Authors' objectives: To determine whether there is any evidence on the effectiveness of extra corporeal shockwave therapy (ESWT) in treating costochondritis and soft tissue contusions.

Authors' results and conclusions: Of the three hundred twenty-six published studies were identified through the search and after duplicates were removed, 250 published studies were identified through the search. Examination of the titles and abstracts of these published studies, there were two studies thought to be relevant to ESWT use in treating costochondritis while 166 were excluded due to incorrect population, 46 due to incorrect interventions, 11 due to incorrect study design, and 25 were animal/cell culture studies. Of the two studies that were retrieved in full, both studies were found to be relevant to this systematic review. Morgan et al. (2020) is a retrospective study, level of evidence 4 whereby the treatments and recovery times of muscle injuries suffered of twenty elite football players were examined. Of the 20, three had contusions in the adductor digiti minimi (hand), vastus medialis (thigh), and gluteus maximus (buttocks) respectively. Treatment used a multimodal therapy approach including a specific protocol of almost daily radial extracorporeal shock wave therapy (rESWT) except one contusion patient who received focused extracorporeal shock wave therapy (fESWT). All contusion patients reported decrease in VAS score compared to pre-intervention levels. Return-to-play was achieved after four days in the three contusion patients. Ciftci et al. (2021) is a single blind, randomized control trial, level of evidence 1 whereby 67 patients with costochondritis received either high-energy flux density ESWT (hESWT) or intra-articular steroid injection (IASI). The ESWT group received a total of seven sessions at three-day intervals while IASI group received injections twice at two-week intervals. In both groups, there was a statistically significant decrease in VAS scores after treatment compared with pre-intervention levels at one month. The ESWT group was statistically significantly greater than the IASI group for both VAS and pressure pain threshold. There is one low level low-quality study (level of evidence 4) and one high level moderate-high quality study (level of evidence 1) reporting on the efficacy of ESWT for the treatment of costochondritis and soft tissue contusions respectively. Both studies showed the ESWT improved pain outcomes compared to baseline while one study did show improved pain outcomes compared to other interventions. It should be noted that selection bias, lack of studies/population, and methodological inconsistencies cannot be excluded from the reported outcomes. Therefore, further studies need to be completed to determine if there is conclusive evidence reporting on the efficacy of ESWT in the treatment of costochondritis and soft tissue contusions.

Authors' methods: In 2019, WorkSafeBC Evidence-based Practice Group (EPBG) commissioned a systematic review to investigate the efficacy or effectiveness of ESWT in treating costochondritis and soft tissue contusions. The findings concluded that there is no published study investigating the efficacy/effectiveness of ESWT in treating costochondritis or soft tissue contusions. This current update seeks to review the literature from the last update in 2019 in order to determine the efficacy of ESWT in treating costochondritis or soft tissue contusions. A systematic literature search was started on May 7, 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.

Project Status: Completed

URL for project: https://www.worksafebc.com/en/about-us/research-services/evidence-based-medicine-and-systematic-reviews

Year Published: 2024

URL for published report: https://www.worksafebc.com/en/resources/health-care-providers/guides/effectiveness-extra-corporeal-shockwave-therapy-eswt-treating-costochondritis-soft-tissue-contusion-2024-update?lang=en&origin=s&returnurl=https%3A%2F%2Fwww.worksafebc.com%2Fen%2Fforms-resources%23sort%3DDate%26q%3DEffectiveness%2520of%2520Platelet%2520Rich%2520Plasma%2520Therapy%2520(PRP)%2520in%2520Treating%2520Shoulder%2520Labral%2520Tears%26tags%3DGuide%7C2d7eb4b30f6a4a319e0d40565c9abbab%2CHealth%2520Care%2520Provider%7C13468b0b3f074f6bade3f57ac3cdfb8e%2CSystematic%2520Review%7Cf78c29d570c14ec3b5a394385905df70&highlight=Effectiveness%20of%20Platelet%20Rich%20Plasma%20Therapy%20(PRP)%20in%20Treating%20Shoulder%20Labral%20Tears

English language abstract: An English language summary is available

Publication Type: Mini HTA

Country: Canada

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