ABSTRACT

Objective:

Lateral epicondylitis is a disease with unknown etiology that influences 1-3 % of society. The major symptom is a kind of pain which originates from common extensor tendon, spreads out distally and increases with activities. Generally, it depends on using muscles excessively while sport or working and comprises of macroscopic and microscopic ruptures in common extensor origin and especially extensor tendon that are formed while strong grasping and eccentric contractions with recurrent, rapid movements of wrist. The aim of this study was to investigate the efficacy of shock wave therapy (ESWT) in the treatment of lateral epicondylitis.

Methods:

We evaluated patients with lateral epicondylitis who were admitted to the treatment program and who had not yet received treatment. Sixty patients were studied in two groups of 30s. Patients applied treatment (1000 shots/18 hz frequency/1.8 bar point and 1000 shots/21 hz frequency/1.4 bar peripheral) total 2000 shots once a week for three times. Socio-demographic properties, dominant hand, affected elbow, existence of trauma or repetitive movements and the comorbid diseases, duration of symptoms, triggering factors and clinical examination results created the data. By the assessment of symptoms and signs visual analog scale, algometer, Health Assessment Questionnaire and PRTEE-T scores were evaluated.

Results:

At the end of the study, the ESWT-treated group showed statistically significant improvement in all variables compared with the groups (p<0.05).

Conclusion:

ESWT in the treatment of lateral epicondylitis showed a positive effect on symptoms and clinical signs. At the end of this study we concluded that ESWT therapy is effective in the conservative treatment of lateral epicondylitis.

Keywords: Lateral epicondylitis, ESWT, elbow pain

References

Boyer MI, Hastings H 2nd. Lateral tennis elbow: “Is there any science out there?” J Shoulder Elbow Surg 1999;8:481-91.

Stasinopoulos D, Johnson MI. Cyriax physiotherapy for tennis elbow/lateral epicondylitis. Br J Sports Med 2004;38:675-7.

Nordin M. FV. Basic Biomechanics of the Musculoskeletal System 3rd Ed., Lippincott Williams & Wilkins, . 2001:340-57.

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.

Noteboom T, Cruver R, Keller J, Kellogg B, Nitz AJ. Tennis elbow: a review. J Orthop Sports Phys Ther 1994;19:357-66.

Ernst E. Conservative therapy for tennis elbow. Br J Clin Pract 1992;46:55-7.

Cohen MS, Romeo AA, Hennigan SP, Gordon M. Lateral epicondylitis: Anatomic relationships of the extensor tendon origins and implications for arthroscopic treatment. J Shoulder Elbow Surg 2008;17:954-60.

Nayak SR, Ramanathan L, Krishnamurthy A, Prabhu LV, Madhyastha S, Potu BK, et al. Extensor carpi radialis brevis origin, nerve supply and its role in lateral epicondylitis. Surg Radiol Anat 2010;32:207-11.

Waugh EJ, Jaglal SB, Davis AM, Tomlinson G, Verrier MC. Factors associated with prognosis of lateral epicondylitis after 8 weeks of physical therapy. Arch Phys Med Rehabil 2004;85:308-18.

DK S. Assessment of fine motor control in patients with occupation-related lateral epicondylitis. Master of science thesis University of Alberta, Edmonton. 2005:1-29.

Kochar M, Doğra A. Effectiveness of a specific physiotherapy regimen on patients with tennis elbow. Physiotherapy 2002;88:333-41.

Sevier TL, Wilson JK. Treating lateral epicondylitis. Sports Med 1999;28:375-80.

Baloğlu İ. ÖMH, Aydınok H, Lök V. Ortopedi ve Travmatolojide Þok Dalga Tedavisi. Türk Ortopedi ve Travmatoloji Birliði Derneği Dergisi 2005;4:33-49.

Rompe JD, Hope C, Küllmer K, Heine J, Bürger R. Analgesic effect of extracorporeal shock-wave therapy on chronic tennis elbow. J Bone Joint Surg (Br) 1996;78:233-7.

Fairbank SM, Corlett RJ. The role of the extensor digitorum communis muscle in lateral epicondylitis. J Hand Surg Br 2002;27:405-9.

Hong QN, Durand MJ, Loisel P. Treatment of lateral epicondylitis: where is the evidence? Joint Bone Spine 2004;71:369-73.

Martinez-Silvestrini JA, Newcomer KL, Gay RE, Schaefer MP, Kortebein P, Arendt KW. Chronic lateral epicondylitis: comparative effectiveness of a home exercise program including stretching alone versus stretching supplemented with eccentric or concentric strengthening. J Hand Ther 2005;18:411-9, quiz 420.

Stasinopoulos D, Stasinopoulos I. Comparison of effects of Cyriax physiotherapy, a supervised exercise programme and polarized polychromatic non-coherent light (Bioptron light) for the treatment of lateral epicondylitis. Clin Rehabil 2006;20:12-23.

Krischek O, Hopf C, Nafe B, Rompe JD. Shock-wave therapy for tennis and golfer’s elbow--1 year follow-up. Arch Orthop Trauma Surg 1999;119:62-6.

Wang CJ WF, Yang KD, Weng LH, Hsu CC, Huang CS, Yang LC. Shock wave therapy induces neovascularization at the tendon-bone junction. A study in rabbits. J Orthop Res 2003;21:984-9.

Orhan Z OK, Guven A, Cam K. The effect of extracorporeal shock waves on a rat model of injury to tendo Achillis. J Bone Joint Surg (Br) 2004;86:613-8.

Maier M, Steinborn M, Schmitz C, Stäbler A, Köhler S, Veihelmann A, et al. Extracorporeal shock-wave therapy for chronic lateral tennis elbow-prediction of outcome by imaging. Arch Orthop Trauma Surg 2001;121:379-84.

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.

Speed CA, Nichols D, Richards C, Humphreys H, Wies JT, Burnet S, et al. Extracorporeal shock wave therapy for lateral epicondylitis--a double blind randomised controlled trial. J Orthop Res 2002;20:895-8.

Richter D, Ekkernkamp A, Muhr G. Extracorporeal shock wave therapy--an alternative concept for the treatment of epicondylitis of the humerus and radius? Orthopade 1995;24:303-6.

Efficacy of Extracorporeal Shock Wave Therapy in the Treatment of Lateral Epicondylitis

ABSTRACT

References