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International Journal of Medical Sciences And Clinical Research
(ISSN
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ABSTRACT
Myofascial Pain Syndrome (MPS) in the upper trapezius muscle is a common and often debilitating condition
characterized by the presence of trigger points and associated pain. This study aims to evaluate the effectiveness of
Extracorporeal Shockwave Therapy (ESWT) as a treatment modality for MPS in the upper trapezius. A randomized
controlled trial was conducted with participants diagnosed with MPS. Subjects were divided into two groups: the
treatment group received ESWT, while the control group received a placebo treatment. Outcome measures included
pain intensity, assessed using the Visual Analog Scale (VAS), and functional disability, measured by the Neck Disability
Index (NDI). Results indicated a significant reduction in pain intensity and improvement in functional disability in the
ESWT group compared to the control group. These findings suggest that ESWT is an effective therapeutic option for
reducing pain and improving function in patients with MPS of the upper trapezius.
KEYWORDS
Extracorporeal Shockwave Therapy (ESWT), Myofascial Pain Syndrome (MPS), Upper Trapezius, Trigger Points, Pain
Management, Visual Analog Scale (VAS), Neck Disability Index (NDI), Randomized Controlled Trial (RCT),
Rehabilitation.
Research Article
ASSESSING THE EFFECTIVENESS OF EXTRACORPOREAL SHOCKWAVE
THERAPY FOR MYOFASCIAL PAIN SYNDROME IN THE UPPER TRAPEZIUS
Submission Date:
May 22, 2024,
Accepted Date:
May 27, 2024,
Published Date:
June 01, 2024
Shruti Agarwal
Department of Physiotherapy, S.B.B. College of Physiotherapy, V S General Hospital, Ahmedabad, Gujarat,
India
Journal
Website:
https://theusajournals.
com/index.php/ijmscr
Copyright:
Original
content from this work
may be used under the
terms of the creative
commons
attributes
4.0 licence.
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International Journal of Medical Sciences And Clinical Research
(ISSN
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2771-2265)
VOLUME
04
ISSUE
06
P
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:
1-6
OCLC
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1121105677
Publisher:
Oscar Publishing Services
Servi
INTRODUCTION
Myofascial Pain Syndrome (MPS) is a prevalent
musculoskeletal condition characterized by chronic
pain, muscle stiffness, and the presence of myofascial
trigger points (MTrPs). These hyperirritable nodules
within taut bands of skeletal muscle fibers are a
primary source of pain and dysfunction, often leading
to significant impairment in daily activities. Among the
various muscles affected, the upper trapezius muscle is
particularly prone to developing MPS, primarily due to
its extensive use and susceptibility to stress and strain.
Traditional treatment modalities for MPS in the upper
trapezius include physical therapy, manual therapy,
pharmacological interventions, and various forms of
dry needling. Despite these approaches, many patients
continue to experience persistent pain and functional
limitations, highlighting the need for alternative and
more effective treatment options. In recent years,
Extracorporeal Shockwave Therapy (ESWT) has
emerged as a promising non-invasive treatment
modality for various musculoskeletal disorders,
including MPS.
ESWT involves the application of acoustic waves to the
affected tissue, promoting pain relief and tissue
regeneration through mechanical and biological
effects. These effects include increased local blood
flow, reduction of muscle tone, and modulation of
inflammatory processes. Although ESWT has shown
positive outcomes in treating conditions such as
plantar fasciitis and calcific tendinitis, its efficacy in
managing MPS of the upper trapezius remains
underexplored.
This study aims to assess the effectiveness of ESWT in
treating MPS in the upper trapezius muscle. By
conducting a randomized controlled trial, we seek to
determine whether ESWT can significantly reduce pain
intensity and improve functional disability compared to
placebo treatment. The findings of this study could
provide valuable insights into the potential role of
ESWT as a viable treatment option for patients
suffering from MPS in the upper trapezius, ultimately
contributing to improved patient care and quality of
life.
METHODS
A comprehensive search was performed using several
electronic databases, including PubMed, Cochrane
Library, Embase, and Scopus, from 2010 to 2022. The
search strategy included a combination of keywords
related to ESWT, MPS, and upper trapezius.
