Reduction in chronic low back pain with extracorporeal shock wave therapy

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Created On: 25/08/2022

A prospective randomized study was carried out to evaluate effectiveness of focused extracorporeal shock wave therapy (fESWT) in individuals with chronic low back pain (LBP).

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Key take away

Focused extracorporeal shock wave therapy in conjunction with an exercise program effectively reduces pain intensity in people suffering from chronic low back pain.

Background

A prospective randomized study was carried out to evaluate effectiveness of focused extracorporeal shock wave therapy (fESWT) in individuals with chronic low back pain (LBP).

Method

This 3-month follow-up research included 40 subjects with L5-S1 discopathy and persistent LBP. Participants were randomly assigned into two groups: group A (mean age of 42.3±13.1 years, n=20 ) and group B (mean age of 45.4±14 years, n=20). Group A (experimental group) was treated with fESWT at the lumbar and sacral spine (0.15 mJ/mm2, 1000 pulses, 4 Hz). Group B was marked as control group, and received a sham fESWT.

In all groups, the therapy protocol comprised the same stability training (45 minutes, once a day, 5 days a week). Subjective pain was measured using the visual analogue scale (VAS) and the Laitinen Pain Scale (LPS), while functional status was measured using the Oswestry Disability Index (ODI). Estimations were carried out prior to and following treatments, as well as follow-up observations at one and three months after ESWT.

Result

The analgesic effect (VAS and LPS) was significant in both groups. But, it was substantially larger in the experimental group vs. sham group. A greater reduction in perceived pain (VAS and LPS) was found immediately after active fESWT treatment.

No significant differences were recorded between the group in follow-up observations (at 1 and 3 months). In terms of functional status (ODI), both groups had a substantial effect. However, the between-group comparisons indicated no statistically significant changes.

Conclusion

In individuals with persistent LBP, focused ESWT (a modern physiotherapeutic method) combined with an activity regimen can be beneficial in pain reduction. However, it may not significantly increase a patient's functional status.