Efficacy of Focused Extracorporeal Shock Wave Therapy in Chronic Low Back Pain: A Prospective Randomized 3-Month Follow-Up Study

Rajfur, Katarzyna; Rajfur, Joanna; Matusz, Tomasz; Walewicz, Karolina; Dymarek, Robert; Ptaszkowski, Kuba; Taradaj, Jakub

doi:10.12659/msm.936614

Cited by 11 publications

(22 citation statements)

References 14 publications

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“…The studies by Walewicz et al 16 and Lee et al 17 also reported that ESWT can significantly reduce pain and improve the general functional state. However, a recent study by Rajfur et al 15 reported that ESWT has a role in reducing pain, but no significant effect on improving functional state. In our study, our results were consistent with the conclusions made by Zhang, Walewicz and Lee et al 17 The mechanism of action of the ESWT involves cell membrane destruction at the pain site as a result of the mechanical stress effect, cavitation effect and osmotic effect of the shock wave.…”

Section: Discussionmentioning

confidence: 98%

“…14 However, recent studies on the effect of ESWT combined with exercise have conflicting results on whether ESWT with exercise can effectively improve patients' functional state. [15][16][17] Therefore, the current study analyzes and compares the effects of extracorporeal shock wave and thermomagnetic therapy on pain relief and limb function improvement in the treatment of LBP, to provide more valuable reference for the clinical treatment of this disease.…”

Section: A H E a D O F P R I N Tmentioning

confidence: 99%

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Comparison of pain relief and limb function improvement after extracorporeal shock wave therapy and thermomagnetic therapy in the treatment of low back pain

Wu¹,

Wang²,

Zhang³

et al. 2022

Pak J Med Sci

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Objective: To compare the rehabilitation effects of extracorporeal shock wave therapy (ESWT) and thermomagnetic therapy (TMT) in patients with low back pain (LBP). Methods: As a single-centre retrospective observational study, clinical data of patients with LBP who received rehabilitation treatment in our hospital from January 2020 to May 2021 were retrospectively collected. Based on the treatment mode, the patients were retrospectively divided into two groups: the control group (patients received core muscle training + TMT, n=51) and the observation group (patients received core muscle training + ESWT, n=56). The general data of the patients were collected and the groups were matched for age, gender and pain duration. The visual analogue scale (VAS) score of pain, improvement of limb function, β-endorphin (β-EP), prostaglandin E2 (PGE2) and nitric oxide (NO) were compared between the two groups before and after treatment. Results: The VAS scores of the observation group were lower than those of the control group at one, two weeks and one month after the treatment (P<0.05). After the treatment, the proportion of mild limb dysfunction in the observation group was 57.14% (32/56), which was higher than 35.29% (1 /51) in the control group. The proportion of patients with severe and obvious disorders was 0 and 5.36% (3/56), respectively, which was lower than 11.76% (6/51) and 5.88% (3/51) in the control group (P<0.05). After the treatment, levels of NO and PGE2 in the observation group were lower, and the level of β-EP was significantly lower than in the control group (P<0.05). Conclusions: A combination of core muscle training and ESWT can effectively improve the analgesic effect of the treatment and promote greater improvement of limb function in patients with LBP. doi: https://doi.org/10.12669/pjms.39.1.6668 How to cite this: Wu T, Wang D, Zhang X, Li J, Yuan B. Comparison of pain relief and limb function improvement after extracorporeal shock wave therapy and thermomagnetic therapy in the treatment of low back pain. Pak J Med Sci. 2023;39(1):---------. doi: https://doi.org/10.12669/pjms.39.1.6668 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Section: Discussionmentioning

confidence: 98%

Section: A H E a D O F P R I N Tmentioning

confidence: 99%

Comparison of pain relief and limb function improvement after extracorporeal shock wave therapy and thermomagnetic therapy in the treatment of low back pain

Wu¹,

Wang²,

Zhang³

et al. 2022

Pak J Med Sci

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“…Fourteen studies, [9][10][11][12][13]15,18,19,[21][22][23][24][25]29] including 1242 patients, reported posttreatment ODI with significant heterogeneity (I 2 = 98%, P < .00001). The meta-analysis used a random-effects model, and the results showed that ESWT improved dysfunction better than the others (MD = −6.01, 95%CI [−7.97, −4.05], P < .00001).…”

Section: Oswestry Disability Index (After Treatment)mentioning

confidence: 99%

“…Five studies, [15,19,[21][22][23] including 209 patients, reported ODI at the 3-month follow-up, with moderate heterogeneity (I 2 = 70%, P = .01). The ODI of the experimental group remained lower than that of others according to a meta-analysis using a randomeffects model (MD = −5.95, 95%CI [−10.06, −1.84], P = .005).…”

