Extracorporal shock wave induced mechanical transduction for the treatment of low back pain – a randomized controlled trial

Thore-Björn Haag1, Eva Fellinger2, Martin Handel3, Christina Beckmann4, Christian Schneider5


Context: Selective application of extracorporal shock waves (ESW) is a well-known treatment for orthopedic diseases, but effects of a complete body application on pain intensity and postural control in low back pain patients have not yet been evaluated.

Objective: To evaluate the effect of a 23Hz extracorporal complete body shock wave (CBSW) therapy (EvoCell) for the treatment of low back pain in comparison to current therapies (Fango).

Design: We conducted a randomized controlled trial in 100 patients admitted to 4 different groups from March till November 2015. The subjects received 9 interventions (ESWT/Fango) within 3 weeks with follow-up measurements after 4 and 8 weeks.Primary outcomes include parameters of posture, assessed by a Lightrasterstereography (LRS), a sitting-stability-check (S3) and changes in pain experience due to a Visual Analogue Scale (VAS), Heart Rate (HF) and Blood Pressure (BP).

Results: Only Fango had a significant decreasing acute effect on pain or blood pressure, but the subjects treated with EvoCell showed a significant pain reduction after 4 sessions and a greater pain reducing effect after 3 weeks of treatment. EvoCell had a highly significant reducing effect on heart rate (p<0.001). Additionally, the CBSW seemed to influence the ability to stabilize the trunk in an upright sitting position in the lateral direction above other treatments.

Conclusion: Regarding to the individually different response of proteins and other structures on ESW frequencies, the specific underlying mechanisms remain unclear. But as we were able to show, it can be assumed that the periodic application of a CBSW stimulates mechanical transduction and therefore is advisable to be part of a treatment in low back pain patients.

Keywords back pain, longitudinal, shock wave, treatment.

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