SavedAdd your journal

Journals / Bozok Tıp Dergisi / 2026 / Cilt: 16 Sayı: 3

EFFICACY OF EXTRACORPOREAL SHOCK WAVE THERAPY IN CHRONIC NON-RADICULAR LOW BACK PAIN

Kronik Radiküler Olmayan Bel Ağrısında Ekstrakorporeal Şok Dalgası Tedavisinin Etkinliği

Emine Bilir(SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, ANKARA ŞEHİR SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ)0000-0002-0671-1335
Ferda Surel(SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, ANKARA ŞEHİR SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ)0000-0003-3748-3109
Banu Ece Savtok Güler(SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, ANKARA ŞEHİR SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ)0009-0008-8923-6314
Kaan Çavdarcı(SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, ANKARA ŞEHİR SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ)0009-0007-1582-1759
Pages
452–462
Publication Date
2026-09-25
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

However, its effects on anxiety were transient, and no additional benefit was observed for depression. rESWT may be considered a safe and effective adjunctive treatment for improving pain and function in this patient population.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Objective: Extracorporeal shock wave therapy (ESWT) is a modern physical therapy modality used to treat musculoskeletal conditions.
📊
Key Findings & Data:Material and Methods: Sixty-nine patients with chronic nonradicular LBP were included in the study and randomized to two groups: rESWT (group 1) or sham ESWT (group 2).
💡
Conclusion & Impact:However, its effects on anxiety were transient, and no additional benefit was observed for depression. rESWT may be considered a safe and effective adjunctive treatment for improving pain and function in this patient population.
🔬Design:Araştırma Makalesi
📍Scope:Comprehensive Sample
⚙️Variables:Bel Ağrısı · Ekstrakorporeal Şok Dalgası Tedavisi · Plasebo (Sham) Tedavi

Abstract

Objective: Extracorporeal shock wave therapy (ESWT) is a modern physical therapy modality used to treat musculoskeletal conditions. In this study, we aimed to assess the effectiveness of radial ESWT on pain, disability and depression in chronic non-radicular low back pain (LBP). Material and Methods: Sixty-nine patients with chronic nonradicular LBP were included in the study and randomized to two groups: rESWT (group 1) or sham ESWT (group 2). A total of 62 patients completed the study; the intervention group (n=30, mean age of 45.7±10.7 years) received rESWT, and the control group (n=32, mean age of 47.0±10.1 years) received sham ESWT. Outcome parameters included the Visual Analog Scale (VAS), Oswestry Disability Index (ODI), and Hospital Anxiety and Depression Scale (HADS). The evolutions were made before treatment, after treatment, and 1st month after treatment. Results: Sixty-two patients completed the study (rESWT, n=30; sham ESWT, n=32). Pain intensity decreased significantly more in the rESWT group than in the sham group both immediately after treatment (VAS change: 2.9±1.3 vs. 1.8±1.4, p=0.002) and at 1-month follow-up (3.3±1.7 vs. 2.3±1.9, p=0.035). Functional disability also improved significantly more with rESWT (ODI change after treatment: 6.5 [4.0-12.0] vs. 2.0 [-2.0-3.5], p<0.001; at 1 month: 8.0 [0.0-12.5] vs. 0.0 [0.0-5.5], p=0.014). Although anxiety improved more in the rESWT group immediately after treatment (p=0.036), this difference was not maintained at 1 month (p=0.184). No significant between-group differences were observed in depression scores either after treatment (p=0.994) or at 1 month (p=0.177). Conclusion: rESWT appears to be an effective intervention for reducing pain and disability, with superior short-term outcomes compared to sham treatment. However, its effects on anxiety were transient, and no additional benefit was observed for depression. rESWT may be considered a safe and effective adjunctive treatment for improving pain and function in this patient population.

