Objective: The aim was to objectively evaluate the role of shoulder and scapular movement in neck pain and assess the efficacy of ESWT for treatment.

Background: Extracorporeal Shockwave Therapy (ESWT) is widely used for musculoskeletal pain management, with ultrasound guidance improving precision and outcomes [1-3]. Motion analysis is an effective tool for assessing treatment impact. Neck pain treatments often target the site of pain, but addressing associated shoulder and scapular dysfunction may enhance outcomes.

Method: Sixty patients with neck pain were randomized into three groups (n=20 each):

– ESWT applied to the shoulder;

– ESWT applied to the scapula;

– ESWT applied to both the shoulder and scapula.

ESWT was applied precisely under ultrasound guidance focusing on affected areas of muscles, tendons and fascia. 

A standardized diagnostic protocol included motion analysis (Showmotion system) and Visual Analog Scale (VAS) for pain assessment.

Results: The third group (ESWT on both the shoulder and scapula) demonstrated the most favorable improvement. Motion analysis revealed significant gains in shoulder mobility and stability, particularly in flexion/extension and abduction/adduction movements. Normality scores improved across multiple zones, with enhanced repeatability and increased range of motion. Group 3 movement patterns achieved near-normal values (e.g., flexion/extension score: 99.07, abduction/adduction score: 99.28), while groups 1 and 2 movements showed substantial improvement compared to baseline. Pain reduction was significant across all groups, with the most pronounced decrease in the combined treatment group.

Conclusion: ESWT should be applied to both the shoulder and scapula in patients with neck pain, as shoulder-scapular dysfunction plays a crucial role. Objective motion analysis and VAS confirm the efficacy of ESWT in improving both movement and pain outcomes.

References: 1. Kalika L, Bubnov R, Benito JG, Domenech DH. Precision and functional application of ultrasound-guided extracorporeal shock wave therapy in neuromusculoskeletal pathologies: A multicenter retrospective study. 26th ISMST World Congress, June 6-9th 2024, Amsterdam: 33.
2. Kalika L, Bubnov R. TARGETED ULTRASOUND-GUIDED SHOCKWAVE THERAPY OF LOW BACK PAIN USING FOCUSED, DEFOCUSED AND RADIAL SHOCKWAVE. Neuromodulation 2022; 25(7): S339. https://doi.org/10.1016/j.neurom.2022.08.408
3. Bubnov R, Kalika L. Comparative Study of Dry Needling under Ultrasound Guidance and Extracorporeal Shock Wave Therapy for Myofascial Pain and Spasticity Management. Movement Disorders 2019; 34: S557.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/extracorporeal-shockwave-therapy-eswt-for-neck-pain-and-shoulder-scapular-dyskinesis-an-objective-evaluation-study/