EFFECTIVENESS OF EXTRACORPOREAL SHOCK WAVE THERAPY IN THE TREATMENT OF PREVIOUSLY UNTREATED LATERAL EPICONDYLITIS

Chung B, Wiley JP. Am J Sports Med2004;32:1660–7OpenUrlCrossRefPubMedWeb of Science

Background: Extracorporeal shock wave therapy (ECSWT) has been proposed as a treatment modality for chronic tendon-related pain, but few randomised controlled trials have been performed to evaluate its efficacy.

Research question/s: Does ECSWT result in a higher rate of treatment success than placebo in patients suffering from lateral epicondylitis?

Methodology:Subjects: 60 subjects (23 female, 37 male) with untreated lateral epicondylitis (<1 year, >3 weeks).

Experimental procedure: Subjects were randomly allocated to receive one session per week for 3 weeks of either sham (CON = 29) or active treatment (ECSWT = 31). Subjects in the ECSWT group received 2000 pulses (energy flux density, 0.03 to 0.17 mJ/mm²) once per week for 3 weeks, while all subjects performed regular forearm stretching. Follow up was conducted after 8 weeks of therapy. Visual analogue scale scores (0–10) for pain at rest, during sleep, during activity, at its worst, and at its least, as well as for quality of life (using the EuroQoL questionnaire) and grip strength were collected.

Measures of outcome: Treatment successes (%) according to fulfilment of three criteria: (1) ⩾50% reduction in the overall pain (VAS score); (2) a maximum overall pain score of 4.0 cm (VAS); and (3) no use of pain medication for elbow pain for 2 weeks before the 8 week assessment.

Results:

• There was a mean increase in quality of life of 1.3 and 3.3 for …