Are Extracorporeal Shock Waves Just a Therapeutic Tool?

Background: Focused extracorporeal shock wave therapy (ESWT) has been successfully used to treat musculoskeletal conditions, but ESWT stimulates nociceptors, causing pain deep in the tissue during treatment. The occurrence of pain during ESWT is a side effect, but it can help identify painful sites...

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Main Authors: Bernardo Gialanella, Laura Comini, Gian Pietro Bonometti, Fabio Vanoglio, Andrea Bettinsoli, Raffaele Santoro, Adriana Olivares, Alberto Luisa
Format: Article
Language:English
Published: MDPI AG 2024-10-01
Series:Diagnostics
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Online Access:https://www.mdpi.com/2075-4418/14/21/2440
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author Bernardo Gialanella
Laura Comini
Gian Pietro Bonometti
Fabio Vanoglio
Andrea Bettinsoli
Raffaele Santoro
Adriana Olivares
Alberto Luisa
author_facet Bernardo Gialanella
Laura Comini
Gian Pietro Bonometti
Fabio Vanoglio
Andrea Bettinsoli
Raffaele Santoro
Adriana Olivares
Alberto Luisa
author_sort Bernardo Gialanella
collection DOAJ
description Background: Focused extracorporeal shock wave therapy (ESWT) has been successfully used to treat musculoskeletal conditions, but ESWT stimulates nociceptors, causing pain deep in the tissue during treatment. The occurrence of pain during ESWT is a side effect, but it can help identify painful sites and assess minimum (MiTI) and maximum (MaTI) pain thresholds to ESWT pressure stimuli. This topic has received limited attention in literature. Methods: This observational study describes a specific approach to using ESWT to study pain in 71 patients. The approach proposes moving the ESWT transducer head of the device over the entire joint surface, progressively increasing the energy level until the patient experiences pain. Results: In the study, MiTI and MaTI were 0.218 ± 0.090 and 0.416 ± 0.165 mJ/mm<sup>2</sup> in the affected joint and 0.282 ± 0.128 and 0.501 ± 0.174 mJ/mm<sup>2</sup> in the contralateral homologous healthy joint, being significantly lower in the affected joint (MiTI: <i>p</i> < 0.001 and MaTI: <i>p</i> = 0.003, respectively). ESWT induced pain in 94.37% of the sites with the highest subjective pain and in a greater number of sites (204) than digital pressure (123) (<i>p</i> < 0.001). All sites with digital pressure pain also had ESWT pain. Conclusions: These results suggest that the ESWT device may be useful in investigating pain in musculoskeletal conditions and tailoring therapy.
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spelling doaj-art-edbd608095314140b4a313b2283eefef2025-08-20T02:49:56ZengMDPI AGDiagnostics2075-44182024-10-011421244010.3390/diagnostics14212440Are Extracorporeal Shock Waves Just a Therapeutic Tool?Bernardo Gialanella0Laura Comini1Gian Pietro Bonometti2Fabio Vanoglio3Andrea Bettinsoli4Raffaele Santoro5Adriana Olivares6Alberto Luisa7Istituti Clinici Scientifici Maugeri IRCCS, Neuromotor Rehabilitation Unit, Institute of Lumezzane, 25065 Lumezzane, ItalyIstituti Clinici Scientifici Maugeri IRCCS, Scientific Direction, Institute of Lumezzane, 25065 Lumezzane, ItalyIstituti Clinici Scientifici Maugeri IRCCS, Neuromotor Rehabilitation Unit, Institute of Lumezzane, 25065 Lumezzane, ItalyIstituti Clinici Scientifici Maugeri IRCCS, Neuromotor Rehabilitation Unit, Institute of Lumezzane, 25065 Lumezzane, ItalyIstituti Clinici Scientifici Maugeri IRCCS, Neuromotor Rehabilitation Unit, Institute of Lumezzane, 25065 Lumezzane, ItalyIstituti Clinici Scientifici Maugeri IRCCS, Neuromotor Rehabilitation Unit, Institute of Lumezzane, 25065 Lumezzane, ItalyIstituti Clinici Scientifici Maugeri IRCCS, Scientific Direction, Institute of Lumezzane, 25065 Lumezzane, ItalyIstituti Clinici Scientifici Maugeri IRCCS, Neuromotor Rehabilitation Unit, Institute of Lumezzane, 25065 Lumezzane, ItalyBackground: Focused extracorporeal shock wave therapy (ESWT) has been successfully used to treat musculoskeletal conditions, but ESWT stimulates nociceptors, causing pain deep in the tissue during treatment. The occurrence of pain during ESWT is a side effect, but it can help identify painful sites and assess minimum (MiTI) and maximum (MaTI) pain thresholds to ESWT pressure stimuli. This topic has received limited attention in literature. Methods: This observational study describes a specific approach to using ESWT to study pain in 71 patients. The approach proposes moving the ESWT transducer head of the device over the entire joint surface, progressively increasing the energy level until the patient experiences pain. Results: In the study, MiTI and MaTI were 0.218 ± 0.090 and 0.416 ± 0.165 mJ/mm<sup>2</sup> in the affected joint and 0.282 ± 0.128 and 0.501 ± 0.174 mJ/mm<sup>2</sup> in the contralateral homologous healthy joint, being significantly lower in the affected joint (MiTI: <i>p</i> < 0.001 and MaTI: <i>p</i> = 0.003, respectively). ESWT induced pain in 94.37% of the sites with the highest subjective pain and in a greater number of sites (204) than digital pressure (123) (<i>p</i> < 0.001). All sites with digital pressure pain also had ESWT pain. Conclusions: These results suggest that the ESWT device may be useful in investigating pain in musculoskeletal conditions and tailoring therapy.https://www.mdpi.com/2075-4418/14/21/2440ESWTevaluationpain thresholdsite of painmusculoskeletal diseases
spellingShingle Bernardo Gialanella
Laura Comini
Gian Pietro Bonometti
Fabio Vanoglio
Andrea Bettinsoli
Raffaele Santoro
Adriana Olivares
Alberto Luisa
Are Extracorporeal Shock Waves Just a Therapeutic Tool?
Diagnostics
ESWT
evaluation
pain threshold
site of pain
musculoskeletal diseases
title Are Extracorporeal Shock Waves Just a Therapeutic Tool?
title_full Are Extracorporeal Shock Waves Just a Therapeutic Tool?
title_fullStr Are Extracorporeal Shock Waves Just a Therapeutic Tool?
title_full_unstemmed Are Extracorporeal Shock Waves Just a Therapeutic Tool?
title_short Are Extracorporeal Shock Waves Just a Therapeutic Tool?
title_sort are extracorporeal shock waves just a therapeutic tool
topic ESWT
evaluation
pain threshold
site of pain
musculoskeletal diseases
url https://www.mdpi.com/2075-4418/14/21/2440
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