Extracorporeal shockwave therapy improves pain and function in subjects with chronic low back pain: a systematic review and meta-analysis of randomized clinical trials

Abstract Background: Extracorporeal shock wave therapy (ESWT) has been widely used for pain control in musculoskeletal disorders. Whether ESWT can relieve chronic low back pain and improve lumbar function is still controversial. Therefore, we designed a meta-analysis based on relevant studies to comprehensively analyze and determine the efficacy and safety of ESWT for chronic low back pain. Methods:PubMed, Embase, Cochrane Library, and Web of Science were systematically searched for randomized controlled trials (RCT) studies on extracorporeal shock wave therapy for chronic low back pain from inception to September 2022. The quality of the included literatures was evaluated according to Cochrane systematic review criteria, relevant data were extracted, and meta-analysis was performed using RevMan 5.4 software. Results:12 RCTs involving 632 patients were included to this investigation. In terms of pain relief, ESWT was associated with lower VAS scores in patients receiving ESWT in comparison with controls at 4 weeks (WMD =−1.04; 95% CI =−1.44 to −0.65; P <0.001) and 12 weeks (WMD =−0.85; 95% CI =−1.30 to −0.41; P <0.001). In terms of improvement of dysfunction index, ESWT significantly increased ODI score in comparison with control group at 4 weeks (WMD =−4.22; 95% CI =−7.55 to −0.89; P <0.001) and 12 weeks (WMD =−4.51; 95% CI =−8.58 to −0.44; P = 0.03). For mental health, there was no significant difference in the ESWT group compared with the control group after 4 weeks of intervention (SMD =1.17; 95% CI =−0.10 to 2.45; P = 0.07). Conclusion: ESWT can relieve pain and improve lumbar dysfunction in patients with chronic low back pain, but has no significant effect on patients' mental health.