Elastographic Changes in Cervical Muscle Following Combined Radial Extracorporeal Shockwave Therapy and Orthopedic Manual Therapy: A Randomized Controlled Trial.

Study Summary

24 patients with non-specific neck pain were randomized to receive combined radial extracorporeal shockwave therapy (rESWT) and orthopaedic manual therapy (OMT) or OMT alone. Both groups received one weekly 15-minute OMT session for four weeks, while the intervention group additionally received rESWT using 1500 impulses per painful point at 10 Hz and 2–4 bar. The primary outcome was cervical muscle stiffness assessed using SWE in meters per second (m/s) and kilopascals (kPa). Secondary outcomes included visual analogue scale (VAS) pain, pressure pain threshold (PPT), cervical range of motion (ROM), and shoulder elevation strength (SES). Outcomes were assessed throughout the four-week intervention, immediately after treatment, and at one-month follow-up. Overall, the results revealed that adding rESWT produced significantly greater reductions in cervical muscle stiffness and pain and greater improvements in PPT than OMT alone. Improvements in most ROM and strength outcomes were less consistent. These findings suggest that rESWT may be a useful addition to OMT for improving short-term muscle mechanical properties and pain-related outcomes in non-specific neck pain.