Efficacy of extracorporeal shock wave therapy in the treatment of lateral epicondylitis

Korhan Bayram, Hilal Yesil, Erdal Dogan, Korhan Bayram, Hilal Yesil, Erdal Dogan

Abstract

Objective: Lateral epicondylitis is one of the widely seen lesions of the arm characterized by pain localized over lateral epicondyle which is the insertion site of the wrist extensors, and extensor muscles of the forearm. It is easy to diagnose lateral epicondylitis but treatment involves some inherent drawbacks. Conservative management includes non-steroidal anti-inflammatory drugs, ultrasound therapy, steroid injections, functional bracing, laser therapy and extracorporeal shock wave therapy, however none of these modalities have been shown to be really effective based on evidence-based data. Our study is aimed to determine the efficacy of extracorporeal shock wave therapy (ESWT) therapy in the treatment of lateral epicondylitis.

Methods: A total of 12 patients with the diagnosis of lateral epicondylitis were included in the study and 3 sessions of ESWT were applied (1 session per week). Maximum grip strength and pain scores were assessed before and at 1. month after the treatment. Spesific tests for lateral epicondylitis were utilized and Turkish version of the Patient Rated Tennis Elbow Evaluation (PRTEE-T) questionnaire was administered and data obtained were analyzed.

Results: Visual analog scale (VAS) scores were significantly lower (p<0.05) and grip strength significantly increased (p<0.05) one month after ESWT treatment. Overall PRTEE-T survey scores decreased significantly at first month (p<0.001) after treatment. Patient's and physician's global self-assessment scores were significantly lower after treatment (p<0.05).

Conclusion: To conclude, ESWT utilization in conservative treatment of lateral epicondyilitis was found to be effective on reducing pain, and improving functional activities and quality of life.

Keywords: Conservative treatment; ESWT; lateral epicondylitis.

Conflict of interest statement

No conflict of interest was declared by the authors.

References

    1. Stasinopoulos D, Johnson MI. Cyriax physiotherapy for tennis elbow/lateral epicondylitis. Br J Sports Med. 2004;38:675–7.
    1. Kamien M. A rational management of tennis elbow. Sports Med. 1990;9:173–91.
    1. Nirschl RP. The etiology and treatment of tennis elbow. J Sports Med. 1974;2:308–23.
    1. Meyer NJ, Walter F, Haines B, Orton D, Daley RA. Modeled evidence of force reduction at the extensor carpi radialis brevis origin with the forearm support band. J Hand Surg Am. 2003;28:279–87.
    1. Nirschl RP, Pettrone FA. Tennis elbow. The surgical treatment of lateral epicondylitis. J Bone Joint Surg Am. 1979;61:832–9.
    1. Nordin MFV. Basic biomechanics of the musculoskeletal system. 3rd ed. Lippincott Williams & Wilkins; 2001. pp. 340–57.
    1. Vicenzino B. Lateral epicondylalgia: a musculoskeletal physiotherapy perspective. Man Ther. 2003;8:66–79.
    1. Howitt SD. Lateral epicondylosis: a case study of conservative care utilizing ART and rehabilitation. J Can Chiropr Assoc. 2006;50:182–9.
    1. Labelle H, Guibert R, Joncas J, Newman N, Fallaha M, Rivard CH. Lack of scientific evidence for the treatment of lateral epicondylitis of the elbow. An attempted meta-analysis. J Bone Joint Surg Br. 1992;74:646–51.
    1. Sevier TL, Wilson JK. Treating lateral epicondylitis. Sports Med. 1999;28:375–80.
    1. Kochar MDA. Effectiveness of a specific physiotherapy regimen on patients with tennis elbow. Physiotherapy. 2002;88:333–4.
    1. Chan HL, Ng GY. Effect of counterforce forearm bracing on wrist extensor muscles performance. Am J Phys Med Rehabil. 2003;82:290–5.
    1. Ogden JA, Alvarez RG, Levitt R, Marlow M. Shock wave therapy (Orthotripsy) in musculoskeletal disorders. Clin Orthop Relat Res. 2001;387:22–40.
    1. Kalyon TA. Ultrason. In: Elektroterapi. 2nd ed. Tuna N, editor. Istanbul: Nobel Tip Kitabevleri; 2001. pp. 129–40.
    1. Pienimäki T, Tarvainen T, Siira P, Malmivaara A, Vanharanta H. Associations between pain, grip strength, and manual tests in the treatment evaluation of chronic tennis elbow. Clin J Pain. 2002;18:164–70.
    1. Altan L, Ercan I, Konur S. Reliability and validity of Turkish version of the patient rated tennis elbow evaluation. Rheumatol Int. 2010;30:1049–54.
    1. Boyer MI, Hastings H., 2nd Lateral tennis elbow: “Is there any science out there?”. J Shoulder Elbow Surg. 1999;8:481–91.
    1. Theis C, Herber S, Meurer A, Lehr HA, Rompe JD. Evidence-based evaluation of present guidelines for the treatment of tennis elbow-a review. [Article in German] Zentralbl Chir. 2004;129:252–60. [Abstract]
    1. Wang CJ. Extracorporeal shockwave therapy in musculoskeletal disorders. J Orthop Surg Res. 2012;7:11.
    1. Staples MP, Forbes A, Ptasznik R, Gordon J, Buchbinder R. A randomized controlled trial of extracorporeal shock wave therapy for lateral epicondylitis (tennis elbow) J Rheumatol. 2008;35:2038–46.
    1. Buchbinder R, Green SE, Youd JM, Assendelft WJ, Barnsley L, Smidt N. Shock wave therapy for lateral elbow pain. Cochrane Database Syst Rev. 2005;4:CD003524.
    1. Reza Nourbakhsh M, Fearon FJ. An alternative approach to treating lateral epicondylitis. A randomized, placebo-controlled, double-blinded study. Clin Rehabil. 2008;22:601–9.
    1. Mehra A, Zaman T, Jenkin AI. The use of a mobile lithotripter in the treatment of tennis elbow and plantar fasciitis. Surgeon. 2003;1:290–2.
    1. Spacca G, Necozione S, Cacchio A. Radial shock wave therapy for lateral epicondylitis: a prospective randomised controlled single-blind study. Eura Medicophys. 2005;41:17–25.
    1. Collins EDH, Jafarnia KK. A clinical study of extracorporeal shock waves (ESW) for treatment of chronic lateral epicondylitis. Current Orthopaedic Practice. 2011;22:185–92.
    1. Crowther MA, Bannister GC, Huma H, Rooker GD. A prospective, randomised study to compare extracorporeal shock-wave therapy and injection of steroid for the treatment of tennis elbow. J Bone Joint Surg Br. 2002;84:678–9.
    1. Gündüz R, Malas FÜ, Borman P, Kocaoğlu S, Özçakar L. Physical therapy, corticosteroid injection, and extracorporeal shock wave treatment in lateral epicondylitis. Clinical and ultrasonographical comparison. Clin Rheumatol. 2012;31:807–12.
    1. Rompe JD, Decking J, Schoellner C, Theis C. Repetitive low-energy shock wave treatment for chronic lateral epicondylitis in tennis players. Am J Sports Med. 2004;32:734–43.

Source: PubMed

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