Investigating the Effect of Extracorporeal Shock Wave Therapy on reducing Chronic Pain in Patients with Pes Anserine Bursitis: A Randomized, Clinical- Controlled Trial

Abstract

Background:Knee pain, is one of the most common causes of patients’ referring to physiatric clinics, and several factors, are involved in its creation. One of these factors is pes anserine bursitis (PAB) for which various treatment methods are used. This study aims to investigate the effect of this method on reducing chronic pain in these patients.Materials and Methods:This clinical trial was conducted in 2013- 2014 on patients with PAB referring to academic, physical medicine clinics. The patients with chronic PAB (pain duration more than 3 months), who were refractory to conservative treatments, were randomly divided into two 20-member experimental groups (extracorporeal shock wave therapy [ESWT] and sham ESWT). Pain scores of all patients were measured using the Visual Analog Scale (VAS) and McGill Pain Questionnaire (MPQ) (total and present pain indexes [TPIs and PPIs]) before intervention, immediately after intervention (3rd week), and after 8 weeks. The pain scores were then compared and statistically analyzed.Results:In the ESWT group, the mean patient pain score of the VAS and TPI in MPQ were significantly lower than in the sham ESWT group immediately after intervention (3rd week): P =0.02, P = 0.04 respectively; and 8 weeks after the end of treatment: P =0.01, P = 0.000. Moreover, the PPI in both groups had significantly decreased over time, although in ESWT group this decrement was significantly more than sham ESWT group (P < 0.001).Conclusion:The results showed that ESWT could be effective in reducing the pain and treating PAB.

Effect of polydeoxyribonucleotide injection on pes anserine bursitis

“…Most patients recover spontaneously, by activity modification and conservative management. [ 4 ] However, PA bursitis occasionally results in intractable pain and requires long-term therapy for recovery. [ 4 ] It can also trigger weakness of hip adductors and weakness of medial hamstring muscles.…”

“…[ 4 ] However, PA bursitis occasionally results in intractable pain and requires long-term therapy for recovery. [ 4 ] It can also trigger weakness of hip adductors and weakness of medial hamstring muscles. [ 4 ] Ultrasound facilitates the diagnosis of PA bursitis.…”

“…[ 4 ] It can also trigger weakness of hip adductors and weakness of medial hamstring muscles. [ 4 ] Ultrasound facilitates the diagnosis of PA bursitis. [ 5 ] Initial treatment includes nonsteroidal anti-inflammatory drugs (NSAIDs) or ice to reduce inflammation and pain.…”

“…[ 5 ] Initial treatment includes nonsteroidal anti-inflammatory drugs (NSAIDs) or ice to reduce inflammation and pain. [ 4 ] Rehabilitation of these patients includes increasing the stretching, flexibility, and endurance of PA muscles. [ 4 ] Use of short-term knee orthosis may be suitable for reducing the pain.…”

“…[ 4 ] Rehabilitation of these patients includes increasing the stretching, flexibility, and endurance of PA muscles. [ 4 ] Use of short-term knee orthosis may be suitable for reducing the pain. [ 6 , 7 ] In cases when intractable pain causes functional limitations or where conservative managements fail, local glucocorticoid injection is administered.…”