Efficacy of extracorporeal shock wave therapy in the treatment of lateral epicondylitis (original) (raw)
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Procedia - Social and Behavioral Sciences, 2014
The extracorporeal shockwave therapy (ESWT) was used for the first time in 1980, for fragmenting kidney stones. Since 1981, it also began to be used in Orthopedics, due to the contribution of German scientists-its use was to be developed more after 1990. Ten years later, ESWT was introduced in the treatment of several musculoskeletal disorders. This paper aims at highlighting the effects of ESWT on lateral epicondylitis in people between 40 and 50 years old, who unsuccessfully followed a conventional treatment. Lateral epicondylitis can be encountered in tennis players (5% of the cases), violinists, surgeons, dentists, persons who type (secretaries), people who use the computer mouse very often, housewives. The largest incidence can be found in the age groups between 40 and 50, especially in amateur tennis players. The treatment for this condition is very diverse and complex. Nevertheless, the recurrences are quite frequent, a large number of patients being unresponsive even after 3 months of treatment. The experiment was conducted on a group of 43 patients, men and women, with various backgrounds, diagnosed with lateral epicondylitis, and who had previously been subjected to classical treatments, without any result. The study was conducted over a period of 5 weeks. The ESWT treatment was performed twice a week. The assessment of the subjects was done by observing and recording their pain intensity during palpation, and during the performance of their daily activities, at the beginning and at the end of treatment. This was done using the Visual Analogue Scale (VAS) for Pain. The final results presented a significant decrease and disappearance of the patients' pain. Thus, one can say that positive results were obtained, and the ESWT treatment had an effect on the athletes with lateral epicondylitis who did not respond to a conventional treatment.
American Journal of Physical Medicine & Rehabilitation, 2016
The aim of this study was to investigate the effects of radial extracorporeal shock wave therapy (rESWT) on pain, function, and grip strength in the treatment of patients with lateral epicondylitis unresponsive to previous treatments. Design: A double-blind, randomized, placebo-controlled trial was conducted in outpatient clinics in a medical faculty hospital. Fifty-six patients with lateral epicondylitis were randomized to rESWT (n = 28) or sham rESWT (n = 28) groups. Both the patients and the outcome assessing investigator were blinded to group assignment. The rESWT was administered to the painful epicondyle at the elbow with a total of 2000 pulses of 10 Hz frequency at a 1.8 bar of air pressure at each session at three once weekly sessions. Sham rESWTwas applied without the contact of the applicator at the same area. Study patients were assessed at baseline and at 1 and 3 mos after treatment using a visual analog scale for pain and Roles and Maudsley scale and Patient-Rated Tennis Elbow Evaluation for pain and function. Grip strength of the affected extremity was also measured using a hand dynamometer. Results: Both rESWT and sham rESWT groups showed a significant improvement in all outcome measures at posttreatment follow-up points. Favorable absolute and percentage changes in assessments at 1-and 3-mo posttreatment did not show any significant difference between groups. Conclusions: The rESWTdoes 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.
Turkish Journal of Osteoporosis, 2019
The aim of this study was to investigate the effects of extracorporeal shock wave therapy (ESWT) and dry needling (DN) combination to the trigger points in the forearm extensor muscles on pain, grip strength and functionality in patients diagnosed with lateral epicondylitis. Materials and Methods: Forty patients who were clinically diagnosed with lateral epicondylitis were included in the study. The patients were divided into two groups as ESWT and ESWT + DN. Patients in the ESWT and exercise group were applied 2.000 pulses, once a week, three sessions; in addition to that three sessions of DN therapy was applied to the other group. Also, stretching and eccentric strengthening exercises were applied to the patients in both groups. The pain severity of the patients which occured with palpation and grip was measured by Visual Analog Scale (VAS), lateral epicondyle sensitivity by an algometer, grip strength by dynamometer and functionality level by the patient-rated tennis elbow evaluation (PRTEE) pre-treatment and at the end of treatment (first month). Results: In both groups; there were statistically significant improvements in first month VAS scores of the pre-and post-treatment (morning, activity, and rest) (p<0.001); in the comparison of the intergroup, the improvement in pain scores, except for night pain, was found to be superior in the ESWT + DN group (p<0.001). The evaluation of the most sensitive region of the lateral epicondylitis pre-and post-treatment with algometer were compared, there was a significant improvement in both groups (p<0.001), whereas the improvement in ESWT + DN group was observed to be superior (p<0.001). While the maximum grip strength values measured in the elbow flexion and extension position increased significantly in both groups after the treatment, the increase in the extension position in the ESWT + DN group was outstanding (p<0.05). When the pre-and post-treatment changes seen in the PRTEE scale of the patients were examined; a statistically significant decrease was observed in all groups in favor of improvement post-treatment (p<0.05). In ESWT + DN group, pain score and function score change were more effective than ESWT group (p<0.001). Conclusion: These results suggest that ESWT and DN combination therapy in lateral epicondylitis provide better clinical outcomes than ESWT treatment alone.
