Extracorporeal Shockwave Therapy in Pain Management - an In-Depth Narrative Review

Area of Science:

• Pain Medicine
• Regenerative Medicine
• Biophysics

Background:

• Chronic pain involves complex cellular mechanisms, including central sensitization and inflammation.
• Extracorporeal shockwave therapy (ESWT) is an emerging non-invasive treatment modality.
• The precise cellular mechanisms of ESWT remain incompletely understood.

Purpose of the Study:

• To review the cellular mechanisms of chronic pain.
• To elucidate the mechanisms of action for extracorporeal shockwave therapy (ESWT).
• To evaluate the efficacy of ESWT for diverse chronic pain conditions.

Main Methods:

• A comprehensive literature search was performed across Scopus, PubMed, Embase, and Cochrane Database of Systematic Reviews.
• Studies published between 2000 and 2024 were included.
• The review focused on studies evaluating ESWT for chronic pain pathologies.

Main Results:

• Extracorporeal shockwave therapy (ESWT) utilizes mechanotransduction to trigger cellular responses.
• ESWT demonstrates potential in preventing central sensitization and reducing inflammation.
• Recent clinical trials and meta-analyses (2024) support ESWT's efficacy for numerous chronic pain conditions.
• Reported adverse effects associated with ESWT are minimal.

Conclusions:

• Extracorporeal shockwave therapy (ESWT) holds significant promise for managing a wide spectrum of chronic pain conditions.
• Further research is warranted to fully understand ESWT's mechanisms and optimize its clinical application.
• ESWT offers a potentially effective treatment option with a favorable safety profile for chronic pain management.