Use of Extracorporeal shock wave therapy for the treatment o
Extracorporeal shock wave therapy (ESWT) has been used for various pathologies associated with bone marrow oedema (BME). Therefore, the aim of this systematic review was to assess the efficacy of ESWT for the treatment of BME.

Both randomized and non-randomized trials were included. Case reports and conference abstracts were excluded. Titles and abstracts were screened and full-text articles of included studies were retrieved. Data on the effect of ESWT on pain, function, and the BME area on magnet resonance imaging were extracted.

--Pain, function, and MRI results all improved across the studies — regardless of whether it was a randomized or non-randomized study.

--This effect was consistent across multiple pathologies such as osteonecrosis of the femoral head, BME associated with knee osteoarthritis, Kienbock’s disease, and osteitis pubis.

--The meta-analysis showed that pain (after 1 month: weighted mean difference (WMD) = - 2.23; after 3–6 month: WMD = - 1.72 and function (after 1 month: WMD = - 1.59; after 3–6 month: WMD = - 2.06; after more than 12 month: WMD = - 1.20) was reduced in terms of ESWT treatment compared to a control group.

Conclusively, based on the available evidence, ESWT may be an adequate option for conservative therapy in pathologies involving BME.