Side-effects of extracorporeal shock wave therapy (ESWT) in the treatment of tennis elbow.
Apart from a few observational reports, there are no studies on the side-effects of extracorporeal shock wave therapy (ESWT) in the treatment of insertion tendopathies. Within the framework of a randomised, placebo-controlled, single-blind, multicentre study to test the effectiveness of ESWT in the case of lateral epicondylitis (LE), side-effects were systematically recorded. A total of 272 patients from 15 centres was allocated at random to active ESWT (3 x 2000 pulses, energy flux density ED(+) 0.04 to 0.22 mJ/mm(2) under local anaesthesia) or placebo ESWT. In all, 399 ESWT and 402 placebo treatments were analysed. More side-effects were documented in the ESWT group (OR = 4.3, CI = [2.9; 6.3]) than in the placebo group. Most frequently, transitory reddening of the skin (21.1%), pain (4.8%) and small haematomas (3.0%) were found. Migraine was registered in four and syncopes in three instances after ESWT. ESWT for LE with an energy flux density of ED(+) 0.04 to 0.22 mJ/mm(2) is a treatment method which has very few side-effects. The possibility of migraine being triggered by ESWT and the risk of a syncope should be taken into account in the future. No physical shock wave parameters could be definitely identified as the cause of the side-effects observed.
Haake
M
M
Klinik für Orthopädie, Philipps-Universität Marburg, Baldingerstr. 1, 35033 Marburg, Germany. haake2@mailer.uni-marburg.de
Böddeker
I R
IR
Decker
T
T
Buch
M
M
Vogel
M
M
Labek
G
G
Maier
M
M
Loew
M
M
Maier-Boerries
O
O
Fischer
J
J
Betthäuser
A
A
Rehack
H C
HC
Kanovsky
W
W
Müller
I
I
Gerdesmeyer
L
L
Rompe
J D
JD
D000328:Adult; D005260:Female; D006801:Humans; D008096:Lithotripsy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000209:etiology; D016037:Single-Blind Method; D019462:Syncope, Vasovagal / Q000209:etiology; D013716:Tennis Elbow / Q000628:therapy*