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Home / Equine Research Bank / Equine Vet J / Extracorporeal shockwave therapy raises mechanical nocicepti...
Equine veterinary journal2019; 52(2); 250-257; doi: 10.1111/evj.13159

Extracorporeal shockwave therapy raises mechanical nociceptive threshold in horses with thoracolumbar pain.

Abstract: Although extracorporeal shockwave therapy (ESWT) is a common treatment for horses with back pain, effects on mechanical nociceptive threshold (MNT) and multifidus muscle cross sectional area (CSA) in the spine are unknown. Objective: To evaluate effects of ESWT on spinal MNT and multifidus muscle CSA in horses with thoracolumbar pain. Methods: Non-randomised trial. Methods: Thoracolumbar spines of 12 horses with thoracolumbar pain were radiographed to document existing pathology. Each horse received three ESWT treatments, 2 weeks apart (days 0, 14, 28). Palpation scores were documented (days 0, 45 and 65). Ultrasonographic CSA of left and right multifidus muscles was recorded at T12, T14, T16, T18, L3 and L5 (days 0, 45 and 65). MNT was measured at the same spinal sites every 7 days (day 0-56). Results: Mechanical nociceptive threshold in 10/12 horses (83%) was greater at each time point compared with day 0 (P < 0.05). Mechanical nociceptive threshold increased at all time points at six sites in 2/12 (16%), at five sites in 3/12 (25%), at four sites in 4/12 (33%) and at one site in 1/12 (8%; P < 0.05). Mechanical nociceptive threshold average per cent  increase from day 0 to 56 was 64% for the thoracic region (T12-T18) and 29% for the lumbar region (L3-L5). There was no statistical difference in MNT from day 35 to 56 (P = 0.25). A bimodal analgesic trend was observed following ESWT. Degree of radiographic change was not associated with response to treatment. No significant change in multifidus muscle CSA was observed. Conclusions: Small study size and lack of control group. Conclusions: Three treatments of ESWT 2 weeks apart raised MNT over a 56-day period in horses with back pain, but did not influence change in CSA of the multifidus muscle. While ESWT appears justifiable for analgesia, physiotherapeutic techniques may be necessary in conjunction for concurrent muscle rehabilitation.
© 2019 EVJ Ltd.
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Publication Date: 2019-09-04 PubMed ID: 31393628DOI: 10.1111/evj.13159Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

This research investigates the effects of extracorporeal shockwave therapy (ESWT) on horses with back pain, specifically regarding mechanical nociceptive threshold (pain reception) and changes in the cross-sectional area of a major back muscle. ESWT treatments showed a sizeable increase in the pain tolerance in most horses, but no significant changes in muscle size were observed.

Study Methodology

The study was conducted using a non-randomized trial involving 12 horses with thoracolumbar pain, or back pain. The horses underwent thoracolumbar spine radiographs to document any pre-existing conditions. ESWT treatments were administered to the horses on three occasions, each session 2 weeks apart from the other. Various measurements were recorded across the treatment period, including:

  • Palpation scores (an assessment of pain through touch by a trained professional) documented on days 0, 45, and 65
  • Cross-sectional area (CSA) of the left and right multifidus muscles – important muscles in spinal stability – recorded at various points along the spine (T12, T14, T16, T18, L3, and L5) on days 0, 45, and 65
  • Mechanical nociceptive threshold (pain reception to mechanical stress) measured at the same spinal sites on a weekly basis from day 0 to 56

Study Findings

The study found that 10 out of 12 horses showed an increase in their pain tolerance at each time point when compared to the start of the treatment. No significant difference in MNT was observed from day 35 to 56, indicating the effects of ESWT potentially plateau. Interestingly, the degree of radiographic change (indicative of physical changes in the spine’s structure) did not correlate with the response to the treatment. Despite the increased tolerance to pain, no significant change was observed in the CSA of the multifidus muscle, suggesting that ESWT might not influence muscular rehabilitation.

Conclusions

While the small study size and lack of a control group were identified as limitations, the study concluded that three ESWT treatments, spaced two weeks apart, raised the mechanical nociceptive threshold over a 56-day period in horses with back pain. This implies that ESWT could effectively increase pain tolerance in horses with back pain. However, because it didn’t influence the change in the multifidus muscle’s CSA, physiotherapeutic techniques might need to be used in conjunction for comprehensive muscle rehabilitation.

Cite This Article

APA
Trager LR, Funk RA, Clapp KS, Dahlgren LA, Werre SR, Hodgson DR, Pleasant RS. (2019). Extracorporeal shockwave therapy raises mechanical nociceptive threshold in horses with thoracolumbar pain. Equine Vet J, 52(2), 250-257. https://doi.org/10.1111/evj.13159

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English
Volume: 52
Issue: 2
Pages: 250-257

Researcher Affiliations

Trager, L R
  • Department of Large Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg, Virginia, USA.
Funk, R A
  • Department of Large Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg, Virginia, USA.
Clapp, K S
  • Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg, Virginia, USA.
Dahlgren, L A
  • Department of Large Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg, Virginia, USA.
Werre, S R
  • Laboratory for Study Design and Statistical Analysis, Virginia-Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg, Virginia, USA.
Hodgson, D R
  • Department of Large Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg, Virginia, USA.
Pleasant, R S
  • Department of Large Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg, Virginia, USA.

MeSH Terms

  • Animals
  • Back Pain / veterinary
  • Extracorporeal Shockwave Therapy / veterinary
  • Horse Diseases / therapy
  • Horses
  • Lumbosacral Region
  • Spine

Grant Funding

  • 449746 / Virginia Horse Industry Board

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Citations

This article has been cited 10 times.
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