The effectiveness of different types of extracorporeal shock wave therapy in the management of frozen shoulder: a systematic review
DOI:
https://doi.org/10.47197/retos.v78.118678Keywords:
Frozen shoulder, adhesive capsulitis, extracorporeal shock wave therapy, focused shock wave therapy, radial shock wave therapy, pain management, shoulder function, randomized control trial, systematic reviewAbstract
Introduction: Frozen shoulder (FS) is a condition marked by pain and stiffness, which limits daily activities and quality of life. This review evaluates the effectiveness of extracorporeal shock wave therapy (ESWT) in the form of focused (fSWT) and radial (rSWT) modalities for managing FS, aiming to clarify their comparative effectiveness and synthesize current clinical evidence. Evidence Acquisition: A systematic review was conducted according to PRISMA guidelines. Searches were performed across nine databases for randomized controlled trials (RCTs) published between 2010 and 2024 assessing ESWT in FS. Studies were screened using predefined inclusion and exclusion criteria. Extracted data included pain outcomes, shoulder function, and ROM measures.
Methodological quality was assessed using the PEDro scale. Due to study heterogeneity, findings were summarized narratively.
Evidence Synthesis: Nine RCTs met the criteria: four evaluated fSWT and five evaluated rSWT, with intervention and follow‑up durations ranging from 6 to 24 weeks.
Findings for fSWT were inconsistent, showing early benefits within the first two months but limited improvement in internal rotation. Outcomes were less reliable in individuals with uncontrolled diabetes. In contrast, rSWT consistently improved pain, ROM, and functional measures, with effects lasting up to 24 weeks. rSWT also demonstrated systemic benefits, including improved HbA1c levels in diabetic patients. Both ESWT types were well tolerated, with only minor, transient adverse effects such as mild discomfort or small hematomas.
Conclusion: Radial SWT shows more consistent and sustained improvements in FS management compared to focused SWT, which demonstrates variable results across studies.
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