Journal of Medical – Clinical Research & Reviews
Objective: The current study aimed to examine effect of ESWT vs. MWM in the management of tennis elbow. Methods: The study was conducted in the physiotherapy department at PAU. Sample of the study consisted of 22 patients aged between 20-50 years. Patients were selected in the orthopedic clinic and randomly separated into 2 groups. The ESWT group included (12) patients, whereas the MWM group included (10) patients. The first group underwent 3 sessions/week and the latter underwent 2 sessions/week for 4 weeks. The demographic data were assessed. VAS was used for pain intensity. A hand-held dynamometer was used for wrist strength and Quick DASH was used for a functional disability. Results: Inter-group analysis was done using t-test. Comparing pre-post treatments using VAS disclosed that there were not significant differences between groups, P= 0.25. Pre-post treatment for wrist strength uncovered that there wasn't a significant difference between groups, P= 0.47. Pre-post QUICK D...
Journal of Clinical Medicine
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 ...
Extracorporeal Shockwave Therapy In Patients With Lateral Epicondylitis
European Journal of Medical Sciences, 2014
Objective: Lateral epicondylitis (LE) is characterized by inflammation and later degenerative angiogenetic changes of the wrist extensors. The optimal treatment of LE remains elusive with contradictory findings reported. The purpose of this study was to assess the effects of radial shockwave therapy (RSWT) on function, range of motion (ROM), strength, and pain in patients with chronic LE. Methods: Functional status using the Upper Extremity Functional Scale (UEFS), ROM, strength, and pain was measured with the P4 Scale and Visual Analog Scale (VAS) before and 3 months post-treatment. Twenty-eight subjects received 3 treatments (2000 shockwaves, 2.5 bars, 10-15 Hz, 11.5 Mp) on the painful elbow. A Wilcoxen Signed Rank Test and Dependent t-Test was used to analyze the data. Results: There was no significant improvement in VAS pain score at rest (p=.142) and in grip strength (p=.319). There was statistically significant improvement in VAS scores for pain after activity (p=.0001) and overall improvement in pain (p=.0001); P4 Scale scores (p=.0001); UEFS scores (p=.0001); elbow flexor (p=.014) and extensor (p=.008) ROM; elbow flexor, extensor, supinator, and pronator strength (p=.008); and wrist flexor, extensor, radial deviator, and ulnar deviator strength (p=.003). There was no statistically significant improvement in ROM for all other elbow and wrist movements. Conclusions: The use of RSWT is an alternative and effective treatment option for patients diagnosed with chronic LE. This intervention resulted in a reduction in elbow pain and an improvement in function, ROM, and strength in the elbow and wrist.
2018
Aim: We aimed to evaluate the effects of extracorporeal shock wave therapy (ESWT) on clinical and functional status, quality of life and level of pain for short and long terms in patients with lateral epicondylitis. Methods: In total, 34 patients with lateral epicondylitis were included in the study. The patients received three sessions of ESWT administered 1day apart. The Short Form (SF-36) Health Survey evaluating the quality of life, the Turkish version of the patient-rated tennis elbow evaluation (PRTEET) evaluating the level of pain during various activities of daily living, the Nirschl pain phase scale evaluating pain during activity of the affected arm and patient-rated visual analogue scale (VAS) evaluating pain localised in the affected arm were used before andafter therapy and at 6 and 12 weeks after therapy. Results: There were significant decreases in the PRTEE-T, Nirschl and VAS scores at 6 and 12 weeks and significant increases in the SF-36 survey scores. There was a s...
2005
Aim. Despite the lateral epicondylitis or tennis elbow is a common cause of pain in orthopaedic and sports medicine, the results of the different modalities of conservative treatment are still contradictory. The pourpose of this study was to evaluate the efficacy of radial shock wave therapy (RSWT) in the treatment of tennis elbow. Methods. In a prospective randomized controlled singleblind study, of 75 eligible patients, 62 with tennis elbow were randomly assigned to study group and control group. There were 31 patients in the study group and 31 patients in the control group. Both groups had received a treatment a week for 4 weeks; the study group had received 2 000 impulses of RSWT and the control group 20 impulses of RSWT. All patients were evaluated 3 times: before treatment, at the end of treatment and to 6 months follow-up. The evaluation consisted of assessments of pain, pain-free grip strength test, and functional impairment.
Treatment of Lateral Epicondylitis: Steroid Injection versus Extra-Corporeal Shock Wave Therapy
2014
Objective: Several treatments have been proposed to treat lateral epicondylitis. Both steroid injection and extra-corporeal shock wave therapy (ESWT) are treatment modalities. Methods: Thirty-four patients suffering from lateral epicondylitis for at least 6 months were treated in this study. The patients were divided into two groups: the first group included 17 patients treated by ESWT, and the second group included 17 patients treated by local injection of steroid. The results were evaluated using the visual analog scale and the DASH score. Results: In the first group (ESWT), the mean follow-up period was 20.42 months. The VAS improved from 8.1 to 1.85, and the DASH score improved from 73.32 to 52.3. Moreover, 10 cases were satisfied, 2 cases were satisfied with reservation, and 5 cases were not satisfied. In the second group (steroid), the average follow-up period was 17.39 months. The VAS improved from 8.71 to 1.32, and the DASH score improved from 72 to 48.23. Concerning patient satisfaction, 13 cases were satisfied, 3 cases were satisfied with reservation, and 1 case was not satisfied. Conclusion: Steroid injection had good results when compared to ESWT as regards pain relief, improvement of elbow function, and patient satisfaction at follow-up.