High-energy Flux Density Extracorporeal Shock-wave Therapy Versus Therapeutic Steroid Injection in Costochondritis: A Single-Blind, Randomised Controlled Study

Abstract

Background This study aims to investigate the effects of extracorporeal shock-wave therapy (ESWT) and intra-articular steroid injection (IASI) on pain, depression, quality of life and pressure pain threshold (PPT) in patients with costochondritis.

Methods A total of 67 patients diagnosed with costochondritis were included. Patients were divided into 2 groups. Group 1 (n=34) received high-energy flux density (H-ESWT) (> 0.28 mJ/mm²) for a total of 7 sessions at 3-day intervals. Group 2 (n=33) received IASI twice at 2-week intervals. At baseline and one month after treatment, Visual Analog Scale (VAS), Short Form-36 (SF-36), Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory (BDI) scores and PPT values were compared.

Results There was a statistically significant decrease in VAS scores after treatment compared with baseline scores in both groups. The PPT and SF-36 subscale scores were also statistically significantly higher (p<0.05). After treatment, VAS and PPT showed a significantly better improvement in Group 1 compared to Group 2. There was a significant correlation between VAS and SF-36 physical functioning as well as pain subscales in Group 1 and a significant correlation between VAS and SF-36 physical functioning in Group 2.

Conclusions Our data suggest that both treatments H-ESWT and IASI are effective in costochondritis patients. Of note, H-ESWT has a stronger effect on pain and PPT scores.

Zusammenfassung

Hintergrund Ziel dieser Studie ist es, die Auswirkungen der extrakorporalen Stoßwellentherapie (ESWT) und der intraartikulären Steroidinjektion (IASI) auf Schmerzen, Depressionen, Lebensqualität und Druckschmerzschwelle (PPT) bei Patienten mit Costochondritis zu untersuchen.

Methoden Insgesamt wurden 67 Patienten mit der Diagnose einer Costochondritis eingeschlossen. Die Patienten wurden in 2 Gruppen eingeteilt. Gruppe 1 (n=34) erhielt für insgesamt 7 Sitzungen in 3-tägigen Intervallen eine hochenergetische Flussdichte (H-ESWT) (> 0,28 mJ/mm²). Gruppe 2 (n=33) erhielt 2-mal im Abstand von 2 Wochen IASI. Zu Studienbeginn und einen Monat nach der Behandlung wurden die Werte für Visual Analog Scale (VAS), Short Form-36 (SF-36), Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory (BDI) und PPT-Werte verglichen.

Ergebnisse Es gab eine statistisch signifikante Abnahme der VAS-Werte nach der Behandlung im Vergleich zu den Ausgangswerten in beiden Gruppen. Die Subskalenwerte für PPT und SF-36 waren ebenfalls statistisch signifikant höher (p<0,05). Nach der Behandlung zeigten VAS und PPT eine signifikant größere Verbesserung in Gruppe 1 im Vergleich zu Gruppe 2. Es bestand ein signifikanter Zusammenhang zwischen der VAS und der körperlichen Funktionsfähigkeit nach SF-36, sowie Schmerz-Subskalen in Gruppe 1 und eine signifikante Korrelation zwischen der VAS und der körperlichen Funktionsfähigkeit nach SF-36 in Gruppe 2.

Schlussfolgerungen Unsere Daten deuten darauf hin, dass sowohl die H-ESWT als auch die IASI-Behandlung bei Patienten mit Costochondritis wirksam sind. Die H-ESWT hat dabei eine stärkere Wirkung auf Schmerzen und PPT-Scores.

Keywords

costochondritis - extracorporeal shock-wave therapy - quality of life - pressure pain threshold - intra-articular steroid injection

Schlüsselwörter

Costochondritis - Extrakorporale Stoßwellentherapie - Intraartikuläre Steroid injection - Lebensqualität - Druckschmerzschwelle

Publication History

Article published online:
07 September 2020

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