Effects of Extracorporeal Shock Wave Therapy and Low Level Laser Therapy in Myofascial Pain Syndrome

Petz Aladar County Teaching Hospital

Status: Completed

Conditions: Myofascial Pain Syndrome

Treatments: Device: Extracorporeal Shock Wave Therapy; Device: Low Level Laser Therapy

Study type: Interventional

Funder types: Other

Identifiers

NCT03436459

PetzAladarCTH

Details and patient eligibility

About

This study evaluates the effects of low level laser therapy and extracorporeal shock wave therapy in patients with myofascial pain syndrome of the upper trapezius. Half of the patients receive laser therapy, half of them receive shock wave therapy for three weeks.

Full description

Low Level Laser Therapy (LLLT) inducing photochemical and photothermal effect, increases blood flow and vascular permeability and improves cell metabolism. All these lead to muscle recovery. It also activates somatosensory receptors of the skin and reduces local pain and muscle spasm.

The specific mechanisms of extracorporeal shock wave therapy (ESWT) in treating musculoskeletal pain remain unclear. It reduces pain and inflammation by modulating nitrogen-monoxide (NO) and vascular endothelial growth factor (VEGF). It can destroy sensory unmyelinated nerve fibers, and stimulate neovascularization and collagen synthesis in degenerative tissues.

Enrollment: 60 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• patients over 18 years of age with myofascial pain syndrome meeting the Simon's diagnostic criteria (5 major and 1 minor) for at least 8 weeks (chronic pain)
• no physiotherapy or local injection within 3 months before starting the study

Exclusion criteria

• acute onset of neck pain
• physiotherapy or local injection within 3 months before starting the study
• abnormal lab test (ESR, hematology)
• infection, fever
• cervical radiculopathy
• uncontrolled hypertension, anticoagulation or defect in blood coagulation
• previous cervical operaton

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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60 participants in 2 patient groups

Extracorporeal shock wave therapy group

Active Comparator group

Description:

Patients in the shock wave therapy group received total of 1000 shock waves for each treatment at the frequency of 10Hz, with 2 Bar pressure and energy flux density (EFD) of 0.25 mJ/mm2 per minute by using BTL-6000 SWT Topline Power® 3 times with a week's interval between the treatments.

Treatment:

Device: Extracorporeal Shock Wave Therapy

Low Level Laser Therapy group

Active Comparator group

Description:

Patients in the laser therapy group received LLLT once a day for three weeks (altogether 15 working days) to the trigger points and around them in the upper trapezius. The type of laser used: PR999 4 Watt (W) scanning laser; Medical Italia®, around trigger points with 3 Joule /centimeter² (J/cm²), power 800 milliwatt (mW), frequency 2000 Hertz (Hz), on trigger points with 9 J/cm², power 2000mW, frequency 5000Hz for total of 2 minutes on each spot.

Treatment:

Device: Low Level Laser Therapy