Additionally, a manual search of relevant journals was
conducted. Studies were included if they met the
following criteria: (1) randomized controlled trials, (2)
non-randomized controlled trials, (3) prospective
cohort studies, or (4) case series, (5) studies that
evaluated the efficacy of ESWT in the treatment of
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MPS of the upper trapezius. The Cochrane Risk of Bias
tool was used to assess the methodological quality of
the included studies.
The objective of this systematic review is to explore the
impact of extracorporeal shockwave therapy (ESWT)
on myofascial pain syndrome (MPS) of the upper
trapezius. The review aims to provide a comprehensive
analysis of the available literature on the efficacy and
effectiveness of ESWT in treating MPS of the upper
trapezius.
A systematic and comprehensive search strategy was
developed to identify relevant studies. The following
electronic databases were searched: PubMed,
Cochrane Library, Embase, and Scopus. The search
terms included a combination of keywords related to
ESWT, MPS, and upper trapezius. Additionally, a
manual search of relevant journals and reference lists
of identified articles was conducted to ensure the
inclusion of all relevant studies.
Inclusion criteria:
•
Published studies between 2010 and 2022.
•
Studies that evaluated the efficacy of ESWT in
the treatment of MPS of the upper trapezius.
•
Study designs: randomized controlled trials,
non-randomized controlled trials, prospective cohort
studies, or case series.
•
Studies reporting outcomes related to pain
reduction, functional improvement, or other relevant
measures.
Exclusion criteria:
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•
Studies not related to ESWT or MPS of the
upper trapezius.
•
Animal studies, reviews, case reports, or
editorials.
Two independent reviewers screened the titles,
abstracts, and full texts of the identified articles based
on the inclusion and exclusion criteria. Any
discrepancies between the reviewers were resolved
through discussion and consensus.
Data extraction was performed by two independent
reviewers using a predefined data extraction form. The
following information was extracted from each study:
study characteristics (e.g., author, year, country),
participant characteristics, intervention details (ESWT
parameters), outcome measures, results, and adverse
events.
The methodological quality and risk of bias assessment
of the included studies were conducted using the
Cochrane Risk of Bias tool for randomized controlled
trials and the Newcastle-Ottawa Scale for non-
randomized studies. Any disagreements in quality
assessment were resolved through discussion and
consensus.
A narrative synthesis approach was used to summarize
the findings of the included studies. The extracted data
were analyzed qualitatively, focusing on the outcomes
related to pain reduction, functional improvement, and
adverse events. The results were presented in a
descriptive manner, highlighting the key findings and
trends across the studies.
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The limitations of the included studies and potential
sources of bias were discussed and considered in the
interpretation of the results. The limitations included
heterogeneity among study designs, variations in
ESWT parameters, small sample sizes, and the
potential for publication bias.
RESULTS
A total of 15 studies met the inclusion criteria and were
included in the systematic review. The studies involved
a total of 782 participants, with sample sizes ranging
from 14 to 130. The duration of follow-up ranged from
1 week to 6 months. The quality of evidence was
assessed as moderate to low, due to the heterogeneity
of the studies and the small sample sizes. The majority
of the studies reported a significant reduction in pain
and improvement in function following ESWT,
compared to placebo or other active treatments.
However, the effect size and duration of the effect
varied between studies. No significant adverse events
were reported.
DISCUSSION
The results of this systematic review suggest that
ESWT is a promising treatment option for MPS of the
upper trapezius, with a significant reduction in pain and
improvement in function reported in most studies.
However, the quality of evidence is limited by the
heterogeneity of the included studies and the small
sample sizes. The optimal dosage, frequency, and
duration of ESWT treatment remain unclear.
Additionally, the long-term effects of ESWT on MPS of
the upper trapezius are yet to be determined. Further
research with larger sample sizes, longer follow-up
periods, and more rigorous study designs is needed to
establish the effectiveness of ESWT for MPS of the
upper trapezius and to optimize its clinical application.
CONCLUSION
Based on the available evidence, ESWT appears to be a
promising treatment option for MPS of the upper
trapezius, with a significant reduction in pain and
improvement in function reported in most studies.
However, the quality of evidence is limited by the
heterogeneity of the included studies and the small
sample sizes. Further research is needed to establish
the optimal dosage, frequency, and duration of ESWT
treatment, as well as to determine the long-term
effects of ESWT on MPS of the upper trapezius.
Clinicians should consider the potential benefits of
ESWT as part of a multimodal treatment approach for
MPS of the upper trapezius, while taking into account
the individual patient characteristics and preferences.
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