• Clinical Pain
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• 제18권2호
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• pp.138-141
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• 2019

Lateral epicondylopathy represents pain in the lateral (radial aspect) of the elbow caused by degeneration in the common extensor tendon. Calcium deposit frequently developes in lateral epicondylopathy, with the prevalence up to 46%. There are considerable debates on its treatment protocols for lateral epicondylopathy so far, likewise, the effective treatment method for calcific lateral epicondylopathy has not been established. We report here a case of chronic intractable calcific lateral epicondylopathy treated with ultrasound-guided barbotage and focused type extracorporeal shock wave therapy (ESWT). To our knowledge, this is the first report of calcific lateral epicondylopathy treated by ultrasound-guided barbotage combined with ESWT.

• 대한족부족관절학회지
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• 제20권3호
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• pp.93-99
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• 2016

Plantar fasciitis is the most common cause of heel pain. The diagnosis of plantar fasciitis is primarily based on the presentation of symptoms and physical examination. Patients usually complain of heel pain at the medial calcaneal tubercle when taking their first step in the morning or when walking after resting. Diagnostic imaging is rarely required for the initial diagnosis of plantar fasciitis; however, it can be used for differential diagnosis. Conservative treatments, such as stretching, rest, ice massage, oral analgesics, foot orthotics, use of night splint, and corticosteroid injection, may be effective. The majority of patients report improvement with conservative treatments, and those who show no response from conservative treatments for a duration of six months or longer can consider extracorporeal shock wave therapy or surgery.

• 대한통합의학회지
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• 제9권1호
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• pp.151-161
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• 2021

Purpose : This study was to investigate the effectiveness of ESWT and plantar fascia-specific stretching exercise vs ESWT and high-load strengthening exercise in patients with chronic plantar fasciitis. Methods : The subjects were randomized to extracorporeal shock wave therapy ( ESWT, for 3 weeks) and daily plantar-specific stretching (Group I: Stretch group) or ESWT and high-load progressive strength (Group II: Strength group) performed every second day. The main outcome measures were ultrasound, visual analogue scale (VAS), and Korean Foot Function Index (KFFI). The ultrasound (plantar fascia thickness), pain intensity I, II (the most painful of the day?, the pain when you first step in the morning?) and KFFI (functional performance) were compared between the groups. Results : No significant difference was observed between the groups in the plantar fascia thickness but pain intensity I, II was significantly lower in Group 2 than in Group 1 at only 12weeks and functional performance was also significantly increased in Group 2 compared to Group 1 at only 12 weeks. Conclusion : The high-load strengthening exercise consisting of the progressive exercise protocol, resulted in superior after 12 weeks compared with plantar-specific stretching. High-load strength exercise may aid in a quicker reduction in pain and improvements in functional performance.

• Clinics in Shoulder and Elbow
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• 제19권1호
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• pp.20-24
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• 2016

Background: Extracorporeal shock wave therapy (ESWT) is one of the treatment options used for patients with myofascial pain syndrome (MPS), although its effectiveness is controversial. The purpose of this study was to evaluate the effectiveness of ESWT in the treatment of MPS in terms of pain relief and functional improvements. Methods: We assessed 93 patients with MPS who underwent ESWT from March 2009 to July 2014. After exclusion of 25 patients with shoulder diseases, 68 patients were enrolled in the study. The mean follow-up period was 7.5 months (${\pm}4.2weeks$), and the average duration of symptoms was 5 months (range, 2-16 months). ESWT was applied to intramuscular taut bands and referred pain areas once a week for 3 weeks. Visual analog scale (VAS) pain scores and American Shoulder and Elbow Surgeons (ASES) scores were obtained at an initial assessment and at the 6-week, 3-month, and 6-month follow-up assessments. Results: VAS pain scores and ASES scores improved significantly after 3 sessions of ESWT (p<0.05). Both scores were improved, although not significantly, after 6 weeks (p>0.05). Conclusions: ESWT is an effective treatment option for patients with MPS.

