Extracorporeal shockwave therapy as a treatment option for shoulder impingement syndrome: a systematic review and meta-analysis

Abstract Background Shoulder impingement syndrome (SIS) is a common alignment syndrome that causes significant discomfort and functional limitations. In recent years, extracorporeal shock wave therapy (ESWT) has gained attention as a promising non-invasive treatment for SIS. However, its effectivene...

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Main Authors: Ahmad Aldardour, Ahmad R. Al-Qudimat, Mohammad Etoom, Shefa’a Alnammaneh, Wesam al Debes, Loiy Khasaweneh, Alaa Abd-Alrazaq, Sunitha Mysore, Muhammed Al-Jarrah
Format: Article
Language:English
Published: SpringerOpen 2025-07-01
Series:Bulletin of Faculty of Physical Therapy
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Online Access:https://doi.org/10.1186/s43161-025-00300-3
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author Ahmad Aldardour
Ahmad R. Al-Qudimat
Mohammad Etoom
Shefa’a Alnammaneh
Wesam al Debes
Loiy Khasaweneh
Alaa Abd-Alrazaq
Sunitha Mysore
Muhammed Al-Jarrah
author_facet Ahmad Aldardour
Ahmad R. Al-Qudimat
Mohammad Etoom
Shefa’a Alnammaneh
Wesam al Debes
Loiy Khasaweneh
Alaa Abd-Alrazaq
Sunitha Mysore
Muhammed Al-Jarrah
author_sort Ahmad Aldardour
collection DOAJ
description Abstract Background Shoulder impingement syndrome (SIS) is a common alignment syndrome that causes significant discomfort and functional limitations. In recent years, extracorporeal shock wave therapy (ESWT) has gained attention as a promising non-invasive treatment for SIS. However, its effectiveness remains controversial. This review aimed to elucidate the efficacy of ESWT in SIS by analyzing data from randomized controlled trials (RCTs). Material and methods A systematic review of randomized controlled trials (RCTs) was conducted. Search sources included 3 databases, the references list of the included studies that cited the included studies. In total, 2 reviewers (S.N. and L.K.) independently conducted the study selection. W.D. and A.A. carried out data extraction, risk of bias assessment, and quality of evidence appraisal. Extracted data were synthesized using a statistical approach (standard meta-analysis methodologies). A random-effects model was employed to account for potential heterogeneity across studies. Effect sizes were reported as standardized mean differences (SMD) with corresponding 95% confidence intervals (CI). Heterogeneity was assessed using Cochran’s Q test, with statistical significance set at p < 0.05, and quantified using I 2 statistics. Results Our meta-analysis revealed that all four included studies (100%) showed a low risk of bias across all five assessed domains, indicating strong methodological quality and reliability of the findings. Furthermore, this meta-analysis revealed that ESWT significantly reduced pain in patients with SIS over 2–3 months. The pooled analysis demonstrated a marked improvement in pain 2.18 (95% CI: 0.45 to 3.90, I 2 = 0%). Furthermore, the ESWT group demonstrated a significant difference from the other interventional group in terms of SPADI alleviation in 2–3 months 19.46 (95% CI: 5.12 to 33.79, I 2 = 0%). Conclusion This review and meta-analysis highlighted that shockwave therapy is more efficient than other interventions in reducing pain and enhancing functional activities in adults with SIS in 2–3 months period. This systematic review supports the integration of ESWT protocols into clinical practice based on symptom severity and chronicity of SIS. The findings offer valuable guidance for future research and highlight the need for standardized approaches to optimize treatment outcomes.
