Background & Aims

Myofascial pain syndrome (MPS) is a chronic pain syndrome which disrupts the quality of life and functionality. There are few studies and contradictory results on current evidence for the short-term effect of ESWT on MPS of trapezius (1,2). The aim of this study was to determine effectiveness of extracorporeal shock wave treatment (ESWT) on the severity of the pain at the trigger points and patients’ functional status and quality of life as well as quantitative trigger point stiffness by USG measurements in patients with MPS.

Methods

A total of 28 patients with MPS who were aged between 18-60 years and who had been admitted to outpatient clinic of PMR, were included to the study. Age, gender, duration of symptoms, education, body mass index were recorded. The pressure pain threshold at the most painful trigger point was measured by the algometer; the same point was evaluated by shear-wave elastography (SWE) for stiffness. Patients were grouped as Group1 who received ESWT (700 pulse, 4 Hz, 1,5 bar, 5 min) and Group2 who received sham ESWT for trigger points twice a week for 2 weeks. Pain by VAS, functional status by Neck Pain and Disability Index (NPDI)(3) and quality of life by Nottingham Health Profile (NHP)(4) were assessed before and after therapies.

Results

There were 14 patients in Group 1-ESWT and Group2-sham groups respectively. The demographic properties were similar between the groups (p>0.05). There were significant improvements in pain, function and QoL scores in both groups but statistically significant improvements were determined only in Group 1. No significant change was observed in SWE values. VAS-pain scores were correlated with NPDI, and pain, physical and social-subscores of NHP scores in both groups (p<0.05) but SWE and algometric scores did not correlate with any variable.

Conclusions

In conclusion ESWT is effective in treatment of MPS, improves function, increases quality of life and decrease trigger point stiffness. Further research is required in order to determine the long-term effects of ESWT in patients with MPS.

References

1. Ramon S, Gleitz M, Hernandez L, Romero LD. Update on the efficacy of extracorporeal shockwave treatment for myofascial pain syndrome and fibromyalgia. Int J Surg. 2015 Dec;24(Pt B):201-6.
2. Yoo JI, Oh MK, Chun SW, Lee SU, Lee CH. The effect of focused extracorporeal shock wave therapy on myofascial pain syndrome of trapezius: A systematic review and meta-analysis. Medicine (Baltimore). 2020 Feb;99(7):e19085.
3. Telci EA, Karaduman A, Yakut Y, Aras B, Simsek IE, Yagli N. The cultural adaptation, reliability, and validity of neck disability index in patients with neck pain: a Turkish version study. Spine (Phila Pa 1976). 2009 Jul 15;34(16):1732-5.
4.Kücükdeveci AA, McKenna SP, Kutlay S, Gürsel Y, Whalley D, Arasil T. The development and psychometric assessment of the Turkish version of the Nottingham Health Profile. Int J Rehabil Res. 2000 Mar;23(1):31-8.

Presenting Author

Pinar Borman

Poster Authors

Pinar Borman

MD

Ankara Medipol University Medical Faculty Dept of PMR

Lead Author

E-mail

Merve Denizli

MD

Hendek State Hospital Dept of PMR, Sakarya

Lead Author

E-mail

Sibel Mandiroglu

MD

Gaziler PMR Hospital, dept of PMR

Lead Author

E-mail

Serkan Tas

PT

Toros University Physiotherapy School

Lead Author

E-mail

Sevilay Karahan

Hacettepe University Dept of Biostatistics

Lead Author

E-mail

Topics

  • Specific Pain Conditions/Pain in Specific Populations: Muscle and Myofascial pain

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