The effectiveness of radial Extracorporeal Shockwave Therapy (ESWT) on myofascial trigger points of upper trapezius: A randomized clinical trial.

Panagiotis Rentzias, Demetris Lamnisos, Irene Polycarpou, Demetris Stasinopoulos
Purpose:

The purpose of this study was to assess the effectiveness of radial ESWT on Mtrps of upper trapezius.

Methods:

Forty-eight patients (31 female, 17 male) with active Mtrps on upper trapezius were randomly divided into three groups. The first two groups received ESWT (1000 pulses, 10 Hz at 60 mj and 2000 pulses, 10 Hz at 60 mj) and the third group was the control group (5 minutes of continuous therapeutic ultrasound (US) at 1,2 W/cm2 and 10 minutes of hot pack). Evaluation of pain (VAS), pressure pain threshold (PPT), neck Range of Motion (ROM) and functionality were assessed at baseline, at week 2, at week 3 and one month after the end of therapy.

Results:

All groups showed significant change on PPT after the therapy and at one-month follow-up (p0.001), where ESWT groups had higher measurements than classic physiotherapy (control group). In addition, VAS measurements were significantly improved in all three groups (p0.001), but only ESWT groups maintained statistically significant change at the one-month follow up (p0.001), where classic physiotherapy didn’t (p=0.057). This can be explained by the positive effect of ESWT on pain perception. Comparisons between groups have shown that ESWT groups can increase ROM during the sessions and maintain the result one month after (p=0,028 & 0,043), where classic physiotherapy cannot (p=0,959). In terms of functionality, ESWT groups seem to improve faster and better than control, especially in those with pain more than 12 months.   



Conclusion(s):

ESWT is an effective treatment for Mtrps, by improving pain, ROM and functionality. A clinical proposition arising from this study is the use of 1000 pulses of ESWT at 10 Hz and 60 mj, that may prevent any of the possible side effects. Future studies may investigate different parameters of ESWT, for the better setup of treatment. 




Implications:

ESWT may reduce therapy duration, when Mtrps are involved. It can be a reliable adjunct tool for treating Mtrps or conditions including Mtrps. It is safe and can also be used in a variety of other musculoskeletal conditions.




Funding acknowledgements:
No funding
Keywords:
Shockwave
Pain
Trigger-points
Primary topic:
Musculoskeletal
Second topic:
Pain and pain management
Did this work require ethics approval?:
Yes
Name the institution and ethics committee that approved your work:
Institution: Department of Health Sciences, School of Sciences, European University Cyprus, Committee: National Bioethics Committee of Cyprus
Provide the ethics approval number:
ΕΕΒΚ ΕΠ 2019.01.166
Has any of this material been/due to be published or presented at another national or international conference prior to the World Physiotherapy Congress 2025?:
No

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