2Hyperthermia Induced by Microwave Diathermy in the Management of Muscle and Tendon Injuries
British Medical Bulletin (2007) · A. Giombini, V. Giovannini, A. Di Cesare, P. Pacetti, Noriko Ichinoseki-Sekine, M. Shiraishi, Hisashi Naito, Nicola Maffulli
This study explores the effects of hyperthermia induced by microwave diathermy on muscle and tendon injuries. The technique raises deep tissue temperatures between 41°C and 45°C using electromagnetic power and has been widely used in physical medicine and sports traumatology. Research findings indicate that microwave diathermy stimulates tissue repair, enhances drug activity, alleviates pain, aids in waste removal, increases tendon extensibility, and reduces muscle and joint stiffness. The therapy also promotes hyperaemia, improves tissue drainage, accelerates metabolism, and induces cellular changes. While the exact biological mechanisms linking thermal dose to healing remain under investigation, microwave diathermy at 434 and 915 MHz has shown short-term effectiveness in managing musculoskeletal injuries.
View on PubMed →
11Shortwave Diathermy Enhances Hamstring Flexibility
Journal of Orthopaedic & Sports Physical Therapy (2004) · D.O. Draper, J.L. Castro, B. Feland, S. Schulthies, D. Eggett
This study examined whether shortwave diathermy enhances hamstring flexibility when combined with stretching. Thirty college students with tight hamstrings were divided into three groups: (1) diathermy plus stretching, (2) sham diathermy plus stretching, and (3) control. After five days, the diathermy group improved knee extension by 15.8°, significantly more than the sham group (5.2°) and the control (-0.3°). Flexibility gains were better maintained in the diathermy group. These results suggest that combining shortwave diathermy with stretching is an effective method to improve and sustain hamstring flexibility.
View on PubMed →
12Shortwave Diathermy Enhances Recovery in Lateral Epicondylitis
Journal of Bodywork & Movement Therapies (2020) · A. Babaei-Ghazani, B. Shahrami, E. Fallah, T. Ahadi, B. Forough, S. Ebadi
This study evaluated the effectiveness of continuous shortwave diathermy (SWD) in treating chronic lateral epicondylitis (tennis elbow). Fifty patients were assigned to either an SWD + exercise group or a sham diathermy + exercise group. The SWD group received 15 minutes of 40-60 W continuous SWD along with specific exercises. Pain, function, and grip strength were measured at baseline, after 5 and 10 treatment sessions, and at 3 months. The SWD group showed significantly greater improvements in all outcomes compared to the control group. These findings suggest that SWD enhances pain relief and functional recovery in lateral epicondylitis.
View on PubMed →
18Far-Infrared Radiation Reduces Pain & Aids Early Recovery After Rotator Cuff Repair
Korean Journal of Pain (2020) · J.Y. Yoon, J.H. Park, K.J. Lee, et al.
This randomized study evaluated the effects of far-infrared radiation (FIR) therapy on pain and healing after arthroscopic rotator cuff repair in 38 patients with medium-sized tears. The FIR group received twice-daily 30-minute FIR sessions from week 1 to week 5 post-surgery. At 5 weeks, FIR patients reported significantly lower pain scores (1.5 vs. 2.7, P = 0.019) and greater shoulder flexion at 3 months (151.6° vs. 132.9°, P = 0.045). By 6 months, ROM and healing rates were similar between groups. FIR may be a safe and effective method to reduce early postoperative pain and enhance rehabilitation.
View on PubMed →
23Low-Level Laser Therapy Provides Short-Term Pain Relief for Chronic Low Back Pain
Acupuncture in Medicine (2016) · G. Glazov, M. Yelland, J. Emery
This meta-analysis reviewed 15 randomized controlled trials involving 1,039 participants to evaluate the efficacy of low-level laser therapy (LLLT) for chronic non-specific low back pain (CNLBP). Results showed a significant short-term reduction in pain, particularly in studies using at least 3 Joules per point and in patients with pain lasting less than 30 months. Global assessment of improvement also favored laser therapy at immediate follow-up. However, the benefits were only observed in trials that did not use an acupuncture-based laser approach. The study concludes that LLLT may provide short-term relief for CNLBP, but further high-quality, blinded trials are needed to confirm its effectiveness.
View on PubMed →
42Weak Evidence for the Safety and Effectiveness of Endoscopic Plantar Fascia Release
Foot and Ankle Surgery (2020) · Michael-Alexander Malahias, Erwin Brian Cantiller, Vikram V. Kadu, Sebastian Muller
This review evaluated 15 studies on endoscopic plantar fascia release (EPFR), totaling 535 patients and 576 feet. Most studies were low-quality case series, with only two randomized controlled trials. Though subjective scores improved postoperatively, the review concluded there is weak evidence supporting EPFR as safe or effective. The overall complication rate was 11.0%, with persistent heel pain (5.6%), paresthesias or numbness (4.3%), soft tissue healing issues (1.7%), and superficial infection (0.4%) being the most common.
