Extracorporeal Shock Wave Therapy Combined With Oral Medication and Exercise for Chronic Low Back Pain: A Randomized Controlled Trial

Arch Phys Med Rehabil. 2021 Jul;102(7):1294-1299. doi: 10.1016/j.apmr.2020.12.008. Epub 2021 Jan 14.

Abstract

Objective: To compare extracorporeal shock wave therapy combined with oral medication and an exercise program vs sham treatment with medication and exercise for the treatment of chronic low back pain (CLBP).

Design: Randomized controlled trial.

Setting: Outpatient clinic at a university hospital.

Participants: Eligibility criteria were age older than 18 years and duration of CLBP exceeding 3 months. Exclusion criteria were concurrent treatment or history of surgery for CLBP, cancer, fractures, infections, and disk degeneration.

Intervention: The intervention group received extracorporeal shock wave therapy once a week for 4 weeks along with oral medications and an exercise program. The control group received sham extracorporeal shock wave therapy along with oral medications and an exercise program.

Main outcome measures: Visual analog scale and Oswestry Disability Index (ODI) were used to assess pain and disability at baseline and after 3 months.

Results: The pain score in the intervention group (N=16) was 6.6 at baseline and 3.0 after 1 month (P<.0001) and 1.8 after 3 months (P<.0001). In the control group (N=16), the pain score was 6.8 at baseline, 4.6 after 1 month (P<.0001), and 1.1 after 3 months (P<.0001). ODI scores decreased significantly in both groups compared with baseline values (first month: P<.001, third month: P<.05). The mean ODI score did not differ significantly between the groups (P=.942).

Conclusion: Extracorporeal shock wave therapy combined with oral medication and exercise was safe and effective in the short-term treatment of chronic low back pain.

Keywords: Extracorporeal shock wave therapy; Low back pain; Rehabilitation.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Analgesics / therapeutic use
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Clonidine / analogs & derivatives*
  • Clonidine / therapeutic use
  • Combined Modality Therapy
  • Disability Evaluation
  • Exercise Therapy / methods*
  • Extracorporeal Shockwave Therapy / methods*
  • Female
  • Humans
  • Low Back Pain / therapy*
  • Male
  • Meloxicam / therapeutic use*
  • Middle Aged
  • Pain Measurement

Substances

  • Analgesics
  • Anti-Inflammatory Agents, Non-Steroidal
  • tizanidine
  • Clonidine
  • Meloxicam