In the previous article, it has been mentioned that many patients have misconceptions about extracorporeal shock wave therapy (ESWT), believing that more shock wave pulses lead to better outcomes.
The article also discussed the effects of pulse count in the treatment of erectile dysfunction based on literature.
Naturally, there will be questions about whether the number of pulses also yields similar results in soft tissue treatments.
Currently, there is a lack of double-blind comparative studies specifically examining the effects of different pulse counts in soft tissue treatments.
However, there is indeed a study exploring the treatment effects of varying pulse counts and energy intensities in knee osteoarthritis (KOA).
This paper investigated the impact of extracorporeal shock wave therapy (rESWT) at different energy intensities and pulse counts on pain relief and functional improvement in KOA.
The study divided participants into four treatment groups:
low intensity (0.12 mJ/mm²) with 2000 pulses, low intensity with 4000 pulses, high intensity (0.24 mJ/mm²) with 2000 pulses, and high intensity with 4000 pulses, along with a control group (0.02 mJ/mm² with 1000 pulses).
All groups received treatment once a week for a total of four sessions.
The main findings of the study showed that:
●Energy intensity significantly affects pain relief and functional improvement: high-intensity treatment was clearly more effective than low-intensity.
●The pulse count had a relatively minor impact on treatment efficacy:
－there was no significant difference in pain relief between 2000 and 4000 pulses, and statistically, the 2000 pulses showed slightly better results for pain relief than 4000.
－In terms of functional improvement, pulse count had some influence, with 4000 pulses performing slightly better than 2000, but the difference was not substantial.
In summary, the intensity of the shock waves has a greater influence on the effectiveness of treatment for knee osteoarthritis than the number of pulses.
Commentary from Dr. Huang:
As a pain management physician, I understand patients’ desire to pursue better outcomes to alleviate pain.
Extracorporeal shock wave therapy is indeed a valuable tool for tissue repair and pain reduction.
However, patients should understand that in soft tissue treatment, the key to successful therapy lies in the appropriate intensity of the shock waves rather than blindly increasing the number of pulses.
Overemphasizing pulse counts may not only fail to enhance efficacy but could also lead to unnecessary treatment time and costs.
In reality, the moderate intensity treatments suggested in the study (0.12 to 0.24 mJ/mm²) can effectively relieve pain and improve function, making them more tolerable for patients.
When it comes to treating soft tissue conditions, it is important not to blindly believe that "more pulses equal better outcomes."
Appropriate treatment often leads to optimal results, which is key to successful therapy!
