Medical shockwaves for chronic low back pain - a case series

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Medical shockwaves for chronic low back pain: a case series.
Kenneth Craig1
, Bradley Takai2
, Jacqueline Craig3
, Sarah Pelham3*
Danielle MacDonald3**
1
Director Kompass OrthoShock Center for Medical Shockwave Therapy & Research. Auckland, New
Zealand,
2
Lead Physiotherapist Kompass Health Associates, Auckland, New Zealand,
3
Motion
Analyst Assistant & Health Services Specialist (BHSc., PGDip Psychology, MSc. Student),
3*
Research
Assistant (BHSc. Physiotherapy),
3**
Research Assistant (BHSc., MSc.Kinesiology, PhD. Student
Human Kinesiology), Kompass MotionLab, Auckland, New Zealand.
Introduction
Chronic low back pain which may be either specific or non-specific in nature is a
common yet enigmatic major global public health issue arising from multiple
aetiologies.1 - 4
Since the first low back pain (LBP) guideline (Quebec Task Force,
1987), much research has been dedicated to this disease and there are now over
2000 control trials evaluating treatments for LBP in the Cochrane data base alone.
European, Australian and New Zealand guidelines for the management of LBP are
consistent recommending primarily paracetamol followed by NSAID’s.1 – 6
However
consensus for use of opioids, benzodiazepines, muscle relaxants, surgical
intervention and physical manipulation remain considerably varied.1 – 6
The issue
remains that chronic LBP is often indocile to most interventions and functional
capacity often remains limited even when symptomatic relief may be obtained.7
Therefore, disease modifying interventions rather than symptomatic management
alone require investigation.
Aim
To determine if medical shockwaves may be a potential disease modifying modality
for the treatment of chronic LBP, and to encourage further investigation of
shockwaves in this area.
Methods
Ten patients of varying gender, occupation and age were seen in our clinic. All
patients underwent initial screening utilising: subjective pain scale (VAS), Oswestry
Disability Index (ODI)8,9
and dorsaVi-Move quantitative analysis at baseline, wk 3
and wk12. Medical shockwaves were propagated by an electrohydraulic generator

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(MediSpec Ltd.) over three (3) sessions at one (1) week intervals, were a total of
1000 impulses at 0.12mj/mm² per session were focused bilaterally over the erector
spine region ranging from the mid sacrum to L1. All forms of analgesia and pain
medications were ceased two day prior to treatment and remained discontinued
when possible for the entire treatment and follow-up period. Exercise prescription
were commenced at wk6 and only after satisfactory symptomatic relieve, to help
provide improved motion and regional integrity.
Result
Eight of the nine patients showed excellent improvement with one having marginal
improvement and requires further management. The overall improvement (n=6) were
recorded as follows: VAS (mean baseline 6.7/10; mean post ESWT0.5/10), ODI
(mean baseline 55% - severe disability; mean post ESWT 14% - minimal disability)
and dorsaVi-Move assessment recorded improvements and correction in the
respective individual motion and postural areas of extension, flexion and posture
from baseline in each individual. Dependence on analgesics and pain medication
was changed from daily dependence (n=10) to completely independent (n=7), and
infrequent (n=2).
Discussion & Conclusion
Chronic low back pain is a multifactorial phenomenon that prolongs physical
disability interrupting quality of life and productivity. Medical shockwaves have over
the past decades demonstrated safety and efficacy across medical disciplines by
what is considered as the homeostatic regulation of the neurophysiological,
biochemical and biocellular components of the human organism.10 - 19
This case
series reports positive outcomes in both symptomatic relief and functional restoration
in majority of the cases supporting the premise for further investigation to be carried
out in this area.
Keywords: chronic low back pain, disease modifying, non-pharmacogenic,
systemically neutral, extracorporeal shockwave therapy.

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Reference
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Medical shockwaves for chronic low back pain - a case series

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