Influence of Extracorporeal Shockwave Therapy in Patients of Mechanical Neck Pain

December 3, 2025 updated by: Mohamed Faramawy Shible El.deeb, Benha University

Purpose:

The study aimed to determine whether adding extracorporeal shockwave therapy (ESWT) to a standardized physiotherapy program provides additional benefits for patients with chronic mechanical neck pain. Specifically, it examined effects on pain intensity, pressure pain threshold (PPT), neck disability index (NDI), cervical active range of motion (AROM), and joint position sense (JPS).

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Study Summary Summary of the Study: Influence of Extracorporeal Shockwave Therapy in Patients with Mechanical Neck Pain

Purpose:

The study aimed to determine whether adding extracorporeal shockwave therapy (ESWT) to a standardized physiotherapy program provides additional benefits for patients with chronic mechanical neck pain. Specifically, it examined effects on pain intensity, pressure pain threshold (PPT), neck disability index (NDI), cervical active range of motion (AROM), and joint position sense (JPS).

Key Details:

  • Study Design: Double-blinded, pretest-posttest controlled clinical trial.
  • Participants: 52 patients aged 18-29 with chronic mechanical neck pain for over 3 months.

  • Groups:

    • Group A: Standardized physiotherapy only (stretching, isometric exercises, posture training).
    • Group B: ESWT + standardized physiotherapy.
  • Duration: 4 weeks, 2 sessions/week (1 ESWT + 1 physiotherapy in Group B).
  • Assessments: NPRS for pain, pressure algometer for PPT, Arabic NDI, goniometer for AROM & JPS.

  • Results:

    • Adding ESWT significantly improved PPT, left cervical rotation AROM, cervical extension JPS, and right cervical rotation JPS.
    • No significant differences between groups in other measures.
  • Conclusion: ESWT combined with physiotherapy may enhance pain threshold, AROM in rotation, and proprioception compared to physiotherapy alone.

Sources of Strength in the Study:

  1. Double-blind design reduces bias.
  2. Randomized allocation with adequate sample size determined by power analysis.
  3. Use of validated measurement tools (NPRS, NDI Arabic version, Wagner algometer, standard goniometer).
  4. Clearly defined inclusion/exclusion criteria ensuring sample homogeneity.
  5. Use of standardized physiotherapy protocol enhances reproducibility.

Study Type

Interventional

Enrollment (Actual)

52

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Egypt
    • Menofya
      • Shibīn al Kawm, Menofya, Egypt, 32521
        • 12

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  1. The patients (both males and females) with chronic non-specific neck pain for more than three months.
  2. The patient's age is between 18 and 29 years old.
  3. The patient has at least one taut band at the upper fibers of the trapezius as described in assessment procedures.
  4. patient's numeric pain rating scale (NPRS) was 3 to 8 out of 10

Exclusion Criteria:

  1. Were treated for neck or shoulder pain during the last three months.
  2. Had a neck or shoulder operation during the last two years.
  3. Had any structural pathology of the cervical spine, such as disk prolapse, spinal stenosis, or cervical spondylosis.
  4. Had a traumatic history, instability, and spasmodic torticollis.
  5. Had cardiovascular, respiratory, or allergic disease or neck osteoarthritis.
  6. Had homeostatic disorders.
  7. Fibromyalgia, shoulder diseases (tendonitis, bursitis, capsulitis).
  8. Inflammatory rheumatic diseases.
  9. Severe psychiatric illness and other diseases that restrict physical loading, and pregnancy (Salo et al., 2010).
  10. Patients with vertebrobasilar insufficiency and vertigo.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Other: Control group, standardized physiotherapy group receiving (Stretch, strength, Postural correction)
The control group recieve conventional program without additional shockwave
Other: Exercise
Stretch + isometrics + postural correction
Other Names:
  • Strength _ Activation_ stretch_ postural correction
Experimental: Intervention group received Extracorporeal shockwave therapy + Standardized physiotherapy as control
Group B
Other: Exercise
Stretch + isometrics + postural correction
Other Names:
  • Strength _ Activation_ stretch_ postural correction
Device: Extracorporeal Shockwave therapy
Radial, pneumatic extracorporeal shockwave therapy: The ESWT was applied using the following treatment parameters: 2,000 pulses, intensity of 1 to 1.2 bars, and 10 Hz frequency
Other Names:
  • ESWT

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Pressure pain threshold (PPT)
Time Frame: 4 weeks
The minimum amount of pressure applied to body tissue that a person perceives as pain, rather than just pressure, is measured by an algometer. Another definition is the point at which a sensation changes from pressure to pain. measured by an algometer. A higher score is better, and a lower score is worse.
4 weeks

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Active cervical range of motion
Time Frame: 4 weeks
Active cervical range of motion in 6 directions: flexion, extension, sidebending in both directions, and rotation in both directions. The higher score is better, and the lower score is worse.
4 weeks
Joint position sense
Time Frame: 4 weeks
Joint position sense is measured by joint position error via the head repositioning test. The head repositioning test is the ability of the individual to detect the predetermined position again using the neck's sense of position and movement in 6 directions. The lower score is better, and the higher score is worse. The lowest score is zero.
4 weeks
Neck Pain
Time Frame: 4 weeks
Pain is an unpleasant sensation measured by numeric pain rating score (NPRS) The highest score is 10, and the lowest score is zero. Ten is maximum pain, and zero is no pain. The higher score is worse, and the lower score is better.
4 weeks
Neck disability index (NDI)
Time Frame: 4 weeks
The index displays the level of neck disability (questionnaire). The higher score is worse, and the lower score is better. Percentage score: The highest score is 100%, and the lowest score is 0%. Raw score: the lowest score is 0, and the highest score is 50.
4 weeks

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Benha University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

July 1, 2023

Primary Completion (Actual)

February 25, 2024

Study Completion (Actual)

March 27, 2024

Study Registration Dates

First Submitted

November 24, 2025

First Submitted That Met QC Criteria

December 3, 2025

First Posted (Actual)

December 5, 2025

Study Record Updates

Last Update Posted (Actual)

December 5, 2025

Last Update Submitted That Met QC Criteria

December 3, 2025

Last Verified

November 1, 2025

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • Shockwave in neck pain

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

Clinical Trials on Neck Pain

Clinical Trials on Exercise

Search Similar Trials

Sponsors and Collaborators

Medical Conditions

Drug Interventions

CROs by country

CROs in Congo, DR of

Conditions

Rare Diseases

Drug Interventions

Dietary Supplements

Sponsor/Collaborators

Locations

Subscribe