Section: Oswestry Disability Index (Follow-up Of 3 Months)mentioning

confidence: 99%

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Extracorporeal shock wave therapy for low back pain: A systematic review and meta-analysis

Wu,

Zhou,

2023

Medicine

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Background: To provide high-quality evidence for extracorporeal shock wave therapy (ESWT) for low back pain (LBP). Methods: A computerized search screened trials of ESWT for LBP, and the time range was from the establishment of databases to August 2023, including CNKI, CBMdisc, Wanfang Data, VIP, PubMed, Web of Science, Embase, and Cochrane databases. The outcomes were extracted, including patients’ pain, physical and psychological conditions, and adverse reactions. Meta-analysis was completed using Revman 5.4 and Stata 15 software, and GRADEpro software quantitated rate the evidence and assigned a recommendation strength. Results: This meta-analysis included 22 studies involving 1749 patients. After treatment, patients in the ESWT group had lower scores in the visual analog scale (VAS) (mean difference [MD] = −1.14, 95% confidence interval [CI] (−1.47, −0.80), P < .00001), Oswestry disability index (ODI) [MD = −6.01, 95%CI (−7.97, −4.05), P < .00001], and Beck depression inventory [MD = −3.89, 95%CI (−6.59, −1.20), P = .005]; finger-floor distance [MD = −3.71, 95%CI (−5.26, −2.17), P < .00001] was shorter; Japanese orthopedic association scores [MD = 3.20, 95%CI (1.56, 4.85), P = .0001] were higher; at the 3-month follow-up, the VAS [MD = −1.29, 95%CI (−2.39, −0.19), P = .02] and ODI [MD = −5.95, 95%CI (−10.06, −1.84), P = .005] remained lower; adverse reactions [odds ratio = 0.19, 95%CI (0.07, 0.52), P = .001] were less, and the valid cases [odds ratio = 3.84, 95%CI (2.47, 5.96), P < .00001] were more. Sensitivity analyses revealed that the results were stable; Egger test found no publication bias in VAS (P = .270) and valid cases (P = .747); the trim and fill analysis tested the robustness of ODI scores due to the publication bias (P = .029), and the effect sizes before and after the trim and fill were consistent, which means the result was robust. Conclusion: ESWT for LBP has efficacy and safety in improving pain, dysfunction, and psychological conditions compared to other therapies. ESWT has shown advantages in terms of long-term efficacy. Randomized controlled trials with larger sample sizes and more objective outcomes are required.

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Immediate effect of extracorporeal shockwave therapy in patients with chronic non-specific low back pain: A randomised placebo-controlled triple-blind trial

Back,

Peron,

Lopes

et al. 2024

Clin Rehabil

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Objective To compare the immediate effects of shockwave therapy using two different tips in patients with chronic non-specific low back pain. Design Randomised placebo-controlled study with three intervention groups. Setting The patients recruited for this study were sent for physiotherapy treatment at primary care between May and July 2022. Participants Eighty-one patients with chronic non-specific low back pain aged 18–80 years with pain for ≥3 months and pain intensity ≥3 were randomly recruited for the study. Intervention The patients received a single intervention of radial shockwave therapy with 2000 discharges at 100 mJ energy and 5 Hz frequency using concave or convex tips or placebo treatment. Main measures The primary outcome was pain intensity immediately post-intervention. The secondary outcomes were pressure pain threshold, temporal summation of pain, and functional performance. Data were collected at baseline and post-intervention. Results The post-intervention pain intensity in the concave tip group is an average of two points lower (95% CI = −3.6, −0.4; p < 0.01) than that in the placebo group. The post-intervention pressure pain threshold for the concave tip group was an average of 62.8 kPa higher (95% CI = 0.4, 125.1; p < 0.05) than for the convex tip group and 76.4 kPa higher (95% CI = 14, 138.7; p < 0.01) than in the placebo group. Conclusion The concave tip shockwave therapy is effective in reducing pain and local hyperalgesia in patients with chronic non-specific low back pain.

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Efficacy of Focused Extracorporeal Shock Wave Therapy in Chronic Low Back Pain: A Prospective Randomized 3-Month Follow-Up Study

Cited by 11 publications

References 14 publications

Comparison of pain relief and limb function improvement after extracorporeal shock wave therapy and thermomagnetic therapy in the treatment of low back pain

Comparison of pain relief and limb function improvement after extracorporeal shock wave therapy and thermomagnetic therapy in the treatment of low back pain

Extracorporeal shock wave therapy for low back pain: A systematic review and meta-analysis

Immediate effect of extracorporeal shockwave therapy in patients with chronic non-specific low back pain: A randomised placebo-controlled triple-blind trial

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