Radial Extracorporeal Shock Wave Therapy Is Not More Effective Than Placebo in the Management of Lateral Epicondylitis

Çapan, Nalan; Esmaeilzadeh, Sina; Oral, Aydan; Başoğlu, Cengiz; Karan, Ayşe; Sindel, Dilşad

doi:10.1097/phm.0000000000000407

Cited by 40 publications

(26 citation statements)

References 36 publications

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“…Another study by Capan et al found no difference between sham and ESWT treatment for lateral epicondylitis [28] . Some studies found ESWT to be superior to placebo whereas other studies found it to be ineffective [9] .…”

Section: Discussionmentioning

confidence: 94%

Comparison of Ozone and Extracorporeal Shockwave Therapy in the Treatment of Chronic Lateral Epicondylitis

Bilge¹,

Aydin²

2019

IKSST

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Objective: The aim of the current retrospective study was to compare the effects of ozone injections and Extracorporeal Shockwave Therapy in the alleviation of pain associated with chronic lateral epicondylitis. Method: A Retrospective Cohort Study was performed, and data was collected from the documented medical records of 89 patients with unilateral chronic lateral epicondylitis. Patients who received local injections of ozone (n=49) and Extracorporeal Shockwave Therapy (n=40) were evaluated. Pain assessment was made by means of Verhaar scores before and after the first injection and the at 1st, 3rd, 6th, and 9th months after treatment. The two groups were compared with respect to baseline demographics including age, gender, dominant and affected sides and Verhaar scores. Results: Evaluation of pain scores after the treatment showed significant differences between the two groups. Assessment of pain at the 3rd and 9th months after treatment demonstrated that the ozone group had statistically significantly better scores at rest (p<0.001), on compression (p<0.001) and during activity (p<0.001). Conclusion: Our results demonstrated that ozone injection may be superior over Extracorporeal Shockwave Therapy which is an effective therapeutic option for longterm pain relief in patients with chronic lateral epicondylitis who are refractory to conservative treatment.

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Section: Discussionmentioning

confidence: 94%

Comparison of Ozone and Extracorporeal Shockwave Therapy in the Treatment of Chronic Lateral Epicondylitis

Bilge¹,

Aydin²

2019

IKSST

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“…Taheri et al, in a clinical trial, comparing low dose and high dose focused ESWT, highlighted similar results in pain reduction especially in the first 3 months [35]. Considering the radial ESWT, not significant advantages were found in efficacy in reducing pain or improving function when compared with sham radial ESWT [36]. Moreover, our study identifies some risk factors to the persistence of the symptomatology such as age, duration of disease, and the performing of ECRB high involving occupation and sports activities, which could prejudice the satisfaction of the therapy, making the recovery longer.…”

Section: Discussionmentioning

confidence: 96%

Functional Outcome at Short and Middle Term of the Extracorporeal Shockwave Therapy Treatment in Lateral Epicondylitis: A Case-Series Study

Testa

Vescio

Perez

et al. 2020

JCM

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Lateral epicondylitis (LE) of the humerus is a chronic degeneration of wrist extensor tendons at their attachments to the lateral epicondyle of the humerus. There is not a common consensus on a specific therapeutic algorithm, but Extracorporeal Shockwave Therapy (ESWT) is widely used. The purpose of this study is to evaluate the clinical benefits of low dose ESWT in LE-affected patients in short and medium follow-up. Between January 2015 and December 2017, 60 patients (38 male, mean age 52.2 ± 10.1 years, the duration of the disease was 3.6 ± 1.3 months) were clinically evaluated using visual analog scale (VAS) and Patient Rated Tennis Elbow Evaluation Test (PRTEE-I) scores before treatment, at one, three, six and 12 months after treatment. According to the VAS and PRTEE-I scoring systems, all patients achieved an improvement of pain and functional outcome comparing the baseline results with one, six and 12 months values. Low dose ESWT is a safe and effective treatment of LE in the short and middle term. In elderly subjects, patients with a long disease history, or those with occupational and sportive risk factors, a longer persistence of the symptomatology could be observed.

