The science behind shock wave therapy for back pain relief

• Updated on: 2023-07-03
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The health care industry heavily follows and researches solutions to chronic back pain, as approximately 80% of people in the entire population experience back pain at least once during their lives.A multitude of therapy options have been presented with the hope or promise of providing a better quality of life for chronic back pain patients, but shock wave therapy for back pain (also known as pressure wave therapy and focused shockwave therapy) is making a large impact on back pain conditions in chiropractic and health care in general.

Shock wave therapy uses acoustic waves to transmit high peak pressure waves to promote and accelerate the body’s own natural healing for subacute and chronic conditions. This technology triggers a variety of biological responses including:

Shock wave therapy is most commonly seen in two forms:

Fundamentally, these two types of shock waves share the same purpose — trigger the body’s own biological regenerative effects. This offers to promote faster, more effective healing. How do they differ though?

Acoustic radial pressure waves move through the body along a radius. They reach areas with a depth of up to 5-6 cm, depending on the pressure and applicator tip used. The energy decreases as the depth increases. As a result, radial pressure waves are particularly beneficial for treatment of superficial zones. The variety of transmitter tip options enable both localized and generalized treatments for a range of myofascial conditions.

Muscle (kinetic) chains are treated functionally in a linear direction. Radial pressure wave therapy stimulates tissue layers to break up adhesions and trigger points. In addition, the shifting of the layers of tissue causes a myofascial release – a vital prerequisite for fascial treatment.

On the other hand, the therapeutic capacity of focused shock waves reaches a depth of up to 12.5 cm. Therefore, they are primarily used for the treatment of deeper conditions and areas such as non-specific back pain, greater trochanter pain syndrome, insertional hamstring tendinopathy, and piriformis syndrome. Focused technology allows for precise, pinpoint treatment (for example of trigger points or tendon insertion) because the energy is delivered exactly where it is needed.

Chronic back pain that triggers discomfort and inconvenience in daily life tends not to respond to conservative therapy in many cases, which has prompted a search for other therapeutic methods. Shock wave therapy for back pain is a frequently sought-out option, but why?

Shock wave therapy is known for producing several biological effects that maximize reducing back pain. The decrease in substance P and other pain-provoking chemicals, stimulation of  inflammatory reduction, increase in the blood flow rate and revascularization stimulates and reactivates the process of healing of the tendons, surrounding tissues, and bones. These effects are associated with an increase in mobility and an overall decrease in pain.

This study examines the effects of extracorporeal shockwave therapy (ESWT) for patients with chronic back pain and their dynamic balance ability. Two groups were used: extracorporeal shock wave therapy group (ESWTG) and a conservative physical therapy group (CPTG).

An exercise program that included Williams’ exercises and McKenzie’s exercises was performed by both groups. The program was implemented twice a week for six weeks. The visual analog scale (VAS) was used to measure the chronic low back pain of the patients, with their dynamic balance ability measured.

Results: The within-group comparison of the VAS of the ESWTG and the CPTG showed significant improvements after the intervention. In the VAS comparison between the groups after the treatment, the ESWTG showed a significantly larger improvement. In the within-group comparison of dynamic balance ability, the ESWTG showed significant improvements.

This study observes the effects of extracorporeal shock wave therapy (ESWT) on chronic back pain and the quality of life of those with back pain.

Two hundred patients with chronic back pain were divided into an observation group and a control group using a random number table. Patients in the observation group underwent ESWT, while those in the control group received laser therapy. The degree of pain was evaluated using the visual analogue scale (VAS) and compared between the two groups before and after treatment. The quality of life of patients, including physical health, bodily pain, social function, general health, mental health and emotional health was scored and compared after treatment. The patients were followed up for one year after treatment.

Results: The VAS score dropped markedly in both groups compared with that before treatment, and the observation group had an evidently lower VAS score and a significantly higher effective rate than the control group (94.00% vs. 64.00%, P<0.05). After treatment, the quality-of-life score in the observation group was higher than that in the control group (P<0.05), and the observation group had a lower incidence rate of complications than the control group (P<0.05).

This study examined the effects of extracorporeal shock wave therapy on pain, disability, and depression of chronic low back pain patients. Chronic low back pain patients were divided into an extracorporeal shock wave therapy group (ESWTG) and a conservative physical therapy group (CPTG).

The ESWTG received extracorporeal shock wave therapy and the CPTG received general conservative physical therapy two times per week for six weeks. Pain was measured using a visual analog scale (VAS), the degree of disability of the patients was assessed using the Oswestry Disability Index (ODI), and their degree of depression was measured using the Beck depression index (BDI).

In intra-group comparisons, ESWTG and CPTG showed significant decreases in VAS, ODI, and BDI scores. Intergroup comparisons revealed that these decreases in VAS, ODI, and BDI scores were significantly larger in ESWTG than in CPTG.

Conclusion: Extracorporeal shock wave therapy is an effective intervention for the treatment of pain, disability, and depression in chronic low back pain patients.

Research supports the use of shock wave therapy for back pain and it is used widely in the world of physical therapy and rehabilitation for this exact reason. By promoting the body’s own healing processes, shock wave therapy stimulates a faster and more effective treatment method than conservative therapy on its own.

SHARON REYNOLDS-KYLE, DC, has practiced chiropractic for more than 25 years, and is a member of the international Shockwave Society (ISMST). She believes that an unmatched confidence comes from the ability to act independently and take one’s quality of life into one’s own hands. To learn more, go to marinspineandsports.com. For more information on the research backing ESWT for back pain reduction or to learn more about shock wave therapy, email info@kinasmedical.com.