Effects Of ESWT On The Treatment Of Myofascial Pain Syndrome: A Meta-Analysis

BackgroundMyofascial pain syndrome(MPS) is a common clinical diseases of the musculoskeletal system, the appearance of myofascial trigger points(MTrPs) is its main characteristic. Patients often have chronic pain in neck, shoulder, waist or other parts with activity disorder due to pain. The syndrome is more common in older people, MPS is one of the main causes of frequent visits to patients with chronic pain. There are many methods for treating MPS including drug therapy, exercise therapy, physical therapy, acupuncture, massage, trigger point injection, etc. Extracorporeal shock wave (ESWT) has been widely used in the treatments of musculoskeletal system diseases as a non-invasive technique. There are many reports of extracorporeal shock wave treatment on MPS research in recent years, but have not found the systematic evaluation about its clinical treatment effect. This study will evaluate the clinical efficacy of extracorporeal shock wave on MPS, which will provides evidence for clinical treatment.ObjectiveTo systematic evaluate the clinical effect of ESWT in the treatment of MPS with Meta analysis.MethodsWe found randomized controlled trials about extracorporeal shockwave treatment on MPS from Pubmed、Web of Science、Google Scholar、Cochrane Library、CKNI、WANFANG DATA, with the reported time from inception to January 2016. Set the inclusion and exclusion criteria, retrieve the available trial according to the standards. Quality assessment of the included studies was based on the Cochrane Collaboration’s tool for assessing risk of bias, Finally got the VAS data and,made meta-analysis using software RevMan 5.2.ResultsA total of 8 trials were useful for the meta-analysis including 4 in English and 4 in Chinese. Compared VAS score of ESWT and TPI group, the difference does not have statistical significance [MD=-0.35,95%CI (-1.02,0.32), P=0.30].There was no significant difference between ESWT group and TPI group on MPS. Compared VAS score of ESWT and other treatments group, the difference was statistically significant [MD=-0.78,95%CI (-0.99,-0.58), P﹤0.00001].The treatment effect on MPS of ESWT group was better than other treatment group. Compared VAS score of ESWT and placebo group, the difference does not have statistical significance [MD=-1.15,95%CI (-3.18,0.88) P=0.27].The treatment effect of ESWT on MPS is a little better according to the deviation degree of the black diamond center. The sensitivity of the comparison from ESWT group and the placebo group was high. The sensitivity of the comparison from ESWT group and the TPI group was also high.ConclusionESWT is a useful treatment on MPS. There was no significant difference between ESWT group and TPI group on MPS, but have more safety. The treatment effect on MPS of ESWT group was better than control group and other treatment group. There is high sensitivity of the data about the comparison on ESWT group and the placebo group, the same with TPI group. The number of the trials and patients in each trial were little and most of the test quality is not high, So we still need more high quality and large randomized controlled trials to further study the effect of ESWT on MPS.