[Extracorporeal shockwave therapy (ESWT) in epicondylitis humeri radialis. A review of the literature].
This review article evaluates therapeutic procedures and clinical findings of extracorporeal shock wave therapy (ESWT) when used for lateral epicondylitis (LE) based on systematic research of the literature. A total of 20 studies were identified, 2 of which had been carried out as prospective, randomized, and controlled studies; the biometric quality of the remaining is clearly inferior. The inclusion and exclusion criteria used in the studies tallied well. In the more recent literature, important ESWT parameters such as energy used, number of impulses and treatment sessions, and locating methods also tallied in part. The studies reported only occasional side effects that could be evaluated as harmless. When evaluating the clinical success of ESWT, it was stated that about 40-80% of the patients achieved a good or very good result at follow-up examinations after 3-12 months. However, in the single placebo-controlled and blinded study with an independent observer, the same therapy results were achieved in the control group where a local anesthetic was used as in the ESWT group. For this reason, it has been concluded that up to now no clinically relevant efficacy has been proven for the use of ESWT for LE. It should no longer be applied clinically as a matter of course, but only as part of high-quality studies with an adequate control group and blinding of patients and follow-up examiners. Due to the pain incurred when applying ESWT and the risk of uncovering the masking, the blinding of the patients must be checked in each further controlled ESWT study.
Haake
M
M
Klinik für Orthopädie und Rheumatologie, Philipps-Universität, Baldingerstrasse 1, 35033 Marburg. haake2@mailer.uni-marburg.de
Hünerkopf
M
M
Gerdesmeyer
L
L
König
I R
IR
D002986:Clinical Trials as Topic; D006801:Humans; D008096:Lithotripsy; D013716:Tennis Elbow / Q000628:therapy*; D016896:Treatment Outcome