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This Article Full Text Full Text (PDF) All Versions of this Article: 32/3/734    most recent 0363546503261697v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Request Reprints Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (20) Citing Articles via Google Scholar Google Scholar Articles by Rompe, J. D. Articles by Theis, C. Search for Related Content PubMed PubMed Citation Articles by Rompe, J. D. Articles by Theis, C. Related Collections Elbow Tennis Nonoperative

Repetitive Low-Energy Shock Wave Treatment for Chronic Lateral Epicondylitis in Tennis Players

From the Department of Orthopaedic Surgery, Johannes Gutenberg University School of Medicine, Mainz, Germany

^* Address correspondence to Jan D. Rompe, MD, Professor, Department of Orthopaedic Surgery, Johannes Gutenberg University School of Medicine, Langenbeckstrasse 1, D-55101 Mainz, Germany (e-mail: rompe{at}mail.uni-mainz.de).

Background: There is conflicting evidence regarding extracorporeal shock wave treatment for chronic tennis elbow.

Hypothesis: Treatment with repetitive low-energy extracorporeal shock wave treatment is superior to repetitive placebo extra-corporeal shock wave treatment.

Methods: Seventy-eight patients enrolled in a placebo-controlled trial. All patients were tennis players with recalcitrant MRI-confirmed tennis elbow of at least 12 months’ duration. Patients were randomly assigned to receive either active low-energy extracorporeal shock wave treatment given weekly for 3 weeks (treatment group 1) or an identical placebo extracorporeal shock wave treatment (sham group 2). Main outcome measure was pain during resisted wrist extension at 3 months; secondary measures were >50% reduction of pain and the Upper Extremity Function Scale.

Results: At 3 months, there was a significantly higher improvement in pain during resisted wrist extension in group 1 than in group 2 (mean [SD] improvement, 3.5 [2.0] and 2.0 [1.9]; P = .001 for between-group difference of improvement) and in the Upper Extremity Function Scale (mean [SD] improvement, 23.4 [14.8] and 10.9 [14.9]; P < .001 for between-group difference of improvement). In the treatment group, 65% of patients achieved at least a 50% reduction of pain, compared with 28% of patients in the sham group (P = .001 for between-group difference).

Conclusion: Low-energy extracorporeal shock wave treatment as applied is superior to sham treatment for tennis elbow.

Key Words: tennis elbow • shock wave treatment • ESWT • placebo-controlled trial

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