scispace - formally typeset
Search or ask a question
Journal ArticleDOI

Analgesic effect of extracorporeal shock-wave therapy on chronic tennis elbow

J.-D. Rompe, Ch. Hopf, K. Küllmer, J. Heine, R. Bürger1 
01 Mar 1996-Journal of Bone and Joint Surgery-british Volume (British Editorial Society of Bone and Joint Surgery)-Vol. 78, Iss: 2, pp 233-237
TL;DR: There was significant alleviation of pain and improvement of function after treatment in group I in which there was a good or excellent outcome in 48% and an acceptable result in 42% at the final review, compared with 6% and 24%, respectively, in group II.
Abstract: We report a controlled, prospective study to investigate the effect of treatment by low-energy extracorporeal shock waves on pain in tennis elbow. We assigned at random 100 patients who had had symptoms for more than 12 months to two groups to receive low-energy shock-wave therapy. Group I received a total of 3000 impulses of 0.08 mJ/mm 2 and group II, the control group, 30 impulses. The patients were reviewed after 3, 6 and 24 weeks. There was significant alleviation of pain and improvement of function after treatment in group I in which there was a good or excellent outcome in 48% and an acceptable result in 42% at the final review, compared with 6% and 24%, respectively, in group II.

Content maybe subject to copyright    Report

Citations
More filters
Journal ArticleDOI
TL;DR: In conclusion, shock wave therapy induces the ingrowth of neovascularization associated with early release of angiogenesis‐related markers at the Achilles tendon–bone junction in rabbits, which may play a role to improve blood supply and tissue regeneration at the tendon-bone junction.

597 citations


Cites background from "Analgesic effect of extracorporeal ..."

  • ...In clinical application, extracorporeal shock wave therapy has shown effect in the treatment of certain orthopedic conditions including non-union of long bone fracture [21,30,32,37,39], calcifying tendonitis of the shoulder [15,27,31,33,42], lateral epicondylitis of the elbow [10,13,24,28,34], proximal plantar fasciitis [6,19,20, 25,29] and Achilles tendonitis [24]....

    [...]

  • ...For tendinopathy, it was postulated that shock wave therapy provokes painful level of stimulation, and relieves pain due to tendinopathy at the tendon–bone junction by hyper-stimulation analgesia [14,17,22,23,26,28,33,34, 37]....

    [...]

Journal ArticleDOI
TL;DR: The evidence suggests that extracorporeal shock wave therapy is not beneficial in the treatment of tennis elbow and there is a lack of evidence for the long term benefit of physical interventions in general.
Abstract: A systematic review of the literature on the effectiveness of physical interventions for lateral epicondylalgia (tennis elbow) was carried out. Seventy six randomised controlled trials were identified, 28 of which satisfied the minimum criteria for meta-analysis. The evidence suggests that extracorporeal shock wave therapy is not beneficial in the treatment of tennis elbow. There is a lack of evidence for the long term benefit of physical interventions in general. However, further research with long term follow up into manipulation and exercise as treatments is indicated.

398 citations

Journal ArticleDOI
TL;DR: Extracorporeal shockwave therapy (ESWT) is a novel non-invasive therapeutic modality without surgery or surgical risks, and the clinical application of ESWT steadily increases over the years.
Abstract: The sources of shockwave generation include electrohydraulic, electromagnetic and piezoelectric principles. Electrohydraulic shockwaves are high-energy acoustic waves generated under water explosion with high voltage electrode. Shockwave in urology (lithotripsy) is primarily used to disintegrate urolithiasis, whereas shockwave in orthopedics (orthotripsy) is not used to disintegrate tissues, rather to induce tissue repair and regeneration. The application of extracorporeal shockwave therapy (ESWT) in musculoskeletal disorders has been around for more than a decade and is primarily used in the treatment of sports related over-use tendinopathies such as proximal plantar fasciitis of the heel, lateral epicondylitis of the elbow, calcific or non-calcific tendonitis of the shoulder and patellar tendinopathy etc. The success rate ranged from 65% to 91%, and the complications were low and negligible. ESWT is also utilized in the treatment of non-union of long bone fracture, avascular necrosis of femoral head, chronic diabetic and non-diabetic ulcers and ischemic heart disease. The vast majority of the published papers showed positive and beneficial effects. FDA (USA) first approved ESWT for the treatment of proximal plantar fasciitis in 2000 and lateral epicondylitis in 2002. ESWT is a novel non-invasive therapeutic modality without surgery or surgical risks, and the clinical application of ESWT steadily increases over the years. This article reviews the current status of ESWT in musculoskeletal disorders.

