Cochrane meta-analysis: shock wave therapy holds few benefits for rotator cuff disease

  • Surace SJ & al.
  • Cochrane Database Syst Rev
  • 4 Mar 2020

  • curated by Miriam Davis, PhD
  • Clinical Essentials
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Takeaway

  • Shock wave therapy at 3 months of follow-up holds few benefits for patients with rotator cuff disease, according to a Cochrane meta-analysis.

Why this matters

  • Rotator cuff disease is increasing in prevalence with the aging of the population.

Study design

  • A meta-analysis of 32 randomized controlled trials and controlled clinical trials (N=2281).
  • Funding: No external sources.

Key results

  • At 3 months of follow-up, achieving pain relief of ≥50% was no better in the shock wave group than the control group (risk ratio, 1.10; 95% CI, 0.62-1.94), with low certainty.
  • Pain relief on a visual analogue scale (0-10) was slightly better in the shock wave group (standardized mean difference [SMD], −0.49; 95% CI, −0.88 to −0.11) vs the control group (moderate certainty).
    • The absolute effect was 0.78 points better, falling short of being clinically important (cutoff, 1.5 points).
  • Function was no better in the shock wave group (SMD, 0.62; 95% CI, 0.13-1.11), with moderate certainty.
  • No difference between groups in the number of participant withdrawals for adverse events or treatment intolerance, and no difference in experiencing any adverse events.

Limitations

  • Low to moderate certainty of evidence because of bias.
  • Few clinically important benefits.