Effectiveness of extra corporeal shockwave therapy (ESWT) in treating shoulder labral tears

WorkSafeBC Evidence-Based Practice Group, Martin CW
Record ID 32018013510
English
Authors' objectives: To determine whether there is any evidence on the effectiveness of extra corporeal shockwave therapy (ESWT) in treating shoulder labral tears.
Authors' results and conclusions: One hundred forty-four published studies were identified through the one search. After duplicates were removed, 139 published studies were identified through the search. Upon examination of the titles and abstracts of these published studies, there was only one study thought to be relevant to ESWT use in treating shoulder labral tears while 119 were excluded due to incorrect population, six due to incorrect interventions, eight due to incorrect study design, and five were animal/cell culture studies. The study retrieved in full was excluded due to an incorrect population. A manual search of the references from the studies selected for full text screening revealed two additional studies. Therefore, there were two studies relevant to this systematic review. Park et al. (2020) is a retrospective chart review, level of evidence 4 whereby the charts of 55 patients with MRI-diagnosed superior labrum anterior to posterior (SLAP) lesions were examined. Inpatient treatment included ESWT 4 Effectiveness of Extra Corporeal Shockwave Therapy (ESWT) in Treating Shoulder Labral Tears April 2024 among other concomitant therapies. While details of the ESWT methodologies were unknown, the frequency of treatment was recorded in which 27 patients received 1–10 ESWT treatments, 14 patients received 11–20 ESWT treatments, nine patients received 21–30 ESWT treatments, two patients received 31–40 ESWT treatments, and three patients received no ESWT treatment. Spearman correlation coefficient analysis of the number of treatments used and changes in pain via numeric rating scale (NRS) scores revealed that coefficient of ESWT was not significant. Suh et al. (2020) provides a case study level of evidence 4 whereby a 39-year-old male patient presented with severe pain and weakness in the right shoulder. An MRI revealed calcific tendinitis in the posterosuperior labrum of the shoulder joint. Conservative treatment which included ESWT, failed after one week of treatment. Arthroscopic removal of calcification resolved the issue. There were two very low-quality studies, level of evidence 4 reporting on the efficacy of ESWT for the treatment of shoulder labral tears. Both studies showed the ESWT did not improve pain outcomes and other interventions used had greater effect on improvement of these outcomes. It should be noted that selection bias, potential positive effect of co-intervention, and methodological inconsistencies cannot be excluded from the reported outcomes. Therefore, there is no conclusive evidence reporting on the efficacy of ESWT in the treatment of shoulder labral tears.
Authors' methods: A systematic literature search was done on April 24, 2024. This literature search was conducted on commercial medical literature databases. The search was done by employing combinations of keywords. No other limitations on were implemented in any of these searches. A manual search was also planned and conducted on the references of the articles that were retrieved in full.
Details
Project Status: Completed
Year Published: 2024
English language abstract: An English language summary is available
Publication Type: Mini HTA
Country: Canada
MeSH Terms
  • Shoulder Injuries
  • Rotator Cuff Injuries
  • Extracorporeal Shockwave Therapy
Keywords
  • extracorporeal shockwave therapy
  • ESWT
  • shoulder
  • labrum tear
  • labral tear
Contact
Organisation Name: WorkSafeBC
Contact Address: 6591 Westminster Highway, Richmond, BC, V7C 1C6 Canada. Tel: 604-231-8417; Fax: 604-279-7698
Contact Name: ebpg@worksafebc.com
Contact Email: ebpg@worksafebc.com
Copyright: WorkSafe BC
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