Low back pain (LBP) is a common complaint that poses a significant health concern that impacts millions of Americans annually. In fact, low back pain is recognized as the second leading cause of disability among adults, resulting in enormous economic burdens due to lost workdays and the cost of evaluation and treatment protocols. Many, if not most, Americans have or will experience back pain at some point in their lives, indicating its prevalence.
The burden of low back pain (LBP) on patients and society is notable, with billions of dollars spent annually on evaluation and treatment. Traditional therapies can include prescription medications, which may provide short-term relief but may not be well tolerated or have adverse effects. Today, guidelines recommend non-pharmacological, non-invasive management strategies whenever possible.
This introduction sets the stage for a recent study’s exploration into the efficacy and safety of Extracorporeal Shockwave Therapy (ESWT) and its potential application in managing chronic LBP. As the population ages and back pain incidence increases, finding solutions to help patients heal faster with little downtime becomes increasingly essential.
A fascinating systematic review and meta-analysis was conducted by a team of researchers from The First Affiliated Hospital of Hainan Medical University, Hainan, China, published the study in Medicine (Baltimore) on December 30, 2022. To take a deep scientific dive, read this article in its entirety: “Efficacy and Safety of Extracorporeal Shock Wave on Low Back Pain: A Systematic Review and Meta-Analysis."
Materials and Methods of the Systematic Review and Meta-Analysis
Researchers performed this systematic review and meta-analysis to analyze the effectiveness and safety of ESWT interventions on pain and disability in patients with low back pain (LBP).
In this study, researchers conducted a meta-analysis relying upon Cochrane Collaboration and PRISMA guidelines, registered on the Research Registry. Additionally, they searched multiple databases for randomized controlled trials related to Extracorporeal Shockwave Therapy (ESWT) in treating low back pain (without language or publication year restrictions or patient follow-up durations). Two of the researchers independently assessed study eligibility based on predefined criteria.
Methodological quality was evaluated using Cochrane Collaboration tools, and the GRADE approach was utilized for evidence-quality grading. Data extraction included patient characteristics, study details, intervention methods, and outcomes.
A thorough statistical analysis involved assessing heterogeneity, using random or fixed-effects models where appropriate, as well as calculating risk ratios (and mean differences with 95% confidence intervals). Significance was set at p < 0.05. This comprehensive review thoroughly examined ESWT's effectiveness in managing LBP.
Clinical Results of Shockwave Treatment for Low Back Pain
In summary, after an extensive search, researchers pulled from 13 randomized controlled trials (RCTs) in this meta-analysis. This included 648 patients (329 in the ESWT group and 319 in the control group). Research shows that symptom duration ranged anywhere from 5 to 36 months. All studies included a complete assessment of pain intensity pre-and post-intervention.
Below is a recap of key findings in the study:
- Pain score at one month: Meta-analysis revealed a significant difference between the ESWT and control groups, with reduced pain in the ESWT group.
- Pain score at three months: Again, a significant difference favoring the ESWT group was observed.
- ODI score (Oswestry Disability Index is the most commonly used outcome for measure) at one month: Significant improvement in ODI score was noted in the ESWT group.
- ODI score at three months: The ESWT group demonstrated a measurable decrease in ODI score.
- No adverse effects were reported.
- Sensitivity analysis demonstrates the conclusions of this in-depth analysis were robust.
These impressive findings suggest that Extracorporeal Shockwave Therapy effectively alleviates pain and improves functional outcomes in patients with low back pain, based on the available RCT evidence reviewed.
Shockwave treats the root cause of pain non-invasively – no risk, no downtime, no surgery, scarring, or anesthesia.
Find out more about Healing Pain and Injuries with ESWT.
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