Low-energy versus middle-energy extracorporeal shockwave therapy for the treatment of snapping scapula bursitis

Abstract

Objective:Extracorporeal shockwave therapy (ESWT) has been used successfully in treatment of musculoskeletal disorders. Our objective was to assess the effectiveness of low versus middle-energy ESWT on snapping scapula bursitis.Methods:Thirty-five patients, divided into two groups, group (L), received low-energy ESWT, group (M) received middle-energy ESWT. Groups were evaluated at 1,3,6 and 12 months using the Visual Analogue Scale (VAS), the Constant-Murley scoring (CMS) and the Roles and Maudsley criteria.Results:In groups (L) and (M), VAS average values after 1,3,6 months and one year were (43±5.17, 38±4.33, 28±4.18 and 19±3.39) and (37±4.85, 26±4.74, 21±4.45 and 7±3.42) respectively. At six and twelve months, statistical difference was detected, P (0.034, 0.026) respectively. After one year of completing the treatment, the average values of CMS were (83.5±6.44 and 91±5.33) respectively, P=0.046. Roles and Maudsley criteria demonstrated that, patients in group (L), 6 (35%) excellent, 5 (29%) good, 4 (24%) acceptable and 2 (12%) had poor results. Whereas, patients in group (M), 11 (61%) excellent, 3 (17%) good, 3 (17%) acceptable and 1 (5%) had poor results.Conclusion:Although low-energy ESWT showed good early-term results, but middle-energy ESWT protocol demonstrated better early-term, Mid-term, and late-term results.

Effects of Inflammatory Disease on Clinical Progression and Treatment of Ischiogluteal Bursitis: A Retrospective Observational Study

“…Treatment of IGB focuses on symptom control. Primary treatment in IGB is lifestyle modification by avoiding physical activities or daily habits that have caused the symptoms in the first place 24 , 25 . In addition, the use of ESWT in conservative management is recommended to be beneficial in reducing adhesion in chronic bursitis by breaking down scar tissues, increasing extensibility, mobility of surrounding structure, and ultimately promoting normal orientation of collagen fibers 26 , 27 .…”

Diagnosis and Treatment of Snapping Scapula Syndrome: A Scoping Review

“…CSI achieved a mean of 37-point reduction in VAS score on a 100-point scale after 6 months of treatment, compared with a mean of 60-point reduction in VAS score 6 months after ESWT. 1,2 Another study suggested that optimal VAS score reduction and symptom improvement is offered by middle-energy ESWT compared with low-energy ESWT (level 3 evidence), especially with long-term results. 1 All 4 studies using exercise or rehabilitation found clinical improvement posttreatment.…”

“…1,2 Another study suggested that optimal VAS score reduction and symptom improvement is offered by middle-energy ESWT compared with low-energy ESWT (level 3 evidence), especially with long-term results. 1 All 4 studies using exercise or rehabilitation found clinical improvement posttreatment. 10,12,30,39 Rehabilitation aimed at restoring scapular muscle balance, decreasing pain, and improving rotator cuff strength.…”

“…If nonoperative management has proven ineffective, open or arthroscopic scapular superomedial resection and bursectomy is considered. 1,12,21,29,36 SSS is commonly unidentified and can thus go untreated. This review evaluates the available literature to provide clinicians with an evidence-based summary on the diagnosis and management of this condition with the aim to minimize its misdiagnosis in the future.…”

Snapping Scapula Syndrome in the Setting of Elastofibroma Dorsi: A Case Report

“…Physical examination findings include audible, palpable, and/or painful crepitus of the scapulothoracic articulation during active shoulder movements [1,7,13]. Despite the etiology of SSS, nonoperative treatments are warranted first, prior to considering surgery [1,13,14].…”