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In the nodular stage of Dupuytren\u2019s disease, pain might limit daily hand activities and progress to finger contractures. Focused electromagnetic high-energetic extracorporeal shockwave therapy (ESWT) may reduce pain in Dupuytren\u2019s nodules (Tubiana N). In this prospective, randomized, blinded, placebo-controlled single center trial, we enrolled 52 patients (mean age, 58.2\u2009\u00b1\u20099.2) with painful nodular Dupuytren disease Tubiana N. Randomization was done to either (group A) 3 treatments with focused electromagnetic high-energetic ESWT (2000 shots, 3\u00a0Hz, 0.35\u00a0mmJ\/mm<jats:sup>2<\/jats:sup>\/hand, Storz Duolith SD1,<jats:italic>n<\/jats:italic>\u2009=\u200927) or (group B) placebo ESWT (2000 shots, 3\u00a0Hz, 0.01\u00a0mJ\/mm<jats:sup>2<\/jats:sup>\/hand,<jats:italic>n<\/jats:italic>\u2009=\u200925) in a weekly interval. Primary outcome was the level of pain on a visual analogue scale (VAS 0\u201310) at 3\/6\/12\/18\u00a0months, secondary outcomes were patient-related outcome measures (DASH score, MHQ score, URAM scale), grip strength, patient\u2019s satisfaction, and Dupuytren\u2019s disease progression over 18\u00a0months follow-up. Focused ESWT significantly improved outcomes. Pain was reduced from 3.6\u2009\u00b1\u20091.8 to 1.9\u2009\u00b1\u20091.2 at three, to 1.4\u2009\u00b1\u20090.7 at six, to 1.7\u2009\u00b1\u20091.6 after 12\u00a0months and 1.9\u2009\u00b1\u20090.8 after 18\u00a0months in the intervention group (47% reduction,<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). In the placebo group, pain on VAS increased from 2.2\u2009\u00b1\u20091.4 to 3.4\u2009\u00b1\u20091.7 at three, to 3.4\u2009\u00b1\u20091.8 at six, to 3.4\u2009\u00b1\u20091.4 at 12 and 3.1\u2009\u00b1\u20091.1 at 18\u00a0months (35% increase,<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). Quality-of-life score tended to improve in the intervention group (MHQ, 77\u2009\u00b1\u200919 to 83\u2009\u00b1\u200912; DASH, 12\u2009\u00b1\u200918 to 10\u2009\u00b1\u20099) while it deteriorated in the placebo group as Dupuytren\u2019s disease was progressing (MHQ, 79\u2009\u00b1\u200915 to 73\u2009\u00b1\u200917; DASH, 6\u2009\u00b1\u200910 to 14\u2009\u00b1\u200913). The strength of the affected hand and fingers did not change significantly in either of the groups. Patients\u2019 satisfaction was higher in the intervention group for symptom improvement (56% vs. 12%) and reduction of disease progression (59% vs. 24%). Any Dupuytren-related intervention was performed in 26% in the intervention group and in 36% in the placebo group within 18\u00a0months of follow-up (n.s.). Focused electromagnetic high-energetic ESWT can significantly reduce pain in painful nodules in Dupuytren\u2019s disease in an 18-month perspective. (<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link>Identifier: NCT01184586).<\/jats:p>","DOI":"10.1007\/s10103-021-03254-9","type":"journal-article","created":{"date-parts":[[2021,1,23]],"date-time":"2021-01-23T04:34:21Z","timestamp":1611376461000},"page":"323-333","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Focused electromagnetic high-energetic extracorporeal shockwave (ESWT) reduces pain levels in the nodular state of Dupuytren\u2019s disease\u2014a randomized controlled trial (DupuyShock)"],"prefix":"10.1007","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1468-4258","authenticated-orcid":false,"given":"Karsten","family":"Knobloch","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Hellweg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heiko","family":"Sorg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomas","family":"Nedelka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,1,23]]},"reference":[{"issue":"19","key":"3254_CR1","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1007\/s15006-012-1341-3","volume":"154","author":"K Knobloch","year":"2012","unstructured":"Knobloch K (2012) Knuckle pads and therapeutic options. 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