Ann Rehabil Med.  2014 Aug;38(4):523-533. 10.5535/arm.2014.38.4.523.

Outcomes of Ultrasound-Guided Extracorporeal Shock Wave Therapy for Painful Stump Neuroma

Affiliations
  • 1Department of Rehabilitation Medicine, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea.
  • 2Department of Rehabilitation Medicine, Hangang Sacred-Heart Hospital, Hallym University College of Medicine, Seoul, Korea. s9036@naver.com

Abstract


OBJECTIVE
To investigate the effect of extracorporeal shock wave therapy (ESWT) on painful stump neuroma.
METHODS
Thirty patients with stump neuroma at the distal end of an amputation site were assigned randomly to the ESWT group (n=15) and the transcutaneous electrical nerve stimulation (TENS)+desensitization+pharmacological treatment group (n=15). For 3 weeks, the ESWT group received a weekly session involving 1,500 pulses at 0.10 mJ/mm2, while the control group was treated 10 times each, 40 minutes per day with TENS and desensitization treatment, and daily medication for 3 weeks. ESWT stimulation was given by focusing on the area at the neuroma site clearly identified by ultrasound.
RESULTS
The changes in the McGill pain questionnaire were 38.8+/-9.0 prior to treatment and 11.8+/-3.1 following the treatment. The corresponding values for the control group were 37.2+/-7.7 and 28.5+/-10.3. The changes between groups were significantly different (p=0.035). The change in visual analog scale prior to and after treatment was 7.0+/-1.5 and 2.8+/-0.8 in the ESWT group, respectively, and 7.2+/-1.4 and 5.8+/-2.0 in the control group. These changes between the groups were also significantly different (p=0.010). The outcome in the pain rating scale also showed significant differences between groups (p<0.001). Changes in neuroma size and pain pressure threshold (lb/cm2) were not significantly different between groups (p>0.05).
CONCLUSION
The study findings imply that ESWT for stump neuroma is superior to conventional therapy.

Keyword

Amputation stumps; Neuroma; Extracorporeal shock wave therapy; Ultrasonography; Visual analogue scale
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