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

Background: Myofascial pain syndrome (MPS) is recurrent local myofascial pain with various treatment methods. In recent years, extracorporeal shock wave therapy (ESWT) has attracted much attention, but its role still lacks systematic review. We included controlled clinical studies for meta-analysis to systematically evaluate the application effect of ESWT. Methods: The English literature from PubMed, Embase, Cochrane Central Register of Controlled Trials, and Web of Science to October 2021 was searched by computer. After screening, the quality was evaluated by the PEDro (Physiotherapy Evidence Database) scale and analyzed by RevMan 5.4 software. Results: A total of 571 patients were included in 8 studies. The MPS pain sites of 541 patients were in the neck and upper back, and only 30 patients had pain sites in the waist. Meta-analysis showed that the pain level after ESWT was lower than that after other treatment methods [mean difference (MD) =-1.34, 95% confidential interval (CI): -1.87 to -0.81, P<0.00001], the pain threshold after ESWT was higher than that after other treatment methods (MD =0.90, 95% CI: 0.73 to 1.07, P<0.00001), and the neck disability index after ESWT was lower (MD =-1.79, 95% CI: -2.48 to -1.10, P<0.00001). Discussion: ESWT can avoid the adverse effects of invasive procedures on patient tolerance and compliance; compared with trigger point injection (TPI), dry needling, ultrasound-guided pulsed radiofrequency (US), and other methods, ESWT can more effectively relieve pain in patients with MPS.