• Archives of Plastic Surgery
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• 제49권4호
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• pp.554-560
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• 2022

Background Hypertrophic scars cause aesthetic concerns and negatively affect the quality of life. A gold standard treatment for hypertrophic scars has not been established due to various responses of modalities. Extracorporeal shock wave therapy (ESWT) is a noninvasive and affects scar remodeling by fibroblast regulation. This study investigated the effectiveness of ESWT for hypertrophic scars. Methods Twenty-nine patients were enrolled. All patients underwent ESWT once a week for 6 consecutive weeks. Their scars were assessed using the Patient and Observer Scar Assessment Scale (POSAS), erythema index, melanin index, and scar pliability before treatment and again 4 weeks after treatment completion. Results Thirty-four hypertrophic scars in this study had persisted for between 6 months and 30 years. Most scars developed after surgical incision (55.88%). The chest and upper extremities were the predominant areas of occurrence (35.29% each). Most of the POSAS subscales and total scores were significantly improved 4 weeks after treatment (p < 0.05). Furthermore, the pain, itching, and pigmentation subscale were improved. The pliability, melanin index, and erythema index were also improved, but without significance. The patients were satisfied with the results and symptoms alleviation, although subjective score changes were insignificant. No serious adverse events were found. The patients reported pruritus in 62.5% and good pain tolerance in 37.5%. Subgroup analyses found no differences in scar etiologies or properties at different parts of the body. Conclusion The ESWT is a modality for hypertrophic scar treatment with promising results. Most of POSAS subscales were significantly improved.

• 대한임상전기생리학회지
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• 제7권1호
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• pp.29-34
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• 2009

Purpose : This study aims to investigate into the change in muscle power, pain and muscle tension upon application of extracorporeal shock wave therapy (ESWT) and ultrasound (US) at trigger point (TrP) of the Scapular inter angle. Methods : In total of 24 human subjects that experience pain upon stimulation at the scapular inter angle were recruited. They were divided into three groups: control, ESWT and US group. Each group was subjected to appropriate stimulation three times per week for four weeks except the control group which had no restrictions in lifestyle. The ESWT group was subjected to Extracorporeal Shock Wave Therapy with a 2 $cm^2$ head, 20 times at speed of application of 60 pulses/min and depth of intrusion of 25 mm Whereas the US group was subject to Ultra sound therapy with 1$cm^2$ head, 1 MHz in frequency, 1.5 W/$cm^2$ of strength with five minutes of continuous application. Measurements were performed immediately prior to and at the end of the experiment. Results : There was no statistical significance in the change in muscle tension and muscle power as well as the difference between both groups before and after the experiment. VAS and VRS, all of which indicates changes in pain level, had statistically significant differences between them in pretest posttest comparisons. However, ESWT was superior to US in terms of decreasing muscle tension and pain while increasing muscle power. Conclusion : This study has made it evident that ESWT is far more reasonable to apply to TrP.

• 척추신경추나의학회지
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• 제11권2호
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• pp.57-64
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• 2016

This is a case report about left leg radiating pain treated with complex traditional Korean medical intervention, while the case did not responded to prolotherapy and extracorporeal shock wave treatment for lumbar herniated intervertebral disc (HIVD). The patient was diagnosed with a piriformis problem after a physical examination and was treated with lumbar and piriformis muscle treatment. After 9 sessions of treatment for 33 days, Numeric Rating Scale (NRS) for pain has been decreased from 8 to 3. Further studies with more cases and longer observation period should be conducted to provide evidence for optimum acupuncture procedure considering its effectiveness, safety and patients' compliance altogether.

