Repetitive low-energy shock wave treatment for chronic lateral epicondylitis in tennis players

Am J Sports Med. 2004 Apr-May;32(3):734-43. doi: 10.1177/0363546503261697.

Abstract

Background: There is conflicting evidence regarding extracorporeal shock wave treatment for chronic tennis elbow.

Hypothesis: Treatment with repetitive low-energy extracorporeal shock wave treatment is superior to repetitive placebo extra-corporeal shock wave treatment.

Methods: Seventy-eight patients enrolled in a placebo-controlled trial. All patients were tennis players with recalcitrant MRI-confirmed tennis elbow of at least 12 months' duration. Patients were randomly assigned to receive either active low-energy extracorporeal shock wave treatment given weekly for 3 weeks (treatment group 1) or an identical placebo extracorporeal shock wave treatment (sham group 2). Main outcome measure was pain during resisted wrist extension at 3 months; secondary measures were >50% reduction of pain and the Upper Extremity Function Scale.

Results: At 3 months, there was a significantly higher improvement in pain during resisted wrist extension in group 1 than in group 2 (mean [SD] improvement, 3.5 [2.0] and 2.0 [1.9]; P =.001 for between-group difference of improvement) and in the Upper Extremity Function Scale (mean [SD] improvement, 23.4 [14.8] and 10.9 [14.9]; P <.001 for between-group difference of improvement). In the treatment group, 65% of patients achieved at least a 50% reduction of pain, compared with 28% of patients in the sham group (P =.001 for between-group difference).

Conclusion: Low-energy extracorporeal shock wave treatment as applied is superior to sham treatment for tennis elbow.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Chronic Disease
  • Female
  • Hand Strength
  • Humans
  • Lithotripsy / methods*
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Pain Measurement
  • Tennis Elbow / diagnosis
  • Tennis Elbow / physiopathology
  • Tennis Elbow / therapy*
  • Treatment Outcome