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spelling doaj-art-5f46fd65a9a1462685e95a56c08bde6c2025-08-20T04:01:25ZengSpringerOpenBulletin of Faculty of Physical Therapy2536-96602025-07-0130111010.1186/s43161-025-00300-3Extracorporeal shockwave therapy as a treatment option for shoulder impingement syndrome: a systematic review and meta-analysisAhmad Aldardour0Ahmad R. Al-Qudimat1Mohammad Etoom2Shefa’a Alnammaneh3Wesam al Debes4Loiy Khasaweneh5Alaa Abd-Alrazaq6Sunitha Mysore7Muhammed Al-Jarrah8Physical Therapy Department, Rumailah Hospital, Hamad Medical CorporationSurgical Research Section, Department of Surgery, Hamad Medical CorporationDepartment of Rehabilitation Sciences, Jordan University of Science and TechnologyJordan University of Science and TechnologyDoctoral School of Health Sciences, University of PécsFaculty of Medicine, Hashemite UniversityAI Center for Precision Health, Weill Cornell Medicine-QatarFatima College of Health SciencesDepartment of Rehabilitation Sciences, Jordan University of Science and TechnologyAbstract Background Shoulder impingement syndrome (SIS) is a common alignment syndrome that causes significant discomfort and functional limitations. In recent years, extracorporeal shock wave therapy (ESWT) has gained attention as a promising non-invasive treatment for SIS. However, its effectiveness remains controversial. This review aimed to elucidate the efficacy of ESWT in SIS by analyzing data from randomized controlled trials (RCTs). Material and methods A systematic review of randomized controlled trials (RCTs) was conducted. Search sources included 3 databases, the references list of the included studies that cited the included studies. In total, 2 reviewers (S.N. and L.K.) independently conducted the study selection. W.D. and A.A. carried out data extraction, risk of bias assessment, and quality of evidence appraisal. Extracted data were synthesized using a statistical approach (standard meta-analysis methodologies). A random-effects model was employed to account for potential heterogeneity across studies. Effect sizes were reported as standardized mean differences (SMD) with corresponding 95% confidence intervals (CI). Heterogeneity was assessed using Cochran’s Q test, with statistical significance set at p < 0.05, and quantified using I 2 statistics. Results Our meta-analysis revealed that all four included studies (100%) showed a low risk of bias across all five assessed domains, indicating strong methodological quality and reliability of the findings. Furthermore, this meta-analysis revealed that ESWT significantly reduced pain in patients with SIS over 2–3 months. The pooled analysis demonstrated a marked improvement in pain 2.18 (95% CI: 0.45 to 3.90, I 2 = 0%). Furthermore, the ESWT group demonstrated a significant difference from the other interventional group in terms of SPADI alleviation in 2–3 months 19.46 (95% CI: 5.12 to 33.79, I 2 = 0%). Conclusion This review and meta-analysis highlighted that shockwave therapy is more efficient than other interventions in reducing pain and enhancing functional activities in adults with SIS in 2–3 months period. This systematic review supports the integration of ESWT protocols into clinical practice based on symptom severity and chronicity of SIS. The findings offer valuable guidance for future research and highlight the need for standardized approaches to optimize treatment outcomes.https://doi.org/10.1186/s43161-025-00300-3Extracorporeal shockwave therapyShoulder impingement syndromeRotator cuff impingementSub-acromial impingement syndromeShock wave therapy
spellingShingle Ahmad Aldardour
Ahmad R. Al-Qudimat
Mohammad Etoom
Shefa’a Alnammaneh
Wesam al Debes
Loiy Khasaweneh
Alaa Abd-Alrazaq
Sunitha Mysore
Muhammed Al-Jarrah
Extracorporeal shockwave therapy as a treatment option for shoulder impingement syndrome: a systematic review and meta-analysis
Bulletin of Faculty of Physical Therapy
Extracorporeal shockwave therapy
Shoulder impingement syndrome
Rotator cuff impingement
Sub-acromial impingement syndrome
Shock wave therapy
title Extracorporeal shockwave therapy as a treatment option for shoulder impingement syndrome: a systematic review and meta-analysis
title_full Extracorporeal shockwave therapy as a treatment option for shoulder impingement syndrome: a systematic review and meta-analysis
title_fullStr Extracorporeal shockwave therapy as a treatment option for shoulder impingement syndrome: a systematic review and meta-analysis
title_full_unstemmed Extracorporeal shockwave therapy as a treatment option for shoulder impingement syndrome: a systematic review and meta-analysis
title_short Extracorporeal shockwave therapy as a treatment option for shoulder impingement syndrome: a systematic review and meta-analysis
title_sort extracorporeal shockwave therapy as a treatment option for shoulder impingement syndrome a systematic review and meta analysis
topic Extracorporeal shockwave therapy
Shoulder impingement syndrome
Rotator cuff impingement
Sub-acromial impingement syndrome
Shock wave therapy
url https://doi.org/10.1186/s43161-025-00300-3
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