• The Korean Journal of Pain
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• 제34권3호
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• pp.315-321
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• 2021

Background: Pillar pain may develop after carpal tunnel release surgery (CTRS). This prospective double-blinded randomized trial investigated the effectiveness of extracorporeal shock wave therapy (ESWT) in pillar pain relief and hand function improvement. Methods: The sample consisted of 60 patients with post-CTRS pillar pain, randomized into two groups. The ESWT group (experimental) received three sessions of ESWT, while the control group received three sessions of sham ESWT, one session per week. Participants were evaluated before treatment, and three weeks, three months, and six months after treatment. The pain was assessed using the visual analogue scale (VAS). Hand functions were assessed using the Michigan hand outcomes questionnaire (MHQ). Results: The ESWT group showed significant improvement in VAS and MHQ scores after treatment at all time points compared to the control group (P < 0.001). Before treatment, the ESWT and control groups had a VAS score of 6.8 ± 1.3 and 6.7 ± 1.0, respectively. Three weeks after treatment, they had a VAS score of 2.8 ± 1.1 and 6.1 ± 1.0, respectively. Six months after treatment, the VAS score was reduced to 1.9 ± 0.9 and 5.1 ± 1.0, respectively. The ESWT group had a MHQ score of 54.4 ± 7.7 before treatment and 73.3 ± 6.8 six months after. The control group had a MHQ score of 54.2 ± 7.1 before treatment and 57.8 ± 4.4 six months after. Conclusions: ESWT is an effective and a safe non-invasive treatment option for pain management and hand functionality in pillar pain.

• 한국음향학회지
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• 제41권5호
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• pp.570-588
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• 2022

식약처에서 허가된 국내 11개 및 국외 6개 제조사의 46개 탄도형 체외 충격파 치료기 중 기술 문서가 공개된 15개 제품 70개의 충격파 발생 장치에 대해 충격파 음향 출력을 조사했다. 조사 결과, 임상에서 가장 보편적인 피폭 변수로 사용되는 에너지 속 밀도(Energy Flux Density, EFD)는 치료기의 충격파 발생 장치에 따라 최소 출력 설정에서 최대 563.64배, 최대 출력 설정에서 최대 74.62배까지 차이가 나고 있다. 동일 모델 제품에서 충격파 변환자의 선택으로 EFD의 값은 최소 설정에서 최대 81.82배, 최대 설정에서 최대 46.15배 차이를 보이고 있다. 최대 출력 설정에서 EFD의 최저값 0.013 mJ/mm²이 최소 출력 설정에서 EFD의 최대값 0.62 mJ/mm²보다 훨씬 낮은 것(2.1 %)으로 나타났다. 동일한 적응증으로 허가 받은 탄도형 체외 충격파 치료기의 음향 출력이 수십~수백 배 차이가 난다는 것은 치료기의 치료 효과 및 안전성을 보증하기 어렵다는 것을 시사한다. 본 연구의 결과는 치료기의 허가 및 성능의 동등성에 대한 명확한 기준을 포함하는 식약처의 가이드라인 개정 및 사용 중인 치료기의 음향 출력과 기술 문서와의 일치성 확인을 포함하는 치료기의 성능에 대한 규제 기관의 사후 관리의 필요성을 제기한다.

• Clinics in Shoulder and Elbow
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• 제7권1호
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• pp.35-40
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• 2004

Purpose: The aim of this study was to investigate effects of calcific lesion on shockwave therapy of the tennis elbow. Materials and Methods: twenty-four patients with refractory tennis elbow were treated with shock waves. The patients were evaluated by assessment of pain using visual analog scale (VAS) and simple elbow test (SET). Comparision of clinical outcomes for the patients with and without calcification in the extensor tendon and/or cortical irregularity of lateral condyle was tried to determine if this could be a possible prognostic factor in clinical settings. Overall clinical outcomes were evaluated by Roles and Maudsley score at 12 months after ESWT. Results: Significant improvement of symptoms were observed in 20 (83 %) patients at 12 months follow up according to Roles and Maudesley scores. The patients with calcification and/or cortical irregularity improved significantly better, when compared to the patients without calcification and/or cortical irregularity at follow up. Conclusion: This study suggests that shock waves therapy could be considered as effective and noninvasive treatment modality for refractory tennis elbow. Also calcific deposit in extensor tendon and/or cortical irregularity of the lateral epicondyle was seem to be good prognostic factor for shock wave therapy for tennis elbow