Comparison of extracorporeal shock wave therapy (eswt) in acute and chronic lateral epicondylitis

Abstract

Objective: The aim of this study is to evaluate and compare the results of extracorporeal shock wave therapy (ESWT) application in the treatment of acute (<3 months) lateral epicondylitis (LE) and chronic (>6 months) LE groups.
Methods: Fifty-four patients who were diagnosed with LE and treated with BTL-5000 SWT Power (BTL Türkiye Medikal Cihazlar, Ankara, Turkey) ESWT were included in the study. Twenty-four patients who had symptoms for <3 months were defined as the acute LE group (Group A), and 30 patients who had symptoms for >6 months were defined as the chronic LE group (Group B). All cases were evaluated pretherapy and at Weeks 2, 12, and 24 posttherapy according to pain while resting, pain while stretching, pain when pressed, pain while lifting chair, pain while working, nighttime pain on LE zone.
Results: Almost all values in both Group A and Group B were significantly improved at Weeks 2, 12, and 24 compared to the baseline values.
Conclusion: ESWT is equally effective in the treatment of acute LE and chronic LE. In addition, the current data suggest the progression of LE cases from acute phase to chronic phase may be prevented by treatment with ESWT.

 

Keywords

• Epicondylitis; extracorporeal shock wave threapy; tennis elbow.

Akut ve kronik lateral epikondilitte ekstrakorporeal şok dalga tedavisinin karşılaştırılması

Öz

Özet

Arka plan: Ekstrakorporeal şok dalga tedavisinin (EŞDT) kronik kalıcı lateral epikondilitin (LE) tedavisindeki etkinliği çeşitli çalışmalarda gösterilmiştir.

Amaç: Bu çalışmanın