Radial shock wave therapy for lateral epicondylitis: a prospective randomised controlled single-blind study

Abstract

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 single-blind 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 2000 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.

Results: Statistical analysis of visual analogue scale (VAS), disabilities of the arm, shoulder, and hand (DASH) questionnaire and pain-free grip strength test scores has shown, both after treatment and to the follow-up at 6 months, significant difference comparing study group versus control group (P <0.001). Statistical analysis within the groups, showed always statistically significant values for the study group. Also the control group showed statistically significant differences for some analyzed parameters. Nevertheless such differences resulted to be more statistics that not clinics as it showed the percentage of satisfied patients in the study group (87% post-treatment; 84% follow-up) in comparison with that of the control group (10% post-treatment; 3% follow-up), and the number needed to treat (NNT) that is of 1.15 at post-treatment and of 1.25 to the 6 months follow-up.

Conclusion: The use of RSWT allowed a decrease of pain, and functional impairment, and an increase of the pain-free grip strength test, in patients with tennis elbow. The RSWT is safe and effective and must be considered as possible therapy for the treatment of patients with tennis elbow.