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)

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

Device and producing company:
Physiogold 50, MTS

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

Methods:
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.

Results:
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.

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

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