Efficacy of Extracorporeal Shockwave Therapy on Cervical Myofascial Pain Following Neck Dissection Surgery: A Randomized Controlled Trial

Abstract

Objective To investigate the efficacy of extracorporeal shockwave therapy (ESWT) on cervical myofascial pain following neck dissection in reducing pain and improving cervical range of motion (ROM).Methods Forty-six patients with cervical myofascial pain following neck dissection surgery were recruited and subdivided at random into two equal groups. The ESWT group received ESWT once a week for 4 weeks (0.25 mL/mm<sup>2</sup>, 1,000 shocks) and a topical non-steroidal anti-inflammatory drug (3 times/day for 4 weeks). The control group received only topical NSAID. The pain assessment was done by using the visual analog scale (VAS) and pressure algometry. A cervical ROM device was used for the assessment of the lateral flexion and rotation of the neck ROM on both sides. All measurements were collected at baseline, 2 weeks, and 4 weeks.Results The ESWT group revealed a significant improvement in all parameters at post I and post II than did the control group (p>0.001), that revealed a statistical decrease only in the VAS score at post I without any statistical difference in the pain threshold and neck ROM. However, there were statistical differences in all parameters at post II compared to those at pre-treatment and post I (p<0.001).Conclusion As a confirmation of the efficacy of ESWT in cervical myofascial pain control following neck dissection, we observed better results with no side effects in the ESWT group (Clinical Trial Registry No. PACTR202002648274347).

Efficacy of extracorporeal shock waves in the treatment of myofascial pain syndrome: a systematic review and meta-analysis of controlled clinical studies

“…However, this method has a poor energy transfer effect and a low pain relief rate. The control group in previous studies (12,14,15,18) was treated with ultrasound-guided pulsed radiofrequency, but the rate of pain relief was worse than that of ESWT.…”

“…All studies (10,(12)(13)(14)(15)(16)(17)(18)(19) reported the comparison of pain after treatment between the experimental group and the control group using ESWT. There was statistical heterogeneity between the studies (I 2 =85%, P<0.00001).…”

“…Figure 4Comparison of pain intensity after ESWT treatment and other modalities for MPS(10,(12)(13)(14)(15)(16)(17)(18)(19). ESWT, extracorporeal shock wave therapy; MPS, myofascial pain syndrome; SD, standard deviation; CI, confidential interval; IV, inverse variance.…”

Combined Effects of Extracorporeal Shockwave Therapy and Integrated Neuromuscular Inhibition on Myofascial Trigger Points of Upper Trapezius: A Randomized Controlled Trial

“…Rahbar et al [39] compared the efficacy of ESWT to conventional treatments such as ultrasound, hot packs, and self-stretches, and they found that ESWT was superior in reducing discomfort. Kamel et al [40] investigated the impact of ESWT versus regional non-steroidal antiinflammatory medication following neck dissection on pain threshold and intensity for 4 weeks and concluded that ESWT had more significant effects on pain intensity and threshold. The findings of the present trial indicated an increase in SSR latency, which may be due to the anatomical correlation among afferent pain fibers and sympathetic fibers, given that they are parallel within the central nervous system [41].…”

“…Rahbar et al [ 39 ] compared the efficacy of ESWT to conventional treatments such as ultrasound, hot packs, and self-stretches, and they found that ESWT was superior in reducing discomfort. Kamel et al [ 40 ] investigated the impact of ESWT versus regional non-steroidal antii-nflammatory medication following neck dissection on pain threshold and intensity for 4 weeks and concluded that ESWT had more significant effects on pain intensity and threshold.…”