Making Shockwave Therapy More Precise with Ultrasound for Low Back Pain Relief

What is it about?

Chronic low back pain affects millions worldwide, often limiting mobility and quality of life. Extracorporeal shockwave therapy (ESWT) is a non-invasive treatment that can alleviate myofascial and neuropathic pain. However, its effectiveness depends on accurately targeting the right areas. This study explores how ultrasound guidance can enhance the precision and outcomes of ESWT. What did we do? We studied 26 patients with chronic low back pain, comparing two groups: Patients receiving ultrasound-guided ESWT with focused, defocused, and radial shockwaves. Patients receiving shockwave therapy without ultrasound guidance (sham group). The treatment was applied using advanced shockwave devices (Storz Medical DUOLITH® SD1 Ultra and Orthogold 100, SoftWave TRT, LLC), and pain levels were assessed using the Visual Analog Scale (VAS) before and after treatment. What did we find? Ultrasound-guided ESWT resulted in greater pain reduction (VAS from 7.5 to 4.3) compared to blind ESWT (VAS from 7.4 to 5.4). Focused shockwave (F-ESWT) was most effective for tendons, particularly in the back muscles (multifidus, quadratus lumborum). Radial shockwave (R-ESWT) helped relax large leg muscles, reducing neuropathic pain. Defocused shockwave (D-ESWT) targeted the sciatic nerve and thoracolumbar pain in the chest and abdominal walls.

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Why is it important?

This study highlights that using ultrasound improves the accuracy of ESWT, leading to better pain relief and functional recovery. Personalized protocols based on ultrasound imaging could help optimize treatment for different neuromusculoskeletal conditions.

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