Comparison of Outcomes From Radial Extracorporeal Shock Wave Therapy Combined With Physical Therapy Versus Infrared Therapy Combined With Physical Therapy Among Patients With Myofascial Low Back Pain

Med Sci Monit. 2026 May 6;32:e951779. doi: 10.12659/MSM.951779.

ABSTRACT

BACKGROUND Myofascial pain syndrome (MPS) is a common cause of chronic low back pain with trigger points in the muscles and fascia. This study compared outcomes after radial extracorporeal shock wave therapy (rESWT) plus physical therapy versus infrared therapy plus physical therapy among patients with myofascial low back pain. MATERIAL AND METHODS Overall, 112 patients were randomly assigned to the experimental group (n=56) or control group (n=56). For 6 weeks, the experimental group received physical therapy combined with rESWT (2000 pulses, 2.0-2.5 bar, twice weekly), whereas the control group received physical therapy combined with infrared therapy (15 minutes per session, twice weekly). Primary outcomes were pain intensity (Numerical Rating Scale [NRS]), functional disability (Oswestry Disability Index [ODI]), and patient-reported improvement (Patient Global Impression of Change [PGIC]). RESULTS The rESWT group showed greater improvements than the control group in pain (ΔNRS: 0.68±0.81 vs 0.13±0.66, P<0.001, Cohen's d=0.747), disability (ΔODI: 5.29±5.71 vs 0.84±5.49, P<0.0001, Cohen's d=0.793), and patient-reported improvement (PGIC: 2.82±1.53 vs 4.07±1.36, P<0.0001, Cohen's d=0.865). Within-group analysis revealed significant improvements in the rESWT group (NRS and ODI, both P<0.01) but not the control group (both P>0.05). CONCLUSIONS Compared with infrared therapy plus physical therapy, rESWT plus physical therapy yielded greater improvements in pain and disability. These findings support use of rESWT for the management of chronic low back MPS.

PMID:42087422 | DOI:10.12659/MSM.951779