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“…For example, a rESWT regimen that employs 2000 pulses of 10 Hz frequency at a 1.8 bar of air pressure at each session at three once weekly sessions was compared with sham rESWT in a double-blind, randomized, placebo-controlled study. The authors concluded that rESWT does not seem to be effective in patients with lateral epicondylitis (21). On the other hand, another study with different rESWT regimens in which the total number of shocks was 2500, the pressure was 2 bars: 1500 shocks of 5 Hz frequency followed by 500 shocks of 10 Hz frequency were applied locally on the lateral epicondyle and 500 shocks of 2 bars pressure and 5 Hz frequency were compared respectively.…”

Section: Introductionmentioning

confidence: 99%

Dose-related Effect of Radial Extracorporeal Shockwave Therapy (rESWT) on Lateral Epicondylitis in Active Patients: A Retrospective Comparative Study

Arıcan

Turhan

Karaduman

2019

Iran Red Crescent Med J

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Background: Extracorporeal shock wave therapy is a noninvasive, safe, and well-tolerated treatment method which is increasingly used in the treatment of lateral epicondylitis. However, the gold standard treatment protocol is still controversial. Objectives: This study aimed to investigate and compare the efficacy of two different pneumatic pressure levels of radial extracorporeal shockwave therapy (rESWT) in active patients with lateral epicondylitis, unresponsive to conservative treatment. Methods: This retrospective comparative study was carried out in the Department of Orthopedics and Traumatology, Duzce University School of Medicine in 2018. A total of 330 patients with lateral epicondylitis unresponsive to conservative treatment were underwent rESWT during years 2010-2017. The patients were divided into two groups of 181 patients (group 1) with a total of 1500 impulses of 10 Hz frequency at 1 bar of air pressure during five treatment sessions at 1 week intervals, and 149 patients (group 2) with a total of 2000 impulses of 10 Hz frequency at 2 bars of air pressure during five treatment sessions at 1 week intervals. Functional and clinical outcomes were assessed just before the treatment, at six weeks and six months after treatment using the visual analogue scale (VAS) and the Quick-Disabilities of the Arm, Shoulder, and Hand (Q-DASH) score. Results: The mean VAS score had significantly decreased in group 1 from 8.34 ± 1.22 to 2.59 ± 1.49 (P = 0.0001) and had also in group 2 from 8.56 ± 1.22 to 2.56 ± 1.76 (P = 0.0001). The mean Q-DASH score decreased significantly in both groups; from 58.92 ± 18.48 to 9.27 ± 5.85 (P = 0.0001), and from 65.36 ± 19.32 to 9.25 ± 6.28 (P = 0.0001) in group 1 and group 2, respectively. No significant difference was observed between the pretreatment VAS and the 6-month scores of groups 1 and 2 (P = 0.103). The mean difference in the Q-DASH pretreatment and 6-week scores and between the pretreatment and 6-month scores in group 2 were higher than those in group 1 (P = 0.011, P = 0.003). Conclusions: Although both rESWT treatment regimens caused a decrease in pain and loss of function, the superior treatment protocol for rESWT appears to be five treatment sessions at 1-week intervals, with 2000 impulses per session and 2 bars. rESWT is a good option for treating lateral epicondylitis, as it is safe and effective and leads to no complications.

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Radial Extracorporeal Shock Wave Therapy Is Not More Effective Than Placebo in the Management of Lateral Epicondylitis

Abstract: The rESWT does not seem to be more effective either in reducing pain or improving function or grip strength in patients with lateral epicondylitis at least at 3 mos after treatment when compared with sham rESWT.

Cited by 40 publications

References 36 publications

Comparison of Ozone and Extracorporeal Shockwave Therapy in the Treatment of Chronic Lateral Epicondylitis

Comparison of Ozone and Extracorporeal Shockwave Therapy in the Treatment of Chronic Lateral Epicondylitis

Functional Outcome at Short and Middle Term of the Extracorporeal Shockwave Therapy Treatment in Lateral Epicondylitis: A Case-Series Study

Dose-related Effect of Radial Extracorporeal Shockwave Therapy (rESWT) on Lateral Epicondylitis in Active Patients: A Retrospective Comparative Study

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