Efficacy of extracorporeal focused shock waves therapy in patients with enthesopatic chronic pain

Introduction. Extracorporeal Shock Waves are worldwide used for the treatment of musculoskeletal disorders, even though there is still disagreement regarding its appropriate use and efficacy. This pilot study is aimed to evaluate the efficacy of Focused Shock Waves Therapy in reducing enthesopatic chronic pain. Materials and methods. We recruited 35 patients suffering from chronic pain due to enthesopathy (at lower and upper limbs). All the patients included were previously treated with drug therapy without achieving significant results in terms of improvement in pain. We excluded all patients with chronic pain due to other causes (neuropathic, dismetabolic, rheumatic, psychogenic). We evaluated all patients using the “Brief Pain Inventory” (BPI) and Visual Analogic Scale (VAS) before (T0) and after 4 treatments (T1). The treatment was carried out with shock waves generated for a focal, electro-hydraulic principle. The energy was applied in 4 sessions over a range between 0.13 and 0.88 mJ /mm ², without application of local anesthetics. Results. Our study population was composed by 35 patients (16 M and 19 F, mean age 52.3). The mean of the BPI pain severity index and the BPI pain interference index at T0 was 7.85 and 7.17 respectively, while at T1 was 1.43 and 0.82; if we consider the VAS at T0 the mean score was 7.94 and at T1 it was 1.60. If we consider only male subjects the mean of the BPI pain severity index and the BPI pain interference index at T0 was 7.31 and 6.96 respectively, while at T1 was 1.32 and 0.88; the mean VAS score at T0 was 7.31 and at T1 it was 1.44. In the female group the mean of the BPI pain severity index and the BPI pain interference index at T0 was 8.31 and 7.35 respectively, while at T1 was 1.53 and 0.77; the mean VAS score at T0 was 8.47 and at T1 it was 1.74. Conclusions. In our study we found a significant reduction of chronic pain and a significant improvement in the quality of life both in female and in male patients affected by enthesopathy. Bibliography 1. C. A. Speed - Extracorporeal shock-wave therapy in the management of chronic soft tissue conditions. The Journal of Bone and Joint Surgery, VOL. 86-B, No. 2, MARCH 2004.