Özet

Amaç: Ekstrakorporeal şok dalgası tedavisi (ESWT), kas-iskelet sistemi rahatsızlıklarının tedavisinde faydalı olan yeni ve modern bir fizik tedavi yöntemidir. Bu çalışmada, radyal ESWTt’nin kronik radiküler olmayan bel ağrısında ağrı, engellilik ve depresyon üzerindeki etkinliğini değerlendirmeyi amaçladık. Gereç ve Yöntemler: Kronik radiküler olmayan bel ağrısı olan 69 hasta çalışmaya dahil edildi ve rESWT (grup 1) veya plasebo (sham) ESWT (grup 2) alacak şekilde iki gruba randomize edildi. Toplam 62 hasta çalışmayı tamamladı; müdahale grubu olan grup 1 (n=30, yaş ortalaması 45,7±10,7 yıl) rESWT ile, kontrol grubu olan grup 2 (n=32, yaş ortalaması 47,0±10,1 yıl) ise plasebo ESWT ile tedavi edildi. Sonuç parametreleri Görsel Analog Skalası (VAS), Oswestry Engellilik İndeksi (ODI) ve Hastane Anksiyete ve Depresyon Ölçeği (HADS) içeriyordu. Değerlendirmeler tedavi öncesinde, tedavi sonrasında ve tedaviyi takiben 1. ayda yapıldı. Bulgular: Çalışmayı toplam 62 hasta tamamladı (rESWT, n=30; sham ESWT, n=32). Ağrı şiddetindeki azalma rESWT grubunda hem tedavi sonrasında (VAS değişimi: 2,9±1,3'e karşı 1,8±1,4, p=0,002) hem de 1. ay kontrolünde (3,3±1,7'ye karşı 2,3±1,9, p=0,035) anlamlı olarak daha fazlaydı. Fonksiyonel yetersizlikteki iyileşme de rESWT grubunda daha belirgindi (ODI değişimi; tedavi sonrası: 6,5 [4,0-12,0]'ye karşı 2.0 [-2,0-3,5], p<0,001; 1.ay: 8,0 [0,0-12,5]'ye karşı 0,0 [0,0-5,5], p=0,014). Anksiyete skorlarındaki iyileşme tedavi sonrasında rESWT grubunda daha fazla olmasına rağmen (p=0,036), bu fark 1. ayda devam etmedi (p=0,184). Depresyon skorlarındaki değişim açısından ise tedavi sonrası (p=0,994) ve 1. ayda (p=0,177) gruplar arasında anlamlı fark saptanmadı. Sonuç: rESWT, ağrı ve sakatlığı azaltmada etkili bir müdahale gibi görünmektedir ve plasebo tedavisine kıyasla kısa vadeli sonuçları daha üstündür. Bununla birlikte, anksiyete üzerindeki etkileri geçicidir ve depresyon için ek bir fayda gözlemlenmemiştir. rESWT, bu hasta popülasyonunda ağrı ve fonksiyonu iyileştirmek için güvenli ve etkili bir yardımcı tedavi olarak düşünülebilir.

🔖

Cite This Article

Bilir, E., Surel, F., Güler, B. E. S., Çavdarcı, K. (2026). EFFICACY OF EXTRACORPOREAL SHOCK WAVE THERAPY IN CHRONIC NON-RADICULAR LOW BACK PAIN. Bozok Tıp Dergisi, Cilt: 16 Sayı: 3, 452–462. https://doi.org/10.16919/bozoktip.1982575

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (28)

