Affiliations: [a] Department of Anesthesiology and Pain Medicine, Catholic University Seoul St. Mary's Hospital, Seoul, Korea | [b] Department of Physical Medicine and Rehabilitation, College of Medicine, Soonchunhyang University Hospital, Bucheon, Korea
Correspondence:
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Corresponding author: Sang-Hyun Kim, Department of Physical Medicine and Rehabilitation, College of Medicine, Soonchunhyang University, 1174 Jung-dong, Wonmi-gu, Bucheon-si, Gyeonggi-do, 420-767, Korea. Tel.: +82 10 2357 7324; Fax: +82 32 621 5016; E-mail:sanghyunkim71@yahoo.com
Abstract: BACKGROUND: Sacroiliac joint (SIJ) pain can cause lower back pain
and pelvic discomfort. However, there is no established standard treatment
for SIJ pain. Extracorporeal shock wave therapy (ESWT) is a novel,
non-invasive therapeutic modality for musculoskeletal disorders. The
mechanism underlying shockwave therapy is not fully understood, but the
frequency with which ESWT is applied clinically has increased over the
years. OBJECTIVE: We evaluated the efficacy of using ESWT to treating SIJ
pain. METHODS: Thirty patients with SIJ pain were assigned randomly to
ESWT (n = 15) and sham control (n = 15) groups. The ESWT group received
2,000 shockwaves with energy set to the maximum level tolerable by the
patient (energy density = 0.09-0.25 mJ/mm2). The probe was oriented
perpendicular to the posterior SIJ line, and moved up and down along the
joint line. The sham control group received 2,000 shockwaves with the probe
oriented parallel to the posterior SIJ line. A 10-cm numeric rating scale
(NRS) and the Oswestry Disability Index (ODI) scores were assessed before
the intervention, and 1 and 4 weeks post-intervention. Participants were
instructed to refrain from using any other conservative treatment, including
anti-inflammatory medication and other physical modalities during the study. RESULTS: In the ESWT group, NRS decreased significantly at
post-treatment week 4 (3.64 (95% confidence interval, 2.29-4.99))
compared to baseline (6.42 (5.19-7.66); P < 0.05). ODI improved at 1 and 4
weeks compared to baseline, but not significantly. In the sham group, NRS
and ODI did not differ at any post-treatment time point. There was a
significant group difference in NRS at week 4 post-treatment (3.64
(2.29-4.99) in the ESWT group vs. 6.18 (5.34-7.02) in the sham control
group; P < 0.05), but this was not the case for ODI. CONCLUSIONS: ESWT represents a potential therapeutic option for
decreasing SIJ pain.
