Comparative study of shockwave therapy and low-level laser therapy effects in patients with myofascial pain syndrome of the trapezius

Abstract

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 ).

Effects of repeated injection of 1% lidocaine vs. radial extra-corporeal shock wave therapy for treating myofascial trigger points: a randomized controlled trial

“…The rESWT for MTPs of UTM as performed in the present study (three rESWT sessions, one session per week, 2000 rESWs per session with EFD + of 0.10 mJ/mm 2 ) was the least session, similar to some previous studies. 22,28,29,30 resulted in a statistically significant improvement in (i) mean elastic index of UTM, (ii) mean VAS score, (iii) mean pressure pain threshold (PPT), and (iv) mean neck disability index (NDI) at one week and 4 weeks to baseline in the ESWT group, which is in line with previous studies. 22,28,29,30 The intergroup comparison with the 1%lidocaine group revealed statistically significantly better results than the rESWT group at T2 and T3, which was not in line but not statistically significant at T4 at p<0.05, which is in line with a previous study that compared with the dry needle.…”

“…21-31 The outcome measures in this study are in line with other studies in PPT 21-23,25,27,29 and NDI. 21,25,26,28,29 There are only one 20 of these studies 21-31 that elastic index was applied to monitor treatment success of ESWT for MTPs.…”

Effectiveness of extracorporeal shock wave therapy versus standard care in the treatment of neck and upper back myofascial pain: a single blinded randomised clinical trial

“…In line with our results, participants in shockwave therapy group established significantly more improvements in pain intensity but also in neck disability. 47 In addition Lee et al compared the effects of extracorporeal shockwave therapy (1000 impulse and 5 Hz frequency), proprioceptive neuromuscular facilitation and trigger point injection (0.2 mL of 0.3% lidocaine in the pain trigger points) on pain intensity and functional disability in participants with upper trapezius muscle myofascial pain syndrome. In line with our findings, visual analogue scale and neck disability index showed statistically significant differences among the participants in shock wave groups.…”

“…Recently, numerous studies have established the effectiveness of extracorporeal shock wave therapy in subjects with myofascial pain syndrome. 20,21,25,[45][46][47] Ji et al has showed that extracorporeal shock wave therapy on 22 patients with myofascial pain syndrome of upper trapezius is more efficient than standard care in decreasing pain intensity and improving the pain pressure threshold in two weeks. 25 Taheri et al confirmed that three session of radial extracorporeal shock wave therapy with 1000 impulse and 3 J/m2 and 10 Hz frequency and laser therapy had comparable effect in long-term for relieve of pain and eliminating symptoms in patients with myofascial, however laser provides a faster optimal results.…”

Efficacy of Extracorporeal Shock Wave Therapy in Neck and Shoulder Pain Syndrome

“…Neck and shoulder pain is a frequent musculoskeletal problem with an estimated prevalence between 5.9% and 38.7% in a certain population [1][2][3] . Neck and shoulder pain syndrome is called "Katakori" in Japan and characterized by discomfort or spontaneous pain, mild pain on motion in the neck, upper scapula region, scapula region, or interscapular region with tense muscles at palpation as well as tender points or stiffness at those areas 4 .…”