Influence of Extracorporeal Shockwave Therapy in Patients of Mechanical Neck Pain

Influence of Extracorporeal Shockwave Therapy in Patients of Mechanical Neck Pain

Purpose:

The study aimed to determine whether adding extracorporeal shockwave therapy (ESWT) to a standardized physiotherapy program provides additional benefits for patients with chronic mechanical neck pain. Specifically, it examined effects on pain intensity, pressure pain threshold (PPT), neck disability index (NDI), cervical active range of motion (AROM), and joint position sense (JPS).

Study Summary Summary of the Study: Influence of Extracorporeal Shockwave Therapy in Patients with Mechanical Neck Pain

Purpose:

The study aimed to determine whether adding extracorporeal shockwave therapy (ESWT) to a standardized physiotherapy program provides additional benefits for patients with chronic mechanical neck pain. Specifically, it examined effects on pain intensity, pressure pain threshold (PPT), neck disability index (NDI), cervical active range of motion (AROM), and joint position sense (JPS).

Key Details:

• Study Design: Double-blinded, pretest-posttest controlled clinical trial.

• Participants: 52 patients aged 18-29 with chronic mechanical neck pain for over 3 months.

• Groups:

  • Group A: Standardized physiotherapy only (stretching, isometric exercises, posture training).
  • Group B: ESWT + standardized physiotherapy.

• Duration: 4 weeks, 2 sessions/week (1 ESWT + 1 physiotherapy in Group B).

• Assessments: NPRS for pain, pressure algometer for PPT, Arabic NDI, goniometer for AROM & JPS.

• Results:

  • Adding ESWT significantly improved PPT, left cervical rotation AROM, cervical extension JPS, and right cervical rotation JPS.
  • No significant differences between groups in other measures.

• Conclusion: ESWT combined with physiotherapy may enhance pain threshold, AROM in rotation, and proprioception compared to physiotherapy alone.

Sources of Strength in the Study:

1. Double-blind design reduces bias.
2. Randomized allocation with adequate sample size determined by power analysis.
3. Use of validated measurement tools (NPRS, NDI Arabic version, Wagner algometer, standard goniometer).
4. Clearly defined inclusion/exclusion criteria ensuring sample homogeneity.
5. Use of standardized physiotherapy protocol enhances reproducibility.

Inclusion Criteria:

1. The patients (both males and females) with chronic non-specific neck pain for more than three months.
2. The patient's age is between 18 and 29 years old.
3. The patient has at least one taut band at the upper fibers of the trapezius as described in assessment procedures.
4. patient's numeric pain rating scale (NPRS) was 3 to 8 out of 10

Exclusion Criteria:

1. Were treated for neck or shoulder pain during the last three months.
2. Had a neck or shoulder operation during the last two years.
3. Had any structural pathology of the cervical spine, such as disk prolapse, spinal stenosis, or cervical spondylosis.
4. Had a traumatic history, instability, and spasmodic torticollis.
5. Had cardiovascular, respiratory, or allergic disease or neck osteoarthritis.
6. Had homeostatic disorders.
7. Fibromyalgia, shoulder diseases (tendonitis, bursitis, capsulitis).
8. Inflammatory rheumatic diseases.
9. Severe psychiatric illness and other diseases that restrict physical loading, and pregnancy (Salo et al., 2010).
10. Patients with vertebrobasilar insufficiency and vertigo.