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. 2022 Jul 28;58(8):1014.
doi: 10.3390/medicina58081014.

Efficacy and Effectiveness of Extracorporeal Shockwave Therapy in Patients with Myofascial Pain or Fibromyalgia: A Scoping Review

Marco Paoletta  1 , Antimo Moretti  1 , Sara Liguori  1 , Giuseppe Toro  1 , Francesca Gimigliano  2 , Giovanni Iolascon  1
Affiliations

Efficacy and Effectiveness of Extracorporeal Shockwave Therapy in Patients with Myofascial Pain or Fibromyalgia: A Scoping Review

Marco Paoletta et al. Medicina (Kaunas). .

Abstract

Myofascial pain syndrome (MPS) and fibromyalgia (FM) are underestimated painful musculoskeletal conditions that could impact function and quality of life. A consensus about the most appropriate therapeutic approach is still not reached. Considering the long course of the diseases, prolonged assumption of drugs, such as NSAIDs and pain killers, could increase the risk of adverse events, often leading affected patients and physicians to prefer non-pharmacological approaches. Among these, radial and focused extracorporeal shock waves therapies (ESWT) are widely used in the management of painful musculoskeletal conditions, despite the fact that the mechanisms of action in the context of pain modulation should be further clarified. We performed a scoping review on PubMed using Mesh terms for analyzing the current evidence about the efficacy and effectiveness of ESWT for patients with MPS or FM. We included 19 clinical studies (randomized controlled trials and observational studies); 12 used radial ESWT, and 7 used focused ESWT for MPS. Qualitative analysis suggests a beneficial role of ESWT for improving clinical and functional outcomes in people with MPS, whereas no evidence was found for FM. Considering this research gap, we finally suggested a therapeutic protocol for this latter condition according to the most recent diagnostic criteria.

Keywords: extracorporeal shockwave therapy; fibromyalgia; musculoskeletal pain; myofascial pain syndromes; neck pain; pressure pain threshold; rehabilitation; trigger points.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram of the literature review process.
Figure 2
Figure 2
Hypothesized mechanisms of action of ESWT in people with MPS. Abbreviations: Ach, acetylcholine; Ca2+, calcium ion; Pg, prostaglandins; 5HT, 5-hydroxytryptamine.
Figure 3
Figure 3
Hypothesized mechanisms of action of ESWT in people with FM. Abbreviations: ET-1, endothelin 1; CGRP, calcitonin gene-related peptide.
See this image and copyright information in PMC

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