374 citations

Journal ArticleDOI
01 Jun 2010-BMJ

276 citations

Journal ArticleDOI
18 Sep 2002-JAMA
TL;DR: It is found that there is no evidence to support a beneficial effect on pain, function, and quality of life of ultrasound-guided ESWT over placebo in patients with ultrasound-proven plantar fasciitis 6 and 12 weeks following treatment.
Abstract: ContextExtracorporeal shock wave therapy (ESWT) is increasingly used for plantar fasciitis, but limited evidence supports its use.ObjectiveTo determine whether ultrasound-guided ESWT reduces pain and improves function in patients with plantar fasciitis.DesignDouble-blind, randomized, placebo-controlled trial conducted between April 1999 and June 2001.SettingParticipants were recruited from the community-based referring physicians (primary care physicians, rheumatologists, orthopedic surgeons, and sports physicians) of a radiology group in Melbourne, Australia.ParticipantsWe screened 178 patients and enrolled 166; 160 completed the 15-week protocol. Entry criteria included age at least 18 years with plantar fasciitis, defined as heel pain maximal over the plantar aspect of the foot of at least 6 weeks' duration, and an ultrasound-confirmed lesion, defined as thickening of the origin of the plantar fascia of at least 4 mm, hypoechogenicity, and alterations in the normal fibrillary pattern.InterventionsPatients were randomly assigned to receive either ultrasound-guided ESWT given weekly for 3 weeks to a total dose of at least 1000 mJ/mm2 (n = 81), or identical placebo to a total dose of 6.0 mJ/mm2 (n = 85).Main Outcome MeasuresOverall, morning, and activity pain, measured on a visual analog scale; Maryland Foot Score; walking ability; Short-Form–36 Health Survey (SF-36) score; and Problem Elicitation Technique score, measured at 6 and 12 weeks after treatment completion.ResultsAt 6 and 12 weeks, there were significant improvements in overall pain in both the active group and placebo group (mean [SD] improvement, 18.1 [30.6] and 19.8 [33.7] at 6 weeks [P = .74 for between-group difference], and 26.3 [34.8] and 25.7 [34.9] at 12 weeks [P = .99], respectively). Similar improvements in both groups were also observed for morning and activity pain, walking ability, Maryland Foot Score, Problem Elicitation Technique, and SF-36. There were no statistically significant differences in the degree of improvement between treatment groups for any measured outcomes.ConclusionWe found no evidence to support a beneficial effect on pain, function, and quality of life of ultrasound-guided ESWT over placebo in patients with ultrasound-proven plantar fasciitis 6 and 12 weeks following treatment.

268 citations


Cites background from "Analgesic effect of extracorporeal ..."

  • ...While the duration of symptoms was again longer than in our trial (mean [range] duration of symptoms: 22 [6-120] months and24....

    [...]

References
More filters
Journal ArticleDOI
TL;DR: In this article, an anterior muscle-splitting incision was performed to explore the radial nerve and its branches in tennis elbow patients, and the results showed that the operation was effective in 30% of the cases.
Abstract: 1. Resistant cases of tennis elbow are explained on the basis of an entrapment neuropathy of the radial nerve and its branches. 2. An operation is described to explore these nerves through an anterior muscle-splitting incision. 3. Thirty-eight elbows in thirty-six patients have been operated on with improvement in all.

