Extracorporeal shock wave therapy in patients with fibromyalgia syndrome: A case series study

Abstract

Background Fibromyalgia (FM) is a form of nonarticular rheumatism with generalized musculoskeletal pain and tenderness at multiple charecteristic sites in absence of a clear pathophysiology (1). FM symptoms are not restricted to pain, but often include a heterogeneous group of other conditions, such as hyperalgesia, physical and mental fatigue, disrupted or non-restorative sleep, headache, irritable bowel, depression, cognitive impairment, and other functional complaints. Extracorporeal Shock Wave Therapy (ESWT) has been expanded as one of the treatment methods for the diseases of musculoskeletal system. Although there have been reports about the effectiveness of ESWT mainly on epicondylitis, plantar fasciitis, chronic pelvic pain, chronic painful heel syndrome, lymphedema, burn wound, pressure ulcer and calcific tendinitis, its effectiveness on treatment of fibromyalgia syndrome has not been reported (2). Objectives The aim of this study to investigate to effect of ESWT for Fibromyalgia patients with back pain. Methods 5 patients (4 female, 1 male) with FM were enrolled in the study. They were diagnosed with FM by a rheumatologist. Pain was evaluated with 10 cm Visual Analog Scale (VAS) and algometer was used to identify the pressure and/or force eliciting a pressure-pain threshold (kg/cm2) on the most painfull area of back as paravertebral. Beck Depression Scale (BDS) was used to evaluate depression. Also, Nottingham Health Profile (NHP) was used to evaluate emotional, social and physical health problems. ESWT was performed 2 days in a week during 3 week. ESWT was applied 2500 times to the pain trigger points of back muscles at 6 Hz using ESWT (“HC CLINIC SWT”) via an air cylinder method using the head of a 17-mm gun and low power. Results Respectively, the mean age 36.60±11.45 years and BMI 22.81±3.67 kg/cm2. Pain, depression and health profile were improved all the patients after the ESWT. It was shown outcome measures parameters of all patients before and after ESWT in Conclusions This study was demonstrated that ESWT is effective and rapid recovery treatment modality to reduce pain, depression symptoms and health problems in patients with FM. Further research is needed to clarify outcomes among the diversity of ESWT treatment protocol. The long-term effect of ESWT remains unclear and requires further research in patients with FM.