Effectiveness of extracorporeal shock wave therapy versus standard care in the treatment of neck and upper back myofascial pain: a single blinded randomised clinical trial

Objectives: To compare the efficacy of extracorporeal shock wave therapy versus standard care (ultrasound + hot pack + self-stretch-exercises) in treatment of neck and upper back myofascial pain syndrome. Design: Single-blind randomised clinical trial Setting: Outpatients setting. Subjects: Patients with neck and upper back myofascial pain Intervention: Participants were randomly allocated into shock wave group ( n = 24), standard care (ultrasound + hot pack + self-stretch-exercises) group ( n = 24) and control (self-stretch-exercises) group ( n = 24) for four weeks. Main Measures: The primary outcomes were pain intensity (visual analogue scale), pain pressure threshold (algometer) and disability (neck disability index). Measures were performed at baseline (week 0), week 1 and post-intervention (week 4). Results: Shock wave and ultrasound improved visual analogue scale (7.50 ± 1.71 to 5.72 ± 2.20 and 6.22 ± 2.54 to 4.95 ± 2.86, respectively, P = 0.083) and disability index (54.24 ± 15.53 to 39.04 ± 19.58 50.23 ± 19.57 to 32.10 ± 18.34, respectively, P = 0.495) similarly at first week examinations that were significantly higher than control ( P < 0.05). In week 4 measurements, additional improvements were achieved concerning visual analogue scale and disability index in the shock wave (–4.00 ± 2.22 and –20.24 ± 16.56, respectively) and ultrasound (–2.18 ± 2.71 and –21.79 ± 10.56, respectively) groups. However, visual analogue scale improved more significantly in shock wave group than ultrasound group in fourth week measurements ( P = 0.012). Conclusion: Extracorporeal shock wave therapy was more effective in controlling of the pain intensity compared to ultrasound one month after treatment. However it had no superiority over ultrasound in improving neck disability index at this time point. Trial registration www.irct.ir , IRCT201608154104N5, registered 2016-09-25

Download Full-text

Comparison between customised foot orthoses and insole combined with the use of extracorporeal shock wave therapy in plantar fasciitis, medium-term follow-up results: A randomised controlled trial

Clinical Rehabilitation ◽

10.1177/0269215520976619 ◽

2020 ◽

pp. 026921552097661

Author(s):

Manuel Coheña-Jiménez ◽

Manuel Pabón-Carrasco ◽

Ana Juana Pérez Belloso

Keyword(s):

Shock Wave ◽

Visual Analogue Scale ◽

Plantar Fasciitis ◽

Analogue Scale ◽

Extracorporeal Shock Wave Therapy ◽

Foot Orthoses ◽

Shock Wave Therapy ◽

Extracorporeal Shock Wave ◽

Custom Made

Objective: To determine the clinical results of custom-made foot orthoses versus placebo flat cushioning insoles combined with an extracorporeal shock wave therapy on pain and foot functionality in patients with plantar fasciitis. Design and setting: A randomised controlled clinical trial with follow-up at six months. Faculty of Podiatry and Centre Clinical private of Physiotherapy, Seville, Spain. Subjects and interventions: Patients with plantar fasciitis were randomly assigned to either group A ( n = 42), which received custom-made foot orthoses, or group B ( n = 41), which received placebo insoles. All the participants received active extracorporeal shock wave therapy including stretching exercises. Recruitment period was from Mach 2019 to July 2020. Main measurements: The main outcome was foot pain, measured by visual analogue scale and the secondary outcome measures were recorded by Roles and Maudsley scores respectively, at the beginning and at one week, one month and six months. Results: Eighty-eight patients were assessed for eligibility. Eighty-three patients were recruited and randomised. This study showed significant differences between both groups according to the visual analogue scale. In control group, the difference was at baseline ( P 0.01) and, in the experimental group was at the one- and six-month follow-up ( P 0.001). The mean (SD) visual analogue scale at baseline were Control group 6.31 (1.69) and Experimental group 5.27 (1.64); and at six months were 7.52 (3.40) and 3.29 (4.26), respectively. The custom-made foot orthosis was perceived as ‘good’ (85%) and ‘excellent’ (97.5%) at medium-long term. Conclusion: Wearing a custom-made foot orthosis leads to a improvement in patients with plantar fasciitis; it reduced foot pain and improved foot functionality.

Download Full-text