The effect of extracorporeal shock wave therapy on myofascial pain syndrome

Jong Hyun Jeon, Yun Jae Jung, Ju Youn Lee, Ji Soo Choi, Jeong Hyeon Mun, Won Yong Park, Cheong Hoon Seo, Ki Un Jang, Jong Hyun Jeon, Yun Jae Jung, Ju Youn Lee, Ji Soo Choi, Jeong Hyeon Mun, Won Yong Park, Cheong Hoon Seo, Ki Un Jang

Abstract

Objective: To investigate the effect of extracorporeal shock wave therapy (ESWT) on myofascial pain syndrome (MPS).

Method: Thirty patients with MPS in trapezius muscle were randomly divided into two groups, ESWT group (n=15), and trigger point injections (TPI)+transcutaneous electrical nerve stimulation (TENS) group (n=15). For a total of 3 weeks, ESWT was undertaken with 1,500 pulse each time at one week interval totaling 4,500 pulse, TPI for once a week totaling three times and TENS for five times a week totaling three weeks.

Results: The changes in pain threshold (lb/cm(2)) showed the values of 6.86±1.35 before first therapy, 11.43±0.27 after first therapy, and 12.57±0.72 after third therapy, while TPI+TENS group showed the values of 6.20±1.92 before first therapy, 8.80±0.48 after first therapy, and 9.60±2.19 after third therapy, and the changes between the groups were significantly different (p=0.045). The changes in visual analog scale were estimated to be 6.86±0.90 before first therapy, 2.86±0.90 after first therapy, and 1.86±0.69 after third therapy in case of ESWT group, whereas the figures were estimated to be 7.20±1.30 before first therapy, 4.60±0.55 after first therapy, and 2.80±0.84 after third therapy in case of TPI+TENS group, and the changes between the groups were significantly different (p=0.010). The changes in McGill pain questionnaire (p=0.816) and pain rating scale (p=0.644) between the groups were not significantly different. The changes in neck ROM were also not significantly different between the groups (p>0.05).

Conclusion: The ESWT in patients with MPS in trapezius muscle are as effective as TPI and TENS for the purpose of pain relief and improving cervical range of motion.

Keywords: High-energy shock waves; Myofascial pain syndromes; Pain threshold; Trigger points.