511 citations

Journal ArticleDOI
Ronald Melzack1
01 Dec 1975-Pain
TL;DR: The data indicate that the procedure provides a powerful method for the control of some forms of severe pathological pain by brief, intense transcutaneous electrical stimulations at trigger points or acupuncture points.
Abstract: The purpose of this study was to examine the effects of brief, intense transcutaneous electrical stimulations at trigger points or acupuncture points on severe clinical pain. The McGill Pain Questionnaire was used to measure the change in pain quality and intensity produced by stimulation. The data indicate that the procedure provides a powerful method for the control of some forms of severe pathological pain. The average pain decrease during stimulation sessions was 75% for pain due to peripheral nerve injury, 66% for phantom limb pain, 62% for shoulder-arm pain, and 60% for low-back pain. The duration of relief frequently outlasted the period of stimulation by several hours, occasionally for days or weeks. Different patterns of the amount and duration of pain relief were observed. Daily stimulation carried out at home by the patient sometimes provided gradually increasing relief over periods of weeks or months. Control experiments, which included two forms of placebo stimulation, showed that brief, intense electrical stimulation is significantly more effective than placebo contributions. Possible neural mechanisms that underlie these patterns of pain relief by brief, intense stimulation are discussed.

400 citations


"Analgesic effect of extracorporeal ..." refers background in this paper

  • ...The shock waves are used to provoke painful levels of stimulation to relieve pain, by so-called hyperstimulation analgesia (Melzack 1975)....

    [...]

Journal ArticleDOI
TL;DR: The treatment of delayed and nonunion of fractures by a single extracorporeal dose of high energy shock waves generated in a water medium and focused on the fracture site is reported.
Abstract: The treatment of delayed and nonunion of fractures by a single extracorporeal dose of high energy shock waves generated in a water medium and focused on the fracture site is reported. The shock waves break up sclerotic bone by producing microfissures and numerous bony fragments because of the difference in impedance between bone (and calculi) and soft tissues. Osteogenesis is stimulated and contributed to union in 70 out of 82 fractures within a reasonable time. Treatment was given as an outpatient with regional anaesthesia; there were no side effects or complications.

316 citations

01 Jan 1992
TL;DR: Guibert, MSc, Assistant Professor, Groupe deRecherche Interdisciplinaire enSanteUniversity of Montreal, P0 Box 6128-Succ. A,Montreal, Quebec,Canada H3C 3J7.M.Fallaha, MD, FRCS C, assistant Professor ofSurgery, UniversityofMontrealMaisonneuve-Rosemont Hospital, 5415 L'Assomption Boulevard, the authors
Abstract: Orthopaedic Service, Sainte-Justine Hospital, 3175 C#{244}teSainte-Catherine, Montreal, Quebec, Canada H3T 1C5.R.Guibert, MD, MSc, Assistant Professor, Department ofFamilyMedicine and Researcher Groupe deRecherche Interdisciplinaire enSanteUniversity ofMontreal, P0 Box 6128-Succ. A,Montreal, Quebec,Canada H3C 3J7.N.Newman, MD, FRCS C,Assistant ProfessorofSurgery, UniversityofMontrealH#{244}tel-Dieu Hospital, 3840 Sainte-Urbain Street, Montreal, Quebec,CanadaH2W lT8.M.Fallaha, MD, FRCS C,Assistant Professor ofSurgery, UniversityofMontrealMaisonneuve-Rosemont Hospital, 5415 L’Assomption Boulevard,

312 citations

Journal ArticleDOI
TL;DR: There was insufficient scientific evidence to support any of the current methods of treatment for lateral epicondylitis of the elbow, and the importance of the natural evolution of the syndrome and of the placebo effect of all treatments was established.
Abstract: We have reviewed 185 articles published since 1966 to assess the scientific evidence for methods of treatment for lateral epicondylitis of the elbow. Of the 185 articles, 78 discussed treatment, but since the natural history of the syndrome is uncertain we considered only those series with concurrent control groups. Only 18 of these were randomised and controlled studies. We then graded these papers for scientific validity, using the methods of Chalmers et al (1981). The mean score of the 18 articles was only 33%, with a range from 6% to 73%. A minimum of 70% is required for a valid clinical trial, and we therefore concluded that there was insufficient scientific evidence to support any of the current methods of treatment. There were too many methodological differences to allow a quantitative meta-analysis, but our qualitative review established the importance of the natural evolution of the syndrome and of the placebo effect of all treatments. Properly designed, controlled trials are needed.

295 citations


"Analgesic effect of extracorporeal ..." refers methods in this paper

  • ...The best method of treatment has not been established (Labelle et al 1992) and both conservative (Mucha and Wannske 1989; Haker and Lundeberg 1991) and operative regimes (Wittenberg, Schaal and Muhr 1992; Verhaar et al 1993) have been advocated....

    [...]