SHOCKIS / CLINICAL APPLICATION
Myofascial Trigger Points
Myofascial trigger points (MTPs) are hyperirritable spots in skeletal muscle associated with tender nodules within a palpable taut band.
Disease Overview
Myofascial trigger points (MTPs) are hyperirritable spots in skeletal muscle associated with tender nodules within a palpable taut band. They are a common source of muscle pain and dysfunction, capable of causing referred pain, localized tenderness, and muscle spasm.
Clinical Features
Myofascial pain syndrome is characterized by the presence of trigger points. The most widely used diagnostic criteria include tender points within a taut band, patient recognition of the pain, a predictable referred pain pattern, and a local twitch response. However, there is currently no consensus on the case definition of myofascial trigger point pain syndrome.
Professional Evaluation
Assessment usually involves manual palpation to identify tender areas and taut muscle bands. Care should be taken to avoid vital structures such as blood vessels and nerves.
Conservative Management
Therapeutic physical modalities are commonly used in clinical practice for patients with myofascial pain syndrome, including transcutaneous electrical nerve stimulation, extracorporeal shock wave therapy, and laser therapy.
ESWT: Potential Mechanisms and Limitations of Evidence
Extracorporeal Shock Wave Therapy (ESWT) is a non-invasive treatment that uses a device to deliver shock waves through the skin to the affected area. A 2024 systematic review and meta-analysis of randomized clinical trials found that ESWT is effective in reducing pain and improving function in patients with myofascial pain syndrome. However, the certainty of the evidence is limited.
Contact with SHOCKIS
Clinicians and procurement professionals evaluating shock wave therapy systems for myofascial trigger points should consider device-specific characteristics and the applicable regulatory status in their respective regions. The evidence summarized above reflects the broader ESWT literature and does not constitute validation of any specific SHOCKIS product for any particular indication. If you wish to discuss how SHOCKIS can support your clinical or procurement needs, our team is welcome to hear from you.
Clinical Workflow Checklist
- 01CLINICAL ASSESSMENT
Review patient history, symptoms, and contraindications.
- 02TARGET AREA IDENTIFICATION
Identify the treatment area through clinical examination and appropriate imaging when needed.
- 03TREATMENT SETUP
Select treatment parameters according to clinical assessment, device instructions, and patient tolerance.
- 04SHOCKWAVE APPLICATION
Apply coupling gel and deliver treatment while monitoring patient response.
- 05POST-TREATMENT CARE
Clean the treatment area and applicator, and provide appropriate aftercare guidance.
Safety Information
The information below describes conditions and reactions generally associated with extracorporeal shock wave therapy. It does not replace the instructions for use of the specific SHOCKIS device. Clinicians must verify applicability against the current device labeling and their own clinical judgment.
Contraindications & Precautions
Shock wave therapy should not be applied, or should be applied only with particular caution, in the following situations:
- Known hemorrhagic disorders or coagulation dysfunction
- Thrombosis in or adjacent to the intended treatment area
- Severe cognitive impairment or psychiatric illness
- Implanted pacemakers or other active electronic implants
- Tumors located in the treatment area
- Pregnancy, particularly the lower abdominal region
- Ruptured or severely injured tendons and fasciae, as well as regions containing the brain, spinal cord, large blood vessels, or major nerve trunks
- Regions containing abdominal organs, especially lung tissue
- Bone defects exceeding 2 cm
- Joint fluid leakage
- Growing pains in pediatric patients
Any other condition deemed unsuitable by the treating physician.
Potential Adverse Reactions
The following reactions may occur at or near the treatment site:
- Local hematoma, ecchymosis, or petechiae
- Temporary intensification of pain shortly after treatment
- Local numbness, needle-like sensation, or hypoesthesia
- High-energy extracorporeal shock wave therapy may cause local nerve or vascular injury
These reactions are generally transient and typically resolve within approximately one week without special treatment.
References
- [1] Avendaño-López C, Megía-García Á, Beltran-Alacreu H, et al. Efficacy of Extracorporeal Shockwave Therapy on Pain and Function in Myofascial Pain Syndrome: A Systematic Review and Meta-analysis of Randomized Clinical Trials. Am J Phys Med Rehabil. 2024;103(2):89-98. DOI: 10.1097/PHM.0000000000002286. PMID: 37205742.
- [2] Ibrahim Rashad A, Atif Melika M, Mahmoud Youssef N, Safwat Abdelmageed Y. Dry needling versus extracorporeal shockwave therapy in musculoskeletal conditions: a systematic review and meta-analysis. Manuelle Medizin. 2026;64:127-136. DOI: 10.1007/s00337-025-01214-w. Published online December 2025.
- [3] He P, Fu W, Shao H, et al. The effect of therapeutic physical modalities on pain, function, and quality of life in patients with myofascial pain syndrome: a systematic review. BMC Musculoskelet Disord. 2023;24(1):376. DOI: 10.1186/s12891-023-06418-6.
- [4] Tough EA, White AR, Richards S, Campbell J. Variability of criteria used to diagnose myofascial trigger point pain syndrome—evidence from a review of the literature. Clin J Pain. 2007;23(3):278-286. DOI: 10.1097/AJP.0b013e31802fda7c. PMID: 17314589.