Nartea Roxana, Ghiorghiu Ioana, Alexe Maria-Delia, Gheorghievici Gavril Lucian, Mitoiu Brindusa Ilinca
Rehabilitation Department, "Universitatea de Medicină și Farmacie Carol Davila", 050474 Bucharest, Romania.
National Institute of Rehabilitation Physical Medicine and Balneoclimatology, 030167 Bucharest, Romania.
Biomedicines. 2025 Sep 12;13(9):2253. doi: 10.3390/biomedicines13092253.
The supraspinatus has been well studied in recent years, since the rotator cuff muscle is most commonly damaged, affecting the quality of life for patients with tendinopathy. Despite this tiny but crucial muscle being well-described, there is still much left to learn and discover, especially because chronic supraspinatus tendinopathy is a common pain syndrome that causes functional and labor disabilities in the population. The present narrative review, including systematic elements from biomechanical and clinical studies, highlights the role of conservative treatment using shockwave therapy. : We set out to perform a complex analysis of the literature on this topic to identify possible pathophysiological mechanisms that can be used to establish proper therapeutic management, focused specifically on conservative treatment using shockwave therapy. : We researched the medical literature, including clinical studies that met the criteria of being published after 2014. In this review, we described the mechanisms and histological changes in tendinopathy to illustrate the biological effects of shockwave therapy and performed a literature review on its therapeutic effects. : The multifaced pathophysiology of supraspinous tendinopathies compromised the healing responses. Recent findings highlight the value of a thorough diagnostic and treatment strategy, with shockwave therapy (ESWT) as a conservative treatment option. According to available data, shockwave therapy has demonstrated significant improvement in function, improving participants' discomfort, quality of life, and pain relief. It can also be combined with isometric exercise. Given the substantial risk of bias and heterogeneity, our findings should be interpreted cautiously. The need for more research to optimize parameters and provide standardized clinical guidelines is highlighted by the variety of treatment procedures. Improving outcomes in patients with supraspinous tendinopathies will require a better comprehension of the pathology, and individualized treatment needs to be further investigated.
近年来，冈上肌受到了广泛研究，因为肩袖肌群最常受损，会影响肌腱病患者的生活质量。尽管这块微小却关键的肌肉已被充分描述，但仍有许多有待学习和发现之处，特别是因为慢性冈上肌腱病是一种常见的疼痛综合征，会导致人群出现功能和劳动能力障碍。本叙述性综述纳入了生物力学和临床研究的系统性要素，重点介绍了冲击波疗法在保守治疗中的作用。我们着手对该主题的文献进行综合分析，以确定可用于建立恰当治疗管理方案的潜在病理生理机制，尤其关注冲击波疗法的保守治疗。我们检索了医学文献，包括符合2014年后发表标准的临床研究。在本综述中，我们描述了肌腱病的机制和组织学变化，以阐明冲击波疗法的生物学效应，并对其治疗效果进行了文献综述。冈上肌腱病多方面的病理生理学损害了愈合反应。最新研究结果凸显了全面诊断和治疗策略的价值，冲击波疗法（ESWT）可作为一种保守治疗选择。根据现有数据，冲击波疗法已显示出功能上的显著改善，减轻了参与者的不适、提高了生活质量并缓解了疼痛。它还可与等长运动相结合。鉴于存在显著的偏倚风险和异质性，我们的研究结果应谨慎解读。各种治疗程序凸显了开展更多研究以优化参数并提供标准化临床指南的必要性。改善冈上肌腱病患者的治疗效果需要更好地理解病理情况，且需要进一步研究个体化治疗。
