title: Repetitive low-energy shock wave treatment for chronic lateral epicondylitis in tennis players.
abstract: BACKGROUND
  There is conflicting evidence regarding extracorporeal shock wave treatment for chronic tennis elbow.
  
  
  OBJECTIVE
  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).
  
  
  CONCLUSIONS
  Low-energy extracorporeal shock wave treatment as applied is superior to sham treatment for tennis elbow.
authors.affiliation: Department of Orthopaedic Surgery, Johannes Gutenberg University School of Medicine, Mainz, Germany. rompe@mail.uni-mainz.de
authors.forename: Jan D
authors.initials: JD
authors.lastname: Rompe
authors.forename: Jens
authors.initials: J
authors.lastname: Decking
authors.forename: Carsten
authors.initials: C
authors.lastname: Schoellner
authors.forename: Christoph
authors.initials: C
authors.lastname: Theis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D005260:Female; D018737:Hand Strength; D006801:Humans; D008096:Lithotripsy / Q000379:methods*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D013716:Tennis Elbow / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D016896:Treatment Outcome