Efficacy and safety of extracorporeal shock wave therapy for upper limb tendonitis: a systematic review and meta-analysis of randomized controlled trials

Yongqing Xiong; Tianshan Wen; Songzhi Jin; Ling Lin; Qianer Shao; Yue Peng; Qining Zheng; Wei Li

doi:10.3389/fmed.2024.1394268

Efficacy and safety of extracorporeal shock wave therapy for upper limb tendonitis: a systematic review and meta-analysis of randomized controlled trials

Front Med (Lausanne). 2024 Jul 30:11:1394268. doi: 10.3389/fmed.2024.1394268. eCollection 2024.

Authors

Yongqing Xiong¹, Tianshan Wen¹, Songzhi Jin¹, Ling Lin¹, Qianer Shao¹, Yue Peng¹, Qining Zheng¹, Wei Li¹

Affiliation

¹ Gannan Medical University, Ganzhou, Jiangxi, China.

Abstract

Objective: This study synthesized the highest level of evidence to analyse the effectiveness and safety of using extracorporeal shock wave therapy (ESWT) to treat upper limb tendonitis, which was unknown.

Design: We conducted a systematic review and meta-analysis of 18 randomized controlled trials (RCTs) in PubMed, Embase, Web of Science, Medline, and the Cochrane Library.

Methods: Two researchers performed the screening, data extraction, literature quality assessment, and heterogeneity analysis of the searched RCTs.

Results: The main types of morbidity included rotator cuff tendonitis, lateral epicondylitis, finger tendonitis, and long bicipital tendonitis. The results of the meta-analysis showed that ESWT was effective in relieving pain in all four types of tendonitis. In addition, ESWT was more effective in relieving pain in patients with upper limb tendonitis than placebo at the 3- and 6-month follow-ups, especially with radial ESWT (RESWT). Data analysis of the forest plot showed that the experimental group with ESWT as an intervention had a significant improvement in function in patients with rotator cuff tendonitis at the 3-month follow-up. However, subgroup analysis showed that low-energy ESWT was effective in improving function in patients with calcified and non-calcified rotator cuff tendonitis, whereas it was not effective in relieving pain.

Conclusion: ESWT can effectively improve the functional activity in patients with rotator cuff tendonitis and may produce positive analgesic effects in patients with upper limb tendonitis. The incidence of adverse effects is low.

Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023403594, identifier: PROSPERO, CRD42023403594.

Keywords: extracorporeal shock wave; lateral epicondylitis; randomized controlled trials; rotator cuff tendonitis; upper limb tendonitis.

Publication types

Systematic Review

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study was supported by the Science and Technology Research Project of Jiangxi Provincial Education (GJJ190801) to WL.