Immediate effect of shock wave versus muscle energy technique in cases of quadratus lumborum myofascial pain

Abstract

Objective. To compare the effects of applying Extra-Corporal Shockwave treatment (ESWT) and Muscle Energy Technique (MET) to the Quadratus lumborum (QL) with regards to pain and function. Methods. 77 participants were included in this study. Patients were included if they were diagnosed as Myofascial pain syndrome, pain localized on the QL muscle; surrounding tightness; QL tenderness; and painful trigger points, causing referred pain around the QL. Outcome measures. Pain was measured by the Visual analogue scale (VAS), Pain pressure threshold (PPT) by the algometer and functional disability by the Oswestry pain disability index (ODI). Intervention. Patients were randomly divided into two groups. For the first group, ESWT was delivered by the Dornier AR2; smart focus technology on the tender point of the QL muscle. Three sessions were delivered with 2 days of rest following each session. The second group received the MET for 3 sessions as well. Results. The pre-treatment assessment revealed no significant differences between groups with regards to the pain (measured by the VAS & PPT) and Functional disability (measured by ODI). Following treatment, within group comparisons for the ECSW and Met groups respectively revealed significant differences with regards to pain (P = 0.0001), PPT (P = 0.0001) and ODI (P = 0.024 and 0.004 respectively) Between group comparisons revealed significant differences in favor of the ECSW group with regards to pain and PPT (P = 0.0001) with no significant difference with regards to ODI. Conclusion. ESWT showed better outcomes in improving QL myofascial pain and PPT than MET in the short term. Both treatment techniques improved the functional disability but with no significant difference between them.