In this article, we will discuss rotator cuff injuries and shock wave therapy.
The rotator cuff is a soft tissue in the shoulder that supports the joint between the humerus and scapula.Injuries to the rotator cuff are frequently seen in clinical practice, and when we hear of shoulder pain, we have to consider this condition.Depending on the degree of damage, non-surgical treatment options may be chosen, one of which is extracorporeal shock wave therapy.One of these methods is extracorporeal shock wave therapy, which is available in some facilities such as sports clinics, and is a new method of treatment that has shown great promise.There was a study that reviewed this method, and I would like to introduce what kind of results were obtained.
Contents of the study
The study reviewed 2281 participants from 32 trials published by November 2019.
Twelve trials compared shockwave therapy with placebo.
Eleven trials compared high-dose and low-dose shockwave therapy, but the dosage varied between trials.A single trial compared shockwave therapy with other treatments, including ultrasound-guided glycocorticoid needling, transcutaneous electrical nerve stimulation (TENS), exercise, or no treatment.In these studies, 61% of the participants were female, the average age was 52 years, and the rotator cuff injury was sustained, with the average being 33 months old.Two of these trials were funded by a manufacturer of shockwave therapy machines.In the trial in which participants reported 50% or more pain relief, 4/100 participants reported 50% or more pain relief.
42/100 people reported more than 50% pain relief with shockwave therapy, including 38/100 people who reported more than 50% pain relief with shockwave therapy compared to placebo treatment.Reports on pain (the higher the score, the greater the pain) reported improvements ranging from 2 to 14% on a 0 to 10 point scale, or values ranging from 0.17 to 1.4.Those who received shock wave therapy rated their post-treatment pain as 2.2 points, while those who received placebo rated their post-treatment pain as 3 points.In terms of motor functioning (higher scores indicate better functioning), they reported improvement on a scale of 0 to 100 points, with values ranging from 1.6 to 14 percent, or 1.6 to 14.Those who received shock wave therapy rated their post-treatment functionality as 74 points, while those who received placebo rated their post-treatment functionality as 66 points.Participants reported completing treatment between 3% and 49% of the time.In terms of withdrawals due to side effects, 8/100 participants withdrew from treatment with shock wave therapy and 10/100 participants withdrew from the placebo group.
Reviewer's conclusions
Based on the currently available low- to moderate-certainty evidence, there were few clinically important benefits of shock wave therapy and uncertainty about its safety. The wide clinical diversity and variety of treatment protocols meant that we do not know if some trials tested subtherapeutic doses, which may have underestimated the potential benefits.
Further trials of extracorporeal shock wave therapy for rotator cuff disease should be based on strong rationale and considerations that may or may not change the conclusions of this review. Standard doses and treatment protocols need to be determined before further studies can be conducted. The development of a core set of results from trials of rotator cuff disease and other shoulder disorders would also facilitate our ability to integrate the evidence.
Surace SJ, Deitch J, Johnston RV, Buchbinder R. Shock wave therapy for rotator cuff disease with or without calcification. Systematic Reviews 2020, Issue 3. Art. No.: CD008962. DOI: 10.1002/14651858.CD008962.pub2.
Conclusion
Because of the fad and experimental aspect of these new treatments, some people make big claims about their experiences and say that they are better than other treatments.Since this is a treatment that you will receive at a medical institution, you may take it with a certain amount of expectation and trust, but you may want to consider the results of this review before choosing this treatment.At one of the osteopathic clinics, someone who was considering introducing this kind of equipment asked me if I would be interested in a clinical trial. My personal impression is that I can understand how people who are withdrawing from treatment feel.
I wish I could say, "If you're interested, why don't you give it a try? I wish I could say that it is a good idea, but I can`t say for sure because the price for the treatment using this device is quite good.
This review is limited to rotator cuff injuries in the shoulder area, and my own impressions after trying it on my elbow.
I am not sure if the same can be said for other parts of the body.
