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Efficacy and safety of extracorporeal shockwave therapy in chronic low back pain: a systematic review and meta-analysis of 632 patients
BACKGROUND: Extracorporeal shock wave therapy (ESWT) has been widely used for pain control in musculoskeletal disorders. Whether ESWT can relieve chronic low back pain (CLBP) and improve lumbar function is still unclear. Therefore, we conducted a meta-analysis of relevant studies to comprehensively...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10290808/ https://www.ncbi.nlm.nih.gov/pubmed/37355623 http://dx.doi.org/10.1186/s13018-023-03943-x |
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author | Liu, Kun Zhang, Qingyu Chen, Lili Zhang, Haoran Xu, Xiqiang Yuan, Zenong Dong, Jun |
author_facet | Liu, Kun Zhang, Qingyu Chen, Lili Zhang, Haoran Xu, Xiqiang Yuan, Zenong Dong, Jun |
author_sort | Liu, Kun |
collection | PubMed |
description | BACKGROUND: Extracorporeal shock wave therapy (ESWT) has been widely used for pain control in musculoskeletal disorders. Whether ESWT can relieve chronic low back pain (CLBP) and improve lumbar function is still unclear. Therefore, we conducted a meta-analysis of relevant studies to comprehensively analyse and determine the efficacy and safety of ESWT for chronic low back pain. METHODS: Four databases were systematically searched for randomized controlled trials (RCTs) on ESWT for CLBP. The quality of the included studies was evaluated according to Cochrane systematic review criteria, relevant data were extracted, and meta-analysis was performed using RevMan 5.4 software. The primary outcomes were pain intensity, disability status, and mental health. The data were expressed as standardized mean differences (SMD) or weighted mean difference (WMD) and 95% confidence intervals (CI). Heterogeneity was assessed using the I(2) statistic. If I(2) ≥ 50%, a random effects model was applied; otherwise, a fixed effects model was used. RESULTS: Twelve RCTs involving 632 patients were included in this meta-analysis. The ESWT group reported significantly more pain relief than the control group at 4 weeks (WMD = − 1.04; 95% CI = − 1.44 to − 0.65; P < 0.001) and 12 weeks (WMD = − 0.85; 95% CI = − 1.30 to − 0.41; P < 0.001). Regarding the dysfunction index, ESWT led to significant improvement in lumbar dysfunction compared with the control group at 4 weeks (WMD = − 4.22; 95% CI = − 7.55 to − 0.89; P < 0.001) and 12 weeks (WMD = − 4.51; 95% CI = − 8.58 to − 0.44; P = 0.03). For mental health, there was no significant difference between the ESWT group and the control group after 4 weeks of intervention (SMD = 1.17; 95% CI = − 0.10 to 2.45; P = 0.07). CONCLUSION: This systematic review and meta-analysis found that ESWT provided better pain relief and improved lumbar dysfunction compared with the other interventions included, and no serious adverse effects were found. There was no significant effect of ESWT on the mental health of patients, but we hope to obtain more RCTs for further analysis in the future. Based on the pooled results, we suggest that ESWT is effective and safe for treating chronic low back pain. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13018-023-03943-x. |
format | Online Article Text |
id | pubmed-10290808 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-102908082023-06-26 Efficacy and safety of extracorporeal shockwave therapy in chronic low back pain: a systematic review and meta-analysis of 632 patients Liu, Kun Zhang, Qingyu Chen, Lili Zhang, Haoran Xu, Xiqiang Yuan, Zenong Dong, Jun J Orthop Surg Res Systematic Review BACKGROUND: Extracorporeal shock wave therapy (ESWT) has been widely used for pain control in musculoskeletal disorders. Whether ESWT can relieve chronic low back pain (CLBP) and improve lumbar function is still unclear. Therefore, we conducted a meta-analysis of relevant studies to comprehensively analyse and determine the efficacy and safety of ESWT for chronic low back pain. METHODS: Four databases were systematically searched for randomized controlled trials (RCTs) on ESWT for CLBP. The quality of the included studies was evaluated according to Cochrane systematic review criteria, relevant data were extracted, and meta-analysis was performed using RevMan 5.4 software. The primary outcomes were pain intensity, disability status, and mental health. The data were expressed as standardized mean differences (SMD) or weighted mean difference (WMD) and 95% confidence intervals (CI). Heterogeneity was assessed using the I(2) statistic. If I(2) ≥ 50%, a random effects model was applied; otherwise, a fixed effects model was used. RESULTS: Twelve RCTs involving 632 patients were included in this meta-analysis. The ESWT group reported significantly more pain relief than the control group at 4 weeks (WMD = − 1.04; 95% CI = − 1.44 to − 0.65; P < 0.001) and 12 weeks (WMD = − 0.85; 95% CI = − 1.30 to − 0.41; P < 0.001). Regarding the dysfunction index, ESWT led to significant improvement in lumbar dysfunction compared with the control group at 4 weeks (WMD = − 4.22; 95% CI = − 7.55 to − 0.89; P < 0.001) and 12 weeks (WMD = − 4.51; 95% CI = − 8.58 to − 0.44; P = 0.03). For mental health, there was no significant difference between the ESWT group and the control group after 4 weeks of intervention (SMD = 1.17; 95% CI = − 0.10 to 2.45; P = 0.07). CONCLUSION: This systematic review and meta-analysis found that ESWT provided better pain relief and improved lumbar dysfunction compared with the other interventions included, and no serious adverse effects were found. There was no significant effect of ESWT on the mental health of patients, but we hope to obtain more RCTs for further analysis in the future. Based on the pooled results, we suggest that ESWT is effective and safe for treating chronic low back pain. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13018-023-03943-x. BioMed Central 2023-06-24 /pmc/articles/PMC10290808/ /pubmed/37355623 http://dx.doi.org/10.1186/s13018-023-03943-x Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Systematic Review Liu, Kun Zhang, Qingyu Chen, Lili Zhang, Haoran Xu, Xiqiang Yuan, Zenong Dong, Jun Efficacy and safety of extracorporeal shockwave therapy in chronic low back pain: a systematic review and meta-analysis of 632 patients |
title | Efficacy and safety of extracorporeal shockwave therapy in chronic low back pain: a systematic review and meta-analysis of 632 patients |
title_full | Efficacy and safety of extracorporeal shockwave therapy in chronic low back pain: a systematic review and meta-analysis of 632 patients |
title_fullStr | Efficacy and safety of extracorporeal shockwave therapy in chronic low back pain: a systematic review and meta-analysis of 632 patients |
title_full_unstemmed | Efficacy and safety of extracorporeal shockwave therapy in chronic low back pain: a systematic review and meta-analysis of 632 patients |
title_short | Efficacy and safety of extracorporeal shockwave therapy in chronic low back pain: a systematic review and meta-analysis of 632 patients |
title_sort | efficacy and safety of extracorporeal shockwave therapy in chronic low back pain: a systematic review and meta-analysis of 632 patients |
topic | Systematic Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10290808/ https://www.ncbi.nlm.nih.gov/pubmed/37355623 http://dx.doi.org/10.1186/s13018-023-03943-x |
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