High-Energy Flux Density Extracorporeal Shock Wave Therapy Versus Traditional Physical Therapy Modalities in Myofascial Pain Syndrome: A Randomized-controlled, Single-Blind Trial

Abstract

Objectives: This study aims to investigate the effects of extracorporeal shock wave therapy (ESWT) on pain, sleep, fatigue, disability, depression, and quality of life (QoL) in patients with myofascial pain syndrome (MPS). Patients and methods: Between March 2018 and September 2018, a total of 94 patients (16 males, 78 females; mean age 44.2±11.94 years; range, 19 to 74 years) with the diagnosis of MPS were included in the study. The patients were divided into two groups. The treatment group consisted of 49 patients and a total of seven sessions of high-energy flux density ESWT (H-ESWT) (0.26 mJ/mm 2) were given with three days interval. The control group consisted of 45 patients and the treatment of hot pack, transcutaneous electrical nerve stimulation, and ultrasound was given for five days for two weeks. At baseline and one month after treatment, the visual analog scale (VAS), Short Form-36 (SF-36), Pittsburgh Sleep Quality Index (PSQI), Functional Assessment of Chronic Illness Therapy (FACIT)-Fatigue Scale, Neck Disability Index (NDI), and Beck Depression Inventory (BDI) scores were compared between the groups. Results: There were no statistically significant differences in the age, sex, demographic characteristics, and baseline VAS, SF-36, NDI, BDI, FACIT, and PSQI scores between the groups (p>0.05). In the ESWT group, there was a statistically significant decrease in the VAS, SF-36, NDI, BDI, FACIT, and PSQI scores after treatment compared to the baseline scores, while only the SF-36 subscale scores were statistically significantly higher (p<0.05). There was a statistically significant correlation between the VAS and SF-36 scores and the BDI, NDI, FACIT and PSQI scores after the treatment. Conclusion: Our study results suggest that H-ESWT is more effective than traditional physical therapy methods on pain, QoL, sleep, fatigue, depression, and disability in patients with MPS.

Efficacy of extracorporeal shock waves in the treatment of myofascial pain syndrome: a systematic review and meta-analysis of controlled clinical studies

“…However, this treatment method lacks long-term effects, and the direct injection of drugs may bring allergic reactions and other adverse reactions (23). Extracorporeal shock waves do not require invasive procedures and directly conduct energy through the skin into muscle tissue to improve microcirculation and promote the separation of adherent soft tissues, which can have a long-acting analgesic effect (14).…”

“…However, this method has a poor energy transfer effect and a low pain relief rate. The control group in previous studies (12,14,15,18) was treated with ultrasound-guided pulsed radiofrequency, but the rate of pain relief was worse than that of ESWT.…”

“…All studies (10,(12)(13)(14)(15)(16)(17)(18)(19) reported the comparison of pain after treatment between the experimental group and the control group using ESWT. There was statistical heterogeneity between the studies (I 2 =85%, P<0.00001).…”

“…Figure 4Comparison of pain intensity after ESWT treatment and other modalities for MPS(10,(12)(13)(14)(15)(16)(17)(18)(19). ESWT, extracorporeal shock wave therapy; MPS, myofascial pain syndrome; SD, standard deviation; CI, confidential interval; IV, inverse variance.…”

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

“…During the last decades, extracorporeal shock wave therapy (ESWT) has emerged as an effective and safe alternative for treating MTrPs [20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37]. According to a recent systematic review and meta-analysis, ESWT appears to be associated with higher pain alleviation than sham ESWT or ultrasound therapy in treatment of MTrPs in the UTM [38].…”