References

    1. Han TR, Bang MS. Myofascial pain. In: Kang YK, editor. Rehabilitation medicine. 3rd ed. Seoul: Koonja; 2008. pp. 887–896.
    1. McClure S, Weinberger T. Extracorporeal shock wave therapy: clinical applications and regulation. Clin Tech Equine Pract. 2003;2:358–367.
    1. McClure S, Dorfmuller C. Extracorporeal shock wave therapy: theory and equipment. Clin Tech Equine Pract. 2003;2:348–357.
    1. Speed CA. Extracorporeal shock-wave therapy in the management of chronic soft-tissue conditions. J Bone Joint Surg Br. 2004;86:165–171.
    1. Ogden JA, Alvarez RG, Levitt RL, Johnson JE, Marlow ME. Electrohydraulic high-energy shock-wave treatment for chronic plantar fasciitis. J Bone Joint Surg Am. 2004;86:2216–2228.
    1. Rompe JD, Meurer A, Nafe B, Hoffmann A, Gerdesmeyer L. Repetitive low-energy shock wave application without local anesthesia is more efficient than repetitive low-energy shock wave application with local anesthesia in the treatment of chronic plantar fasciitis. J Orthop Res. 2005;23:931–941.
    1. Rompe JD, Kirkpatrick CJ, Kullmer K, Schwitalle M, Krischek O. Dose-related effects of shock waves on rabbit tendo achillis. A sonographic and histological study. J Bone Joint Surg Br. 1998;80:546–552.
    1. Jung KH, Hwang JH, Chang HJ, Yoon YC, Park MJ, Yoo JC, Park WH. Low-energy extracorporeal shock wave therapy on chronic epicondylitis of the elbow: clinical and sonography study. J Korean Acad Rehabil Med. 2009;33:77–83.
    1. Kim SB, Lee KW, Lee JH, Kim YD, Yoon KS, Joe YL. The effect of extracorporeal shock wave therapy in plantar fasciitis. J Korean Acad Rehabil Med. 2009;33:333–338.
    1. Zimmermann R, Cumpanas A, Miclea F, Janetschek G. Extracorporeal shock wave therapy for the treatment of chronic pelvic pain syndrome in males: arandomised, double-blind, placebo-controlled study. Eur Urol. 2009;56:418–424.
    1. Hausdorf J, Lemmens MA, Heck KD, Grolms N, Korr H, Kertschanska S, Steinbusch HW, Schmitz C, Maier M. Selective loss of unmyelinated nerve fibers after extracorporeal shockwave application to the musculoskeletal system. Neuroscience. 2008;155:138–144.
    1. Hausdorf J, Lemmens MA, Kaplan S, Marangoz C, Milz S, Odaci E, Korr H, Schmitz C, Maier M. Extracorporeal shock wave application to the distal femur of rabbits diminishes the number of neurons immunoreactive for substance P in dorsal root ganglia L5. Brain Res. 2008;1207:96–101.
    1. Wang CJ, Wang FS, Yang KD, Weng LH, Hsu CC, Huang CS, Yang LC. Shock wave therapy induces neovascularization at the tendon-bone junction. A study in rabbits. J Orthop Res. 2003;21:984–998.
    1. Davis TA, Stojadinovic A, Amare K, Anam M, Naik S, Peoples GE, Tadaki D, Elster EA. Extracorporeal shock wave therapy suppresses the early proinflammatory immune response to a severe cutaneous burn injury. Int Wound J. 2009;6:11–21.
    1. De Sanctis MT, Belcaro G, Nicolaides AN, Cesarone MR, Incandela L, Marlinghaus E, Griffin M, Capodanno S, Ciccarelli R. Effects of shock waves on the microcirculation in critical limb ischemia (CLI) (8-week study) Angiology. 2000;51:S69–S78.
    1. Fukumoto Y, Ito A, Uwatoku T, Matoba T, Kishi T, Tanaka H, Takeshita A, Sunagawa K, Shimokawa H. Extracorporeal cardiac shock wave therapy ameliorates myocardial ischemia in patients with severe coronary artery disease. Coron Artery Dis. 2006;17:63–70.
    1. Sparsa A, Lesaux N, Kessler E, Bennetblanc JM, Nlaise S, Lebrun-Ly V, Colombeau P, Vidal E, Bedane C. Treatment of cutaneous calcinosis in CREST syndrome by extracorporeal shock wave lithotripsy. J Am Acad Dermatol. 2005;53:S263–S265.
    1. Muller-Ehrenberg H, Licht G. Diagnosis and therapy of myofascial pain syndrome with focused shock waves (ESWT) Med Orthop Tech. 2005;5:1–6.
    1. McNulty WH, Gevirtz RN, Hubbard DR, Berkoff GM. Needle electromyographic evaluation of trigger point response to a psychological stressor. Psychophysiology. 1994;31:313–316.
    1. Chen JT, Chen SM, Kuan TS, Chung KC, Hong CZ. Phentolamine effect on the spontaneous electrical activity of active loci in a myofascial trigger spot of rabbit skeletal muscle. Arch Phys Med Rehabil. 1998;79:790–794.
    1. Lewis C, Gevirtz R, Hubbard D. Needle trigger point and surface frontal EMG measurement of psychophysiological responses in tension type headache patients. Biofeedback Self Regul. 1994;19:274–275.
    1. Giamberardino MA, Costantini R, Affaitati G, Fabrizio A, Lapenna D, Tafuri E, Mezzetti A. Viscero-visceral hyperalgesia: characterization in different clinical models. Pain. 2010;151:307–322.
    1. Vecchiet L, Giamberardino MA, Dragani L, de Bigontina P, Albe-Fessard D. Latent myofascial trigger points: changes in muscular and subcutaneous pain thresholds at trigger point and target level. J Med Pract Manage. 1990;5:151–154.
    1. Kim YJ, Lee YH, Kim IS, Kim SH, Auh KB, Yu MG. Effects of electrical stimulation of transcutaneous electrical nerve and acupuncture stimulation in patients with myofascial pain syndrome. J Korean Acad Rehabil Med. 2007;31:25–29.

Source: PubMed

스폰서 및 공동 작업자

건강 상태

약물 개입

3
구독하다