Comparison of two different protocol for the treatment of Chronic Low Back Pain (Extracorporeal Shock Wave Therapy with oral medication and exercise program versus sham with oral medication and exercise program): A Randomized Controlled Trial

Published:January 13, 2021DOI:https://doi.org/10.1016/j.apmr.2020.12.008
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      Highlights

      • 1.
        Extracorporeal shockwaves therapy significantly alleviated the score of pain and disability in patients with low back pain within the first month after the intervention compared to the control group.
      • 2.
        The effect of extracorporeal shockwaves therapy to relieve the pain and disability in patients with low back pain was similar to the control group.
      • 3.
        Extracorporeal shockwaves therapy would probably be useful to control the pain and disability in a short period of time.

      Abstract:

      Objective

      To compare two different protocols (ESWT, oral medications, and an exercise program with the control group ) for the treatment of CLBP, we designed this study.

      Design

      All the patients were randomly allocated to two intervention and control groups. Simple complete randomization was used for the allocation of the patients using the table of random numbers.

      Setting

      In this study, 32 patients with CLBP were referred to Isfahan University Hospitals randomly divided into intervention and control groups.

      Participant

      Patients were enrolled in the study if they were older than 18 years and had CLBP for more than three months. The patients were not having received any treatment and never having undergone surgery for treatment of CLBP. Also, patients with cancer, fractures, infections, disk degeneration, were excluded.

      Intervention

      Patients in the intervention group received ESWT once a week for four weeks along with oral medications and exercise programs. The control group received sham ESWT along with oral medications and exercise programs.

      Main Outcome Measure(s)

      The visual analog scale and Oswestry disability index (ODI) were used to assess pain and disability at baseline, after one, and after three months.

      Results

      The pain score in the intervention group was 6.6 at baseline that decreased to 3.0 after one month (P<0.0001) and 1.8 after three months (P<0.0001). In the control group, the pain score was 6.8 at baseline, 4.6 after one month (P<0.0001), and 1.1 after three months (P<0.0001). Disability decreased significantly in both groups compared with baseline values (first month: P<0.0001, third month: P<0.05). The mean ODI score did not differ significantly between both groups (P=0.942).

      Conclusion

      ESWT, along with oral medication and exercise therapy, appears to be a safe and effective method in the short-term treatment of patients suffering from CLBP.

      Keywords

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