Efeito imediato da terapia por ondas de choque extracorpórea radiais em pacientes com dor lombar crônica não específica: ensaio clínico randomizado duplo cego

Abstract

This study aimed to assess the immediate effect of radial extracorporeal shockwave therapy with a concave and convex tip on reducing pain intensity in people with chronic non-specific low back pain (NCLD). This study is part of a three-group, single-center, randomized clinical trial with blinded patient, evaluator, and therapist, measuring superiority between interventions. In the present study, we evaluated the difference between two groups. Patients with DLCNE from the Basic and Family Health Units of the Municipality of São Carlos were invited to participate in this study, between January 2021 and December 2021. Fifty-four patients with low back pain for a period greater than or equal to three months, intensity of pain greater than or equal to three, measured on the numerical pain scale (END, 0-10), aged between 18 and 80 years of both sexes were randomly distributed among the groups of shock waves with concave tip (n= 27) and convex (n=27). Randomization was performed from a list of computer-generated random numbers, in a 1:1 block allocation ratio and concealed from sequentially numbered, opaque, sealed envelopes. The patient, outcome assessor and therapist were blinded to the allocation between groups. Both groups received a single intervention with radial shock waves of 100 mJ, 5Hz and 2000 shots, differing between the groups in the type of tip used, concave or convex. The primary endpoint was the difference, immediately after the intervention, in the intensity of post-intervention resting low back pain between the two study groups as measured by the NDT. The mean (SD) of post-intervention pain intensity measured by NDT (0-10) for the concave group was 4.3 (2) and for the convex group, 5.7 (2.6) and the mean (95%CI) the difference between the post-intervention groups was -1.4 (-2.6; -0.3), p=0.034. The application of radial shock waves with a concave tip is more effective than a convex tip in reducing the intensity of low back pain at rest in patients with NCLBP.