The Effectiveness of Extracorporeal Shockwave Therapy in the Treatment of Chronic Low Back Pain: A Systematic Review

1,2 Iva Lončarić Kelečić

1 University Hospital Centre Zagreb, Clinic for rheumatic diseases, Croatia
2 Alma Mater Europea – AMEU, Maribor, Slovenia

Introduction: Low back pain is the most prevalent chronic pain syndrome in clinical practice. Due to safer benefits, nonpharmacological, exercise-based treatments represent the first  choice for chronic low back pain (CLBP). Recently, Extracorporeal Shockwave Therapy (ESWT) has been suggested as a new treatment option for CLBP. The aim was to provide an  overview of the effectiveness of ESWT in combination with exercise versus exercise alone in pain and disability reduction in CLBP through a systematic review of published randomised control trials (RCTs).

Methods: Original RCTs related to the use of ESWT in CLBP were searched in PubMed, Cochrane’s library and the Physiotherapy Evidence Database back ten years from January 2023.  The recommendations of the Preferred Reporting Items for Systematic Review and Meta- Analysis statement and The Prisma in Exercise, Rehabilitation, Sport Medicine and SporTs  scientific guidance were followed. Data on study information, Population characteristics, Intervention treatment, Control or comparators, and Outcomes were extracted. Outcomes of  primary interest were pain and disability, observed before and after treatments. The results are presented systematically and narratively.

Results and Discussion: Two eligible RCTs were included from the initial 30 identified. Despite the evident reduction in pain and disability in the ESWT groups, the significance of the  outcome versus the control groups in the short and long-term periods is conflicting between studies.

Conclusion: In treating CLBP, ESWT combined with exercises is to some extent clinically superior to exercises alone; however, evidence should be used with caution due to the lack of  studies and existing confrontations.

Keywords: chronic pain, extracorporeal shockwave therapy, low back pain, physical therapy modalities, systematic review