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Extracorporeal shockwave therapy is efficacious in minimizing pain and dysfunction in chronic low back pain patients without escalating the risk of adverse reactions.
In a systematic review and meta-analysis of 632 patients, extracorporeal shockwave therapy (ESWT), either as stand-alone or adjuvant therapy for chronic low back pain (CLBP), led to significant reductions in visual analog scale (VAS) scores at week 4 and week 12 in comparison with the control group. Additionally, it also improved lumbar dysfunction. Kun Liu et al. aimed to assess the safety and effectiveness of ESWT in addressing CLBP.
A thorough search was carried out across 4 databases to identify randomized controlled trials (RCTs) focusing on ESWT for CLBP. The quality of the studies incorporated was assessed on the basis of Cochrane systematic review standards. Pertinent information was gathered, and meta-analysis was conducted employing RevMan 5.4 software. The major endpoints encompassed psychological well-being, disability status, and intensity of pain.
The collected data was represented as weighted mean difference (WMD) or standardized mean differences (SMD) along with 95% confidence intervals (CI). The degree of heterogeneity was gauged using the I2 statistic. In instances where I2 was equal to or exceeded 50%, a random effects model was employed; otherwise, utilization of a fixed effects model was done. This study encompassed 12 RCTs with a total of 632 participants.
In the ESWT arm, notable pain alleviation was observed when compared to the control group at 4 weeks and 12 weeks. In terms of the dysfunction index, ESWT demonstrated considerable enhancement in lumbar dysfunction in comparison to the control arm at 4 weeks and 12 weeks. However, no substantial distinction in mental health was noted between the ESWT arm and the control arm following 4 weeks of intervention (Table 1).
ESWT yielded superior pain relief and demonstrated enhanced improvement in lumbar dysfunction when contrasted with the alternative treatments considered. Notably, no major adverse effects were detected. While ESWT did not significantly impact patients' mental health, additional RCTs for more comprehensive future evaluations are warranted. Drawing from the pooled results, it is recommended that ESWT represents an efficient and secure approach for the management of CLBP.
Journal of Orthopaedic Surgery and Research
Efficacy and safety of extracorporeal shockwave therapy in chronic low back pain: a systematic review and meta-analysis of 632 patients
Kun Liu et al.
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