  1. Hartvigsen J, Hancock MJ, Kongsted A, Louw Q, Ferreira ML, Genevay S, et al. What low back pain is and why we need to pay attention. Lancet. 2018;391(10137):2356-67.
  2. Balagué F, Mannion AF, Pellisé F, Cedraschi C. Non-specific low back pain. Lancet. 2012;379(9814):482-91.
  3. Chen S, Chen M, Wu X, Lin S, Tao C, Cao H et al. Global, regional and national burden of low back pain 1990-2019: a systematic analysis of the Global Burden of Disease study 2019. J Orthop Translat. 2022;32:49-58.
  4. Maher C, Underwood M, Buchbinder R. Non-specific low back pain. Lancet. 2017;389(10070):736-47.
  5. Pincus T, Burton AK, Vogel S, Field AP. A systematic review of psychological factors as predictors of chronicity/disability in prospective cohorts of low back pain. Spine. 2002;27(5):E109-20.
  6. Zhou M, Wang H, Zeng X, Yin P, Zhu J, Chen W, et al. Mortality, morbidity, and risk factors in China and its provinces, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2019;394:1145-58.
  7. Qaseem A, Wilt TJ, McLean RM, Forciea MA. Clinical Guidelines Committee of the American College of Physicians. Noninvasive treatments for acute, subacute, and chronic low back pain: a clinical practice guideline. Ann Intern Med. 2017;166(7):514-30.
  8. Chou R, Deyo R, Friedly J, Skelly A, Hashimoto R, Weimer M, et al. Nonpharmacologic therapies for low back pain: A systematic review for an American College of Physicians clinical practice guideline. Ann Intern Med. 2016;166(7):493-505.
  9. Yue L, Sun MS, Chen H, Mu GZ, Sun HL. Extracorporeal shockwave therapy for treating chronic -: a systematic review and meta-analysis of randomized controlled trials. Biomed Res Int. 2021;2021:5937250.
  10. Johnson MI, Paley CA, Jones G, Mulvey MR, Wittkopf PG. Efficacy and safety of transcutaneous electrical nerve stimulation (TENS) for acute and chronic pain in adults: a systematic review and meta-analysis. BMJ Open. 2022;12:e051073.
  11. Çolak TK, Sert N, Sert B, Aptı A. The Effect of Interferential Currents and TENS on Pain and Functionality in Patients with Chronic Mechanical Low Back Pain. J Turk Spinal Surg. 2024;35(1):24-30.
  12. Yurdakul OV, Beydoğan E, Yılmaz Yalçınkaya E. Effects of physical therapy agents on pain, disability, quality of life, and lumbar paravertebral muscle stiffness via elastography in patients with chronic low back pain. Turk J Phys Med Rehabil. 2019 Jan 30;65(1):30-9.
  13. Lange T, Deventer N, Gosheger G, Lampe LP, Bockholt S, Schulze Boevingloh A et al. Effectiveness of radial extracorporeal shockwave therapy in patients with acute low back pain-randomized controlled trial. J Clin Med. 2021;10(23):5569.
  14. Notarnicola A, Maccagnano G, Gallone MF, Mastromauro L, Rifino F, Pesce V, et al. Extracorporeal shockwave therapy versus exercise program in patients with low back pain: short-term results of a randomised controlled trial. J Biol Regul Homeost Agents. 2018;32(2):385-9.
  15. Mariotto S, de Prati AC, Cavalieri E, Amelio E, Marlinghaus E, Suzuki H. Extracorporeal shock wave therapy in inflammatory diseases: Molecular mechanism that triggers anti-inflammatory action. Curr Med Chem 2009;16:2366-72.
  16. Lee S, Lee D, Park J. Effects of extracorporeal shockwave therapy on patients with chronic low back pain and their dynamic balance ability. J Phys Ther Sci 2014;26:7-10.
  17. Han H, Lee D, Lee S, Jeon C, Kim T. The effects of extracorporeal shock wave therapy on pain, disability, and depression of chronic low back pain patients. J Phys Ther Sci 2015;27:397-9.
  18. Walewicz K, Taradaj J, Rajfur K, Ptaszkowski K, Kuszewski MT, Sopel M, et al. The effectiveness of radial extracorporeal shock wave therapy in patients with chronic low back pain: A prospective, randomized, single-blinded pilot study. Clin Interv Aging 2019;14:1859-69.
  19. Çelik A, Altan L, Ökmen BM. The effects of extracorporeal shock wave therapy on pain, disability and life quality of chronic low back pain patients. Altern Ther Health Med 2020;26:54-60.
  20. Hawker GA, Mian S, Kendzerska T, French M. Measures of adult pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF-36 BPS), and Measure of Intermittent and Constant Osteoarthritis Pain (ICOAP). Arthritis Care Res (Hoboken) 2011;63 Suppl 11:S240-52.
  21. Smeets R, Köke A, Lin CW, Ferreira M, Demoulin C. Measures of function in low back pain/disorders: Low Back Pain Rating Scale (LBPRS), Oswestry Disability Index (ODI), Progressive Isoinertial Lifting Evaluation (PILE), Quebec Back Pain Disability Scale (QBPDS), and Roland- Morris Disability Questionnaire (RDQ). Arthritis Care Res (Hoboken) 2011;63 Suppl 11:S158-73.
  22. Zigmond, A. S., Snaith, R. P. The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica, 1983;67(6):361-70.
  23. Liu K, Zhang Q, Chen L, Zhang H, Xu X, Yuan Z, et al. Efficacy and safety of extracorporeal shockwave therapy in chronic low back pain: a systematic review and meta-analysis of 632 patients. J Orthop Surg Res. 2023;18(1):455.
  24. Wu Z, Zhou T, Ai S. Extracorporeal shock wave therapy for low back pain: A systematic review and meta-analysis. Medicine (Baltimore). 2023;102(52):e36596.
  25. Walewicz K, Taradaj J, Dobrzyński M, Sopel M, Kowal M, Ptaszkowski K, et al. Effect of radial extracorporeal shock wave therapy on pain, disability, and functional performance in patients with chronic low back pain: A randomized clinical trial. J Clin Med. 2020;9(2):568.
  26. Ejaz R, Rafique S, Hamid K, Raza Q, Haider S. Comparative effects of shockwave therapy and Maitland lumbar mobilization on pain, disability, and range of motion in patients with mechanical low back pain: A pilot study. J Musculoskelet Surg Res. 2024;8:153-9.
  27. Nedelka T, Katolicky J, Nedelka J, Hobrough P, Knobloch K. Efficacy of high-energy, focused ESWT in treatment of lumbar facet joint pain: a randomized sham-controlled trial. Int J Surg. 2025;111(7):4177-86.
  28. Sun H, Chen H, Mu G, Fu H, Yue L. Comparison of Different Treatment Regimens of Extracorporeal Shockwave Therapy in Chronic Low-back Pain: A Randomized Controlled Trial. Pain Physician. 2022;25(8):E1211-8.