Effect of a Single Administration of Focused Extracorporeal Shock Wave in the Relief of Delayed-Onset Muscle Soreness: Results of a Partially Blinded Randomized Controlled Trial

Arch Phys Med Rehabil. 2017 May;98(5):923-930. doi: 10.1016/j.apmr.2016.11.013. Epub 2016 Dec 16.


Objective: To examine the effects of a single administration of focused extracorporeal shock wave therapy on eccentric exercise-induced delayed-onset muscle soreness (DOMS).

Design: Three-arm randomized controlled study.

Setting: University research center.

Participants: Participants (N=46; 23 women) had a mean age of 29.0±3.0 years and a mean body mass index of 23.8±2.8kg/m2.

Interventions: Participants were randomly allocated to verum- (energy flux density, .06-.09mJ/mm2; pulse ratio per point, 200) or sham-focused extracorporeal shock wave therapy (no energy) at 7 equidistant points along the biceps muscle or no intervention.

Main outcome measures: The primary outcome was the difference in pain intensity. Secondary outcomes included maximum isometric voluntary force (MIVF), pressure pain threshold (PPT), and impairment in daily life.

Results: Despite descriptive clinically meaningful differences, mixed-effects analysis (group × time) of changes to baseline did not reveal significant differences in the reduction of pain intensity between groups (F2,42=2.5, P=.094). MIVF was not significantly different between groups (F2,43=1.9, P=.159). PTT (F2,43=0.2, P=.854) and daily life impairment (F2,42=1.4, P=.248) were not significantly decreased over time, and there were no differences between groups in the post hoc analysis.

Conclusions: DOMS is a common symptom in people participating in exercise, sports, or recreational physical activities. A single treatment with focused extracorporeal shock wave therapy causes clinically relevant effects in the relief of pain, increase in force, and improvement of pain-associated impairments of daily living. Still, results need to be cautiously interpreted because of the pilot character of this study. Focused extracorporeal shock wave therapy might present an option in the midterm recovery from DOMS (72h) and be an approach to enhance the return to play in athletes.

Trial registration: ClinicalTrials.gov NCT02548208.

Keywords: Inflammation; Integrative medicine; Rehabilitation.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Exercise / physiology*
  • Female
  • High-Energy Shock Waves / therapeutic use*
  • Humans
  • Male
  • Muscle, Skeletal / physiology*
  • Myalgia / rehabilitation*
  • Pain Measurement
  • Physical Therapy Modalities*

Associated data

  • ClinicalTrials.gov/NCT02548208