Effect of Radial Extracorporeal Shock Wave Therapy on Pain Intensity, Functional Efficiency, and Postural Control Parameters in Patients with Chronic Low Back Pain: A Randomized Clinical Trial

Abstract

Low back pain (LBP) is the leading cause of disability worldwide, placing a significant economic burden on healthcare systems. Radial extracorporeal shock wave therapy (rESWT) is useful in the rehabilitation of orthopedic diseases; however, there is still limited evidence for patients with LBP. The aim of this study was to assess the effect of rESWT on pain level, functional efficiency, and parameters of postural control in patients with LBP. Participants were randomized into group A (n = 20) treated with rESWT and group B (n = 20) treated with sham rESWT (placebo). Both groups received conventional physiotherapy, including core stability exercises. The following tests were performed: the Laitinen Pain Scale (LPS), the Roland–Morris Questionnaire (RMQ), the original Schober Test (OST), and a stabilometric platform for the assessment of postural sway, including total sway path (TSP). We found that the analgesic effect was higher after rESWT, especially in the follow-up’s (p < 0.05). Similar results were found for functional efficiency and range of motion (p < 0.05). The improved posture stability in placebo group B was not statistically significant (p > 0.05). The stabilometric parameters in group A were still gradually improved and statistically significant, even in follow-ups (p < 0.05). In conclusion, the rESWT had a significant effect on the reduction of pain and the improvement of functional condition compared to a conventional physiotherapy program. Also, rESWT with core stability exercises led to significant improvements in postural sway compared with conventional physiotherapy in patients with LBP.

Efficacy and safety of treating chronic nonspecific low back pain with radial extracorporeal shock wave therapy (rESWT), rESWT combined with celecoxib and eperisone (C+E) or C+E alone: a prospective, randomized trial

“…During the last years a number of studies indicated that extracorporeal shock wave therapy (ESWT) may serve as an alternative in treatment of cnsLBP [32][33][34][35][36][37][38][39][40][41][42] (an overview on these studies is provided in Appendix A). However, in none of these studies ESWT was compared with NSAIDs and SMRs, let alone the investigation of potential advantages of the combination of ESWT with NSAIDs and SMRs over respectively ESWT or NSAIDs and SMRs alone.…”

­Evaluation of Immediate and Short-Term Efficacy of DualStim Therapy with and without Intracavernosal Umbilical Cord-Derived Wharton’s Jelly in Patients with Erectile Dysfunction: Study Protocol for a Pilot Randomised Controlled Trial

“…Shock waves are de ned as a sequence of single, highly energetic, biphasic acoustic impulses described by rapid propagation of rapidly increased pressure in three-dimensional space applied directly into the tissues without in uencing their global destruction (9). There are two types of ESWT generators, focused (fESWT) and radial (rESWT) and with low or high energy (10,11). The fESWT is generated by electromagnetic, piezoelectric and electrohydraulic sources (10).…”

“…The fESWT is generated by electromagnetic, piezoelectric and electrohydraulic sources (10). In this method, the pressure increases quickly to a peak intensity and back downward with a beam that has a concentrated shape with a focal point with the highest energy density (11). In contrast, rESWT is generated by pneumatic methods and the pressure increases slightly, slower, to a lesser intensity and with a dispersed beam shape (10,11).…”

“…In this method, the pressure increases quickly to a peak intensity and back downward with a beam that has a concentrated shape with a focal point with the highest energy density (11). In contrast, rESWT is generated by pneumatic methods and the pressure increases slightly, slower, to a lesser intensity and with a dispersed beam shape (10,11). ESWT also differs according to the energy ux density (EFD), LISWT with low EFD for various minimally invasive techniques and High-intensity with higher EFD used for lithotripsy (11).…”

“…In contrast, rESWT is generated by pneumatic methods and the pressure increases slightly, slower, to a lesser intensity and with a dispersed beam shape (10,11). ESWT also differs according to the energy ux density (EFD), LISWT with low EFD for various minimally invasive techniques and High-intensity with higher EFD used for lithotripsy (11). Both fESWT and rESWT have been used with low EFD in LISWT and studied in regard to erectile dysfunction (12)(13)(14).…”