Journal of Pain Research (Jun 2020)
Low-Intensity Continuous Ultrasound for the Symptomatic Treatment of Upper Shoulder and Neck Pain: A Randomized, Double-Blind Placebo-Controlled Clinical Trial
Abstract
Stephanie Petterson, 1 Kevin Plancher, 1– 4 Dominic Klyve, 5 David Draper, 6 Ralph Ortiz 7 1Orthopaedic Foundation, Stamford, CT, USA; 2Department of Orthopaedics, Albert Einstein College of Medicine, New York, NY, USA; 3Department of Orthopaedics, Weill Cornell Medical College, New York, NY, USA; 4Plancher Orthopaedics & Sports Medicine, New York, NY 10128, USA; 5Department of Mathematics, Central Washington University, Ellensburg, WI, USA; 6Department of Exercise Sciences, Brigham Young University, Provo, UT, USA; 7Medical Pain Consultants, Dryden, NY, USACorrespondence: Ralph OrtizMedical Pain Consultants, Dryden, NY, USATel +1 607 844-9979Email [email protected]: Low-intensity continuous ultrasound (LICUS) is an emerging high-dosimetry ultrasound-based therapy for accelerated tissue healing and the treatment of myofascial pain. In this study, LICUS treatment is clinically evaluated for chronic upper neck and shoulder pain in a randomized, multi-site, double-blind, placebo-controlled study.Patients and Methods: CONSORT guidelines were followed in conducting and reporting the clinical trial. Thirty-three participants with upper trapezius myofascial pain were randomized for treatment with active (n=25) or placebo (n=8) devices. Investigators and subjects were blinded to treatment groups. Participants self-reported pain daily, rating from 0– 10 on the numeric rating scale. If pain rating was more significant than or equal to 3, the LICUS (3MHz, 0.132W/cm 2, 1.3W, 4 hours) was self-applied for total energy dosimetry of 18,720 Joules per treatment. During the 4-week study, daily pain rating was recorded. If LICUS treatment was delivered, pain before, during, and after treatment were recorded as well as the global rate of change (GROC). Independent t-tests were used to assess change from baseline and differences between treatment groups. ClinicalTrials.gov: NCT02135094.Results: There was a 100% completion rate for participants enrolled in the study and no significant differences between the groups regarding demographic variables or baseline outcome measures. Participants treated with active therapy observed a significant mean pain reduction from baseline of 2.61 points for active (p< 0.001), compared to 1.58 points decrease from baseline for placebo (p=0.087), resulting in a 1.03 points significant decrease in the active group over placebo (p=0.003). The total GROC was significantly higher in the active group at 2.84 points compared to the placebo group at 0.46 points (p< 0.001).Conclusion: Low-intensity continuous ultrasound treatment significantly reduced pain in patients with upper trapezius myofascial pain of the neck and shoulder. LICUS treatment showed a clinically meaningful improvement in the GROC scores for patients. The results from this clinical trial indicate that the LICUS treatment of 18,720 Joules can effectively be used to treat clinical pain related to upper trapezius myofascial pain. Further research could investigate varying dosimetry to improve efficacy and/or reduce the dose.Keywords: sustained acoustic medicine, myofascial trigger points, non-steroidal anti-inflammatory drugs, NSAIDs, non-invasive therapy, soft tissue healing, chronic musculoskeletal pain
