Extracorporeal shock wave therapy for lateral epicondylitis - a double blind randomised controlled trial

C. A. Speed, D. Nichols, C. Richards, H. Humphreys, J. T. Wies, S. Burnet and B. L. Hazleman

Journal of Orthopaedic Research

Volume 20, Issue 5, September 2002, Pages 895-898

Extracorporeal shock wave therapy (ESWT) is increasingly being used in the treatment of a number of soft tissue complaints. Although there has been some evidence to suggest ESWT is useful in the treatment of tendonitis where there are calcium deposits in the tendon, there is a lack of evidence which evaluates the usefulness of ESWT in other musculoskeletal conditions.

Speed et al are a group of researchers based at the University of Cambridge, UK, and the aim of this study was to establish if ESWT was effective in the treatment of tennis elbow. The authors used a double blind placebo controlled trial, which means that the subjects were split into two groups, with one group receiving ESWT treatment and the other group receiving 'sham' treatment. None of the subjects knew which group they were in. The trial of treatment lasted for 3 months, with the patients' pain scores evaluated objectively using a valid method (the visual analogue scale).

Extracorporeal shock waves are single pressure pulses of microsecond duration that can be focused upon a specific site using ultrasound guidance. In the past 30 years they have been used as a highly effective treatment of kidney disorders. Recently ESWT has been used in the treatment of a number of musculoskeletal conditions, including tennis elbow, at doses of 10-20% of those used for kidney conditions. The precise mechanism of this treatment is not known, but several theories suggest that shock waves may stimulate tissue healing and reduce both calcification and pain.

Speed et al found that both groups showed significant improvement after two months of treatment, both actual and sham. There were no significant differences between the two groups with respect to pain scores reported. The authors concluded that there was a significant placebo effect with ESWT, although there was no benefit in having actual treatment when compared to sham treatment. The study is rigorously constructed and well presented, and the only criticism can be the small sample of patients used. Speed et al used 75 patients, when a sample of over 400 would be necessary to extrapolate the statistical findings.The authors accept that a natural recovery may have taken place, since the average time of symptoms of the subjects was around 15 months, and both groups improved. A future study may look at patients who had more acute symptoms of tennis elbow and see if ESWT has an affect on the patients' pain scores.

Read the full research text >

• Home
• Research
• Research Reviews

Recommended Products

LEARN

SHOP

© Copyright PhysioRoom.com 2001-2008. All rights reserved. Sitemap.

IMPORTANT SAFETY NOTICE
The articles on this web site are provided for general information only and should not be used as a basis for diagnosis or treatment. All exercises and information featured on this web site should only be practised under the supervision of a qualified healthcare professional.

We accept most major credit/debits cards

PhysioRoom.com Limited, Unit 1 & 2 Dawson Court, Billington Road, Burnley, Lancashire BB11 5UB, England

Sports Injury & Physiotherapy Search Marketing by Epiphany.