Radial Extracorporeal Shockwave Therapy in Fibromyalgia


Radial Extracorporeal Shockwave Therapy in Fibromyalgia
Silvia Ramon (1), Leonor Hernandez-Sierra (1), Antonio Gomez-Centeno (2), Elena Morales-Espeleta (1), Oscar Ares (3), Maria Garcia-Manrique de Lara (2), Fernando Vidiella (1), Ramon Cugat (3)

(1) Dept. of Rehabilitation, (2) Dept. of Rheumatology, (3) Dept. of Orthopedic Surgery, Hospital Quiron, Barcelona, Spain

Device and producing company:
Physiogold 50, MTS

The purpose of this study is to evaluate the evidence of rESWT in fibromyalgia (FM).

We performed a randomized, prospective study with 24 FM patients. All patients were female, mean age 52, 13 years (45-67). Patients were divided into two groups and asked to select the 3 most painful myofascial and asymmetrical regions. Both groups received 5 weekly sessions of radial ESWT (rESWT), using 2000 shocks of rESWT at each of the 3 points. Group 1 (treatment) N= 13 treated with 500 shocks, 1,5 bar, 5 Hz; then 1000 shocks, 2 bar, 8 Hz; and 500 shocks, 1,5 bar, 15 Hz; Group 2 (placebo) N= 11 (using a soft rubber cap leaving air between transmitter and the cap) received 500 shocks, 15 Hz; then 1000 shocks, 8 Hz; and 500 shocks, 15 Hz, with the pressure constant 1,5 bar. Outcome variables were: 1) Pain: VAS, algometer (Wagner instruments®) at 3 points and contralateral; McGill Questionnaire; 2) Emotional status (BDI; Hamilton test) and 3) QOL measures: Fibromyalgia-Impact-Questionnaire; Fibromyalgia-R808-NP2; SF-36. Both groups received a home FM exercise program, according to Fibromyalgia Information Foundation. All patients were assessed for pain before each rESWT and at 6 weeks post treatment.

We found clinical improvement on pain at 6 weeks after treatment and excellent-good results according to Roles and Maudsley in FM patients treated compared to placebo, without side effects.

Patient follow-up 6 to 12 months post-treatment will determine shockwave efficacy over time.

In a multi-disciplinary approach, rESWT appears to be safe and effective as an early adjunctive therapy in fibromyalgia.

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