Effect of Extracorporeal Shock Wave Therapy and Dry Needling in Treatment of Impingement Syndrome

Abstract

Injuries to the shoulder joint have been very common throughout society. There are several common shoulder diseases, including rotator cuff tears, osteoarthritis, shoulder impingement, bursitis, and cervical radiculopathy, which result in shoulder girdle muscle dysfunction, and struggle with everyday tasks [1]of which osteoarthritis (OA. Impingement syndrome refers to rotator cuff abnormalities that encompass all stages of tendon degeneration. Shoulder impingement syndrome (SIS) is caused by compression of the teres minor, teres minor, supraspinatus muscle, soft tissues, biceps tendon, and subacromial bursa between the coracoacromial arch and humeral head. Shoulder discomfort may result from this disorder.Additionally, several structural and functional elements that reduce the subacromial space may potentially contribute to shoulder impingement [2]. Patients with shoulder impingement syndrome have persistent pain. Patients usually report shoulder discomfort in the anterior and lateral acromion regions, and it frequently extends to the lateral aspect of the midarm. When patients lie on the afflicted side, the discomfort can also induce stiffness and weakness; pain is the worst at night [3].Numerous studies have pointed out the association between shoulder discomfort and myofascial trigger points (MTrPs). The tight bands of skeletal muscle have MTrPs, which are incredibly sensitive to pressure. These locations result in motor dysfunction as well as discomfort that can either be caused by compression or arise spontaneously. In terms of biomechanics, the scapula is critical to the function of the shoulder. The normal arthrokinematics at the glenohumeral region might get disrupted as a result of a muscle imbalance. The discomfort and dysfunction resulting from MTrPs, which may alter scapulohumeral rhythms, could lead to the onset of subacromial pain syndrome. In addition to having high levels of acetylcholine and nicotinic receptor activation, studies have demonstrated that the subscapularis tendon and joint capsule also have significant levels of inflammatory mediators. These findings support the theory of the trigger points, which is still being debated [4]. Extracorporeal shock wave treatment (ESWT), a high-pressure sound wave, is applied to address damage to soft tissues and discomfort brought on by degradation of the musculoskeletal system. This technique is 92