Shock Wave Therapy in Different Conditions with Its Dose Parameters – A Systematic Review

Abstract

Background: Shock wave therapy (SWT) has become a noninvasive treatment modality for treatment of musculoskeletal as well as nonmusculoskeletal conditions. Although many studies have shown that it is therapeutic, no consensus has been reached on the optimal dose parameters such as energy fluence density, frequency, and treatment session.

Objective: For systematic review of the effectiveness of shock wave therapy for various clinical conditions and evaluation of variability and efficacy of dose parameters used in recent studies.

Methods: Randomized controlled trials of the rehabilitation of vertigo published between January 2014 and February 2025 were searched in PubMed, Scopus, ScienceDirect and PEDro. For this to be included studies had to evaluate the use of SWT for any condition and report specific dose parameters. PEDro scale was used to assess risk of bias.

Results: The included criteria for the studies of the 21 articles were met conditions plantar fasciitis, lateral epicondylitis, calcific tendinitis, erectile dysfunction, chronic low back pain, osteoarthritis, delayed union fractures. A majority of the studies showed statistically significant improvements the pain relief as well as functional scores in SW radiations. Nevertheless, dose parameters were varied, as energy flux density ranged 0.06–0.4 mJ/mm², frequency from 3–15 Hz, and sessions from 1 to 12.

Conclusion: For example, chronic musculoskeletal pain disorders are indications for which SWT is effective. However, the lack of standardization of dose parameters needs development of clinical guidelines and more comparative research. The aim of the study was to determine the dose parameters and randomized controlled trials of extracorporeal shock wave in the treatment of musculoskeletal pain.