Comparing Focused Shockwave Versus Radial Pressure Wave Therapy For Rotator Cuff Non-calcific Tendinopathies

Background:Shoulder pain is a common kind of clinical symptom.Rotator cuff tendinopathies are main causes of shoulder pain.At present,the treatment of rotator cuff tendinitis mainly includes drugs,physical exercise,extracorporeal shockwave(ESW),surgery and so on.ESW is non-invasive,effectively analgesic and can be used repeatedly.Whether focused shockwave(F-SW)is better than radial pressure wave(R-PW)in the treatment of rotator cuff non-calcific tendinopathies(RCNCT)remains controversial.The purpose of this study was to compare the effects of the two kinds of shockwaves in the treatment of RCNCT,and to provide evidence for clinical practice.Methods:From June 2018 to February 2020,46 patients with RCNCT were selected as the research objects.The subjects were randomly assigned to treatment group(group A,n=23)or control group(group B,n=23).The treatment group received F-SW therapy,and the control group received R-PW therapy.Both groups received 4 courses of intervention:once a week,a total of 4 times,3000 shots each time.The general information of the patients,the pain scale(NRS)and Constant Murley scale(CMS)before treatment and at 4,12,24 and 48 weeks after treatment as well as the MRI results before treatment and at 24 and 48 weeks after treatment were recorded.The difference of NRS score at 24 weeks after treatment was used as the main indicator to evaluate the curative effect,and the difference of NRS score,CMS score and MRI changes at other follow-up time were used as the secondary indicator.All data were entered into SPSS statistics version 21,and the differences between the two groups were compared.Results:At 24 and 48 weeks after treatment,the NRS score,CMS score and MRI results of the treatment group were significantly improved compared with those of the control group(P<0.05).At 4 and 12 weeks after treatment,the NRS pain scores and CMS function scores of the two groups were significantly improved than before treatment(P<0.05),but there was no significant difference between the two groups(P>0.05).Conclusions:After extracorporeal shockwave therapy,the shoulder pain was significantly reduced,the functional score was improved,and the reduction of edema was confirmed by MRI.Both F-SW and R-PW are effective in patients with RCNCT.F-SW proved to be significantly superior to R-SW at 24 and 48 weeks after therapy.