View on PubMed →
92Topical NSAIDs Are Effective for Tennis Elbow Without Oral Side Effects
Cochrane Database of Systematic Reviews (2013) · Pattanittum P, Turner T, Green S, Buchbinder R
This Cochrane systematic review analyzed 15 trials with 759 participants to evaluate the effectiveness of topical and oral NSAIDs for treating lateral elbow pain, commonly known as tennis elbow. The review found that topical NSAIDs were significantly more effective than placebo for short-term pain relief, with a number needed to treat of 7, meaning that for every 7 patients treated with topical NSAIDs, one additional patient experienced significant pain relief compared to placebo. Participants using topical NSAIDs also reported better overall treatment effectiveness at 28 days. Adverse effects from topical NSAIDs were minimal, with only mild skin reactions such as rash reported in 2.5% of users, compared to 1.3% with placebo. For oral NSAIDs, the evidence was conflicting. One trial found significant pain improvement compared to placebo while another found no difference, and neither showed improvement in function. Notably, oral NSAIDs were associated with an increased risk of gastrointestinal side effects, and several participants had to discontinue treatment due to GI issues. The review found no trials that directly compared topical and oral NSAIDs head to head. These findings support the use of topical NSAIDs as a first-line option for conditions like tennis elbow, where the anti-inflammatory medication can be delivered directly to the injured tendon without exposing the gastrointestinal system to the risks associated with oral NSAIDs. For patients who do use oral NSAIDs, the evidence suggests limiting duration to the short term.
View on PubMed →
10Effects of Heat, Cold, and Pressure on the Transverse Carpal Ligament and Median Nerve
Medical Science Monitor (2015) · Michael Laymon, Jerrold Petrofsky, James McKivigan, Haneul Lee, JongEun Yim
This pilot study investigated the effects of heat, cold, and pressure on the median nerve and transverse carpal ligament in healthy individuals. Using ultrasound imaging, researchers assessed ligament elasticity, nerve conduction velocity, and structural changes. Heat therapy (60-120 minutes) increased ligament and tendon elasticity, while cold exposure (20 minutes) reduced compression of the carpal ligament and nerve. Pressure did not significantly alter tissue structure at room temperature or after cold exposure. The findings suggest that heat enhances tissue flexibility, whereas cold may help reduce compression in conditions like carpal tunnel syndrome.
View on PubMed →
57Botox Weakens Muscle Repair in Chronic Rotator Cuff Injury
American Journal of Sports Medicine (2015) · Mohit Gilotra, Thao Nguyen, Matthew Christian, Derik Davis, R. Frank Henn III, Syed Ashfaq Hasan
This animal study evaluated the effects of intramuscular botulinum toxin (Botox) on the repair strength of chronic rotator cuff injuries in rabbits. Twelve weeks after supraspinatus tendon transection, one shoulder was injected with Botox and the contralateral side with saline before repair. Six weeks post-repair, the Botox-treated group had significantly lower repair strength (2.64 N) compared to controls (5.51 N, p = 0.03), and a higher rate of partial healing defects (80% vs. 40%). All samples showed Goutallier Grade 3 or 4 fatty infiltration, which was more pronounced with Botox. Contrary to the initial hypothesis, Botox compromised healing and may increase muscle degeneration in chronic injuries.
View on PubMed →
70COX-2 Inhibitors Significantly Delay Rotator Cuff Tendon Healing
Chinese Medical Journal (2015) · Lu Y, Li Y, Li FL, Li X, Zhuo HW, Jiang CY
This controlled study evaluated the effects of three common anti-inflammatory drugs on rotator cuff healing in 96 rabbits. After rotator cuff repair surgery, animals were divided into four groups: ibuprofen, celecoxib (a COX-2 inhibitor), flurbiprofen, and a control group receiving no medication. After 7 days of treatment, the celecoxib group showed significantly lower failure loads and reduced type I collagen at all time points (3, 6, and 12 weeks) compared to controls. For example, at 3 weeks, collagen was 11.5% in the celecoxib group versus 27.6% in controls. The findings confirm that selective COX-2 inhibitors significantly impair rotator cuff tendon healing, particularly in the early stages of recovery.
View on PubMed →
82Topical NSAIDs Provide Effective Pain Relief Without Systemic Side Effects
Cochrane Database of Systematic Reviews (2015) · Derry S, Moore RA, Gaskell H, McIntyre M, Wiffen PJ
This Cochrane systematic review analyzed 61 studies with over 8,700 participants to evaluate the effectiveness and safety of topical NSAIDs for acute musculoskeletal pain such as sprains, strains, and overuse injuries. The study found that topical NSAID formulations including diclofenac, ibuprofen, and ketoprofen gels provided significantly higher rates of pain relief compared to placebo. The number needed to treat (NNT) for clinical success, meaning the number of patients who need to be treated for one to achieve at least 50% pain relief, was as low as 1.8 for diclofenac gel and 3.9 for ibuprofen gel. These effectiveness rates are probably similar to those provided by oral NSAIDs. Critically, local skin reactions were generally mild and transient, and there were very few systemic adverse events, meaning the gastrointestinal and other body-wide side effects associated with oral NSAIDs were largely avoided. This review supports topical NSAIDs as a safer alternative to oral NSAIDs for managing acute musculoskeletal pain, particularly for patients who need pain relief but want to avoid the risks of GI bleeding, liver damage, or impaired tissue healing associated with systemic NSAID use. Topical application delivers the medication directly to the injured area while minimizing exposure to the rest of the body.
View on PubMed →