Myofascial Syndrome and Low Back Pain: Focused Shockwaves as Diagnostic Tool for Myofascial Trigger Points - preliminary data

Research Objectives: Many factors contribute to the aetiology of chronic low back pain (LBP), but in ca. 80% no specific reason is found. The role of Myofascial trigger points (MTrP) are a promising target of LBP therapy. Focused Extracorporeal Shockwave Therapy (fESWT) reaches deeper layers of the human body precisely and stimulates tissue non-invasively. Literature supports the role of fESWT to diagnose MTrPs while stimulating the nociception of Trigger Points. The aim of this research is to show that fESWT is a good diagnostic tool for MTrPs with reproducible data in patients with chronic LBP.

Design: RCT with experimental condition and waitlist control. Preliminary data of pre-treatment examination from experimental condition is used (23 participants).

Setting: Participants were recruited via newspaper advertisements

Participants: 23 Patients with chronic LBP (age 20y–70y). Exclusion criteria: sensomotoricimpairment, severe spinal stenosis, spondylolisthesis grade 2 or more, vertebral lesions, neoplastic origin, or vascular etiology.

Interventions: Myofascial tissue of the trunk, pelvis and lower limbs is examined manually and with fESWT, searching for MTrPs. Diagnostic criteria: pain, recognition and referral of pain were scored. fESWT with low to middle energy levels is used as a diagnostic tool. Shockwave device: Wolf Piezoelectric.

Main Outcome Measures: Presence of pain, recognition and referral of pain in soft tissue e.g. muscle and fascial tissue.

Results: Preliminary results: M. quadratus lumborum and M. gluteus minimus were most commonly related to LBP (in 91% and 82% of participants, respectively). The diagnostic criteria (Travell and Simons) were elicited by fESWT (M. quadratus lumborum: Recognition of pain: 66%, Referral of pain: 92%; and M. gluteus minimus: Recognition of pain: 80%, Referral of pain 88%).

Conclusions: Our results showed, that focused shockwaves are a reliable tool to diagnose myofascial Trigger Points causing LBP.
The preliminary results suggest that Myofascial Trigger Points in muscles in the gluteal and lumbal region may play an important role in chronic LBP.

Author(s) Disclosures: The authors have no conflicts of interest to declare.