Low back pain is a highly prevalent condition, with statistics showing that approximately eighty percent of adults have experienced it at some point in their lives.
There are various treatment modalities for low back pain, ranging from traditional conservative therapies such as exercise training, physical therapy, and medication, to invasive treatments like acupuncture, dry needling, trigger point injections, and surgical intervention when severe.
However, for patients with stubborn low back pain who do not require or prefer to avoid surgery, traditional conservative treatments may be ineffective, and invasive treatments may be intimidating.
Are there other treatment options available?
The answer is yes!
That's where extracorporeal shockwave therapy comes in!
Due to its ability to stimulate tissue repair and regeneration and alleviate pain, extracorporeal shockwave therapy has found widespread application in the field of musculoskeletal rehabilitation.
Traditionally, shockwave therapy has been primarily indicated for superficial tissue pathologies of the limbs (e.g., tendon disorders of the upper and lower limbs, plantar fasciitis).
However, increasing clinical evidence suggests that extracorporeal shockwave therapy is also effective in treating central and deeper tissue-related pathologies within the body.
Today, Dr. Huang will go through the current medical evidence and clinical efficacy of extracorporeal shockwave therapy for low back pain.
1.Extracorporeal shock wave therapy for low back pain: A systematic review and meta-analysis
Medicine (Baltimore). 2023 Dec 29;102(52):e36596. (IF: 1.552)
https://pubmed.ncbi.nlm.nih.gov/38206739/
This retrospective study analyzed over 600 articles related to extracorporeal shockwave therapy for low back pain, selecting 22 randomized controlled trials involving 1749 patients for integrated analysis.
The study compared the effectiveness of extracorporeal shockwave therapy with other traditional treatments (Kinesitherapy, Trigger point injection, Ultrasound therapy, Thermal therapy, TENS, Magneto-thermo- vibration, acupuncture, Oral drugs) for low back pain.
Results showed that compared to the control group, patients receiving extracorporeal shockwave therapy had lower pain scores on the Visual Analog Scale (VAS), lower Oswestry Disability Index (ODI) scores, lower Beck Depression Inventory scores, shorter finger-to-ground distances, and higher Japanese Orthopaedic Association scores.
At the three-month follow-up, patients receiving shockwave therapy continued to show lower VAS and ODI scores, fewer adverse reactions, and more effective cases.
Conclusion: Extracorporeal shockwave therapy for low back pain demonstrates efficacy and safety in improving pain, functional disability, and psychological conditions compared to other therapies, showing long-term advantages in efficacy.
2.Efficacy and safety of extracorporeal shockwave therapy in chronic low back pain: a systematic review and meta-analysis of 632 patients
J Orthop Surg Res. 2023; 18: 455. (IF: 2.677)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10290808/
This systematic review and meta-analysis focused on chronic low back pain (lasting over three months), selecting 12 randomized controlled trials involving 632 patients from over 180 articles.
The study compared the effectiveness of extracorporeal shockwave therapy with other treatments [Exercise, Laser, Trigger point injection, muscle injection (40 mg triamcinolone + 2 mL lidocaine 2%), Hot packs, ultrasound and electrotherapy, Myofascial trigger therapy, Oral medications] for chronic low back pain.
Results indicated significant improvements in pain and ODI disability index scores with extracorporeal shockwave therapy compared to traditional treatments.
Conclusion: Extracorporeal shockwave therapy is more effective in relieving pain and improving lumbar spine dysfunction compared to other treatment modalities, with no serious adverse reactions.
3.Extracorporeal Shockwave Therapy for Treating Chronic Low Back Pain: A Systematic Review and Meta-analysis of Randomized Controlled Trials
Biomed Res Int. 2021 Nov 15:2021:5937250.
https://pubmed.ncbi.nlm.nih.gov/34840977/
This earlier retrospective study screened 10 randomized controlled trials involving 455 young to middle-aged patients (29.2-55.8 years) to compare the effects of extracorporeal shockwave therapy with other treatments for chronic low back pain.
The conclusion was that patients with chronic low back pain using extracorporeal shockwave therapy showed significant and quantifiable reductions in pain and disability in the short term.
Dr. Huang's Conclusion:
For the vast population suffering from low back pain, traditional conservative treatments such as exercise training, physical therapy, and medication remain the mainstay of treatment.
However, these traditional conservative treatments have the following limitations─
Exercise training: poor adherence; incorrect posture and lack of persistence
Physical therapy: difficulty in achieving long-term pain relief
Medication therapy: potential side effects such as nausea, constipation, and fatigue
Moreover, invasive treatments may not be acceptable for every patient.
Therefore, a treatment that is both more effective and non-invasive is desired by many patients.
Extracorporeal shockwave therapy, known for its regenerative properties and pain relief without the invasiveness of needles, can be considered a "needle-free PRP."
In addition to its application in musculoskeletal rehabilitation, it has wide-ranging applications in urology, including the treatment of male erectile dysfunction.
Traditionally, extracorporeal shockwave therapy has primarily targeted superficial tissue pathologies due to the ease of targeting the shockwaves.
However, low back pain involves pathologies ranging from superficial to deep tissues, making treatment more challenging.
Nevertheless, preliminary studies have affirmed the efficacy of extracorporeal shockwave therapy for low back pain.
Dr. Huang believes that optimizing the treatment process to achieve more precise and effective therapy will be the focus of future research.
I urge all low back pain patients to consider the diverse treatment options available in modern medicine to achieve early recovery and alleviate pain.
