Radial Extracorporeal Shock Wave Therapy Is Not More Effective Than Placebo in the Management of Lateral Epicondylitis (original) (raw)
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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.
Efficacy of extracorporeal shock wave therapy in the treatment of lateral epicondylitis
İstanbul Kuzey Klinikleri, 2014
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.
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.
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.
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...
Pain Medicine, 2018
Objective The aim of this study was to compare the efficacy of prolotherapy with hypertonic dextrose and radial shock wave therapy in chronic lateral epicondilosis. Design Prospective single-blind randomized clinical trial. Setting Physical medicine and rehabilitation clinic. Subjects Thirty-three patients with at least three months of signs and symptoms of lateral epicondilosis, as well as failure of at least one of the conservative treatments, randomly allocated into two groups. Methods Sixteen patients received three sessions of shock wave therapy, and 17 received one session prolotherapy. Severity of pain via visual analog scale (VAS), grip strength via Baseline Pneumatic Dynamometer, pressure pain threshold (PPT) by algometer and Disabilities of Arm, Shoulder, and Hand quick questionnaire (Quick DASH) were assessed at baseline, four weeks, and eight weeks after the intervention. Results Within-group analysis showed that in both groups, differences between all of the outcome mea...
Journal of Functional Morphology and Kinesiology
This study was conducted to investigate the effect of extracorporeal shock-wave therapy (ESWT) on pain, grip strength, and upper-extremity function in lateral epicondylitis. A sample of 40 patients with LE (21 males) was randomly allocated to either the ESWT experimental (n = 20) or the conventional-physiotherapy control group (n = 20). All patients received five sessions during the treatment program. The outcome measures used were the Visual Analog Scale (VAS), the Taiwan version of the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, and a dynamometer (maximal grip strength). Forty participants completed the study. Participants in both groups improved significantly after treatment in terms of VAS (pain reduced), maximal grip strength, and DASH scores. However, the pain was reduced and upper-extremity function and maximal grip strength were more significantly improved after ESWT in the experimental group. ESWT has a superior effect in reducing pain and improving up...
Journal of Physical Therapy Science, 2015
This study aimed to determine and compare the effectiveness of extracorporeal shock wave therapy and local corticosteroid injection in patients with lateral epicondylitis. [Subjects and Methods] Sixty-four patients with lateral epicondylitis were randomly divided into extracorporeal shock wave therapy and steroid injection groups. Patients were evaluated using hand grip strength, visual analog scale, and short-form McGill pain questionnaire at baseline and at 4 and 12 weeks post-treatment. [Results] Both groups showed statistically significant increase in hand grip strength and decreases on the visual analog scale and short form McGill pain questionnaire overtime. There was no statistically significant difference in the percentage of improvement in hand grip strength and on the short-form McGill pain questionnaire between groups at 4 weeks post-treatment, whereas the extracorporeal shock wave therapy group showed better results on the visual analog scale. The percentages of improvements in all 3 parameters were higher in the extracorporeal shock wave therapy group than in the injection group at 12 weeks post-treatment. [Conclusion] Both the extracorporeal shock wave therapy and steroid injection were safe and effective in the treatment of lateral epicondylitis. However, extracorporeal shock wave therapy demonstrated better outcomes than steroid injection at the long-term follow-up.
Effectiveness of Physical Therapy Treatments on Lateral Epicondylitis
Journal of Sport Rehabilitation, 2008
Objective:To analyze research literature that has examined the effectiveness of various physical therapy interventions on lateral epicondylitis.Data Sources:Evidence was compiled with data located using the PubMed, EBSCO, The Cochrane Library, and the Hooked on Evidence databases from 1994 to 2006 using the key words lateral epicondylitis, tennis elbow, modalities, intervention, management of, treatment for, radiohumeral bursitis, and experiment.Study Selection:The literature used included peer-reviewed studies that evaluated the effectiveness of physical therapy treatments on lateral epicondylitis. Future research is needed to provide a better understanding of beneficial treatment options for people living with this condition.Data Synthesis:Shockwave therapy and Cyriax therapy protocol are effective physical therapy interventions.Conclusions:There are numerous treatments for lateral epicondylitis and no single intervention has been proven to be the most efficient. Therefore, future...
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.