10 working days). One hundred millimetre visual analogue scale (VAS) for knee pain, the Western Ontario and McMaster Universities Arthritis Index (WOMAC), the Knee injury and Osteoarthritis Outcome Score (KOOS), the Lequesne Index for physical function and EuroQoL-5D for quality-of-life measurements were recorded at baseline, at the end of treatment (week 2) and 3 months later (week 12). In both groups, all measured parameters improved significantly from the baseline until the end of treatment and during the follow-up period (p < 0.05). There were no significant differences between the groups in terms of the WOMAC, KOOS, EQ-5D and Lequesne Index at any visits. Knee pain improved in both groups at week 2 and week 12; the only significant difference visible between the groups was at the end of the treatment in favour of the Tiszasüly mud pack group (p = 0.009). Tiszasüly and Kolop mud packs both have a favourable effect on knee pain, physical function and quality of life in patients with knee osteoarthritis. Our results proved non-inferiority of Tiszasüly mud pack.Keywords Mud pack therapy . Osteoarthritis of the knee . Hot-pack therapy . Non-inferiority study * Tamás Bender

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BackgroundRheumatoid arthritis (RA) is a progressive inflammatory disease leading to joint destruction. Treatment goals include reducing pain and inflammation as well as preventing joint destruction and maintain working ability. Not only conventional and biological disease-modifying anti-rheumatic drugs (DMARDs) but also non-pharmacologic treatment, such as physiotherapy, can contribute to pain relief, reduction of inflammation, improvement in function and quality of life.ObjectivesThe aim of this study was to evaluate the effect of underwater ultrasound therapy on function and quality of life in RA patients. We conducted a randomized, placebo-controlled, double-blind, follow-up study.MethodsThe study included 50 RA outpatients with low disease activity (3.2Outcome measures included disease activity parameters, such as DAS28, ESR, CRP, swollen and tender joint counts; hand function assessments, as well as Health Assessment Questionnaire (HAQ) and a Self-Report Questionnaire. Study parameters were recorded at baseline, immediately after treatment and three months later.ResultsDisease activity parameters, DAS28 (3.9±0.6 and 3.3±1.1 p<0.001), ESR (23.6±18.1 mm/h and 19.1±12.8 mm/h p=0.023) and CRP (11.1±9.4 mg/l and 6.0±8.3 mg/l p=0.01) showed a significant decrease from baseline to the third month in the treated group compared to the placebo group (DAS28: 4.1±0.6 and 3.8±0.8 p=0.061 ESR: 22.3±12.2 mm/h and 22.9±12.5 mm/h p=0.819 CRP: 6.1±7,8 mg/l and 6.1±7,5 mg/l p=0.987). HAQ also decreased significantly from baseline to the third month (1,3±0.8 and 1.1±0.8 p=0.018) in the treated group. Patients in both groups reported improvement in Self-Report Questionnaire either by the second week or by the third month, respectively (64% and 52% vs 61% and 61%). Hand function improved during the study period in the treated group and statistically significant improvement was revealed in the extension of the left wrist by the third month in group I (59.9±18.9 degree and 64.7±16.8 degree p=0.044).ConclusionsUnderwater ultrasound treatment of patients with RAs can be an additional therapy apart from conventional and biological DMARDs resulting in improvement of function and quality of life.Disclosure of InterestNone declared

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