Myofascial Pain Syndrome causes disability in daily life activities and despite all efforts, it continues to be a challenge, perpetuating suffering, overloading services and costs. New treatment options need to be tested.
OBJECTIVE:
We aimed to quantify the rESWT short-term analgesic effect and identify the predictors of success through comparing results achieved in MPS and Articular Pain (AP).
METHOD:
Retrospective cohort study of 1,580 patients with Myofascial Pain Syndrome or Articular Pain underwent two weekly radial Extracorporeal Shock-wave Therapy sessions. The pain intensity was measured by Visual Analog Scale before and one week after the end of the treatment (3 weeks).
RESULTS:
The therapy decreases pain by 62.50% ( 0.0001), with a high success rate (91.59%) and a low worsening of baseline conditions rate (2.1%). The best recommendation is for patients with intense myofascial pain (Visual Analog Scale 70 mm), using high shock-wave frequency ( 15 Hz).
CONCLUSIONS:
Two rESWT sessions promote pain relief, with a high success rate and low rates of treatment abandonment and worsening. The best results are obtained in myofascial pain patients with high pain intensity, treated with high-frequency dosage.
WoolfADAkessonK. Understanding the burden of musculoskeletal conditions. The burden is huge and not reflected in national health priorities. BMJ.2001; 322: 1079-1080.
2.
GalassoAUritsIAnDNguyenDBorchartMYazdiC, et al. A comprehensive review of the treatment and management of myofascial pain syndrome. Curr Pain Headache Rep.2020; 27; 24(8): 43.
3.
JoyceCRBZutshiDWHrubesVMasonRM. Comparison of fixed interval and visual analogue scales for rating chronic pain. Eur J Clin Pharmacol.1975; 8(6): 415-20.
4.
FosterNEHillJCHayEM. Subgrouping patients with low back pain in primary care: are we getting any better at it? Man Ther.2011; 16(1): 3-8.
5.
ThielMNieswandMDörffelM. Review: the use of shock waves in medicine – a tool of the modern OR: an overview of basic physical principles, history and research. Minimally Invasive Therapy and Allied Technologies.2000; 9(3–4): 247-253.
6.
ThomsonCECrawfordFMurrayGD. The effectiveness of extra corporeal shock wave therapy for plantar heel pain: a systematic review and meta-analysis. BMC Musculoskeletal Disorders.2005; 22; 6: 19.
7.
DizonJNCGonzalez-SuarezCZamoraMTGGambitoEDV. Effectiveness of extracorporeal shock wave therapy in chronic plantar fasciitis: a meta-analysis. American Journal of Physical Medicine and Rehabilitation.2013; 92(7): 606-620.
8.
JeonJHJungYJLeeJYChoiJSMunJHParkWY, et al. The effect of extracorporeal shock wave therapy on myofascial pain syndrome. Ann Rehabil Med.2012; 36(5): 665-674.
KenmokuTNemotoNIwakuraN, et al. Extracorporeal shock wave treatment can selectively destroy end plates in neuromuscular junctions. Muscle Nerve.2018; 57(3): 466-472.
11.
LiuYChenXGuoA, et al. Quantitative assessments of mechanical responses upon radial extracorporeal shock wave therapy. Adv Sci (Weinh).2017; 5(3): 1700797.
12.
SpeedCA. A systematic review of shockwave therapies in soft tissue conditions: focusing on the evidence. Br J Sports Med.2014; 48(21): 1538-1542.
13.
LeoneLVetranoMRanieriD, et al. Extracorporeal Shock Wave Treatment (ESWT) improves in vitro functional activities of ruptured human tendon-derived tenocytes. PLoS One.2012; 7(11): e49759.
14.
ChenYJWangCJYangKD, et al. Extracorporeal shock waves promote healing of collagenase-induced achilles tendinitis and increase TGF-beta1 and IGF-I expression. J Orthop Res.2004; 22: 854-861.
15.
AqilASiddiquiMRSolanM, et al. Extracorporeal shock wave therapy is effective in treating chronic plantar fasciitis: a meta-analysis of RCTs. Clin Orthop Relat Res.2013; 471(11): 3645-3652.
16.
TashjianRZDeloachJPorucznikCAPowellAP. Minimal clinically important differences (MCID) and patient acceptable symptomatic state (PASS) for visual analog scales (VAS) measuring pain in patients treated for rotator cuff disease. J Shoulder Elb Surg.2009; 18(6): 927-32.
17.
AktürkSKayaAÇetintaşD, et al. Comparison of the effectiveness of ESWT and ultrasound treatments in myofascial pain syndrome: randomized, sham-controlled study. J Phys Ther Sci.2018; 30(3): 448-453.
18.
MalliaropoulosNThompsonDMekeM, et al. Individualised radial extracorporeal shock wave therapy (rESWT) for symptomatic calcific shoulder tendinopathy: a retrospective clinical study. BMC Musculoskelet Disord.2017; 18(1): 513-520.
19.
MarshallKLLumpkinEA. The molecular basis of mechanosensory transduction. Adv Exp Med Biol.2012; 739: 142e155.
RomeoPLavangaVPaganiDSansoneV. Extracorporeal shock wave therapy in musculoskeletal disorders: a review. Med Princ Pract.2014; 23(1): 7-13.
22.
AlamSLovettDBDickinsonRBRouxKJLeleTP. Nuclear forces and cell mechanosensing. In: Progress in Molecular Biology and Translational Science. Elsevier B.V. 2014; 205-15.
23.
MoyaDRamónSGuiloffLGerdesmeyerL. Current knowledge on evidence-based shockwave treatments for shoulder pathology. Vol. 24, International Journal of Surgery. Elsevier Ltd; 2015; 171-8.
24.
KenmokuTNemotoNIwakuraN, et al. Extracorporeal shock wave treatment can selectively destroy end plates in neuromuscular junctions. Muscle Nerve.2018; 57(3): 466-472.
25.
OhtoriSInoueGMannojiC, et al. Shock wave application to rat skin induces degeneration and reinnervation of sensory nerve fibres. Neurosci Lett.2001; 315(1–2): 57-60.
26.
JiHMKimHJHanSJ. Extracorporeal shock wave therapy in myofascial pain syndrome of upper trapezius. Ann Rehabil Med.2012; 36(5): 675-680.
27.
SpeedCA. A systematic review of shockwave therapies in soft tissue conditions: focusing on the evidence. Br J Sports Med.2014; 48(21): 1538-1542.
28.
StorheimKZwartJA. Musculoskeletal disorders and the global burden of disease study. Ann Rheum Dis.2014; 73(6): 949-950.
29.
KolkAYangKGTammingaR, et al. Radial extracorporeal shock-wave therapy in patients with chronic rotator cuff tendinitis. Bone Joint J.2013; 95-B(11): 1521-1526.
30.
ImamuraMAlaminoSHsingWT, et al. Radial extracorporeal shock wave therapy for disabling pain due to severe primary knee osteoarthritis. J Rehabil Med.2017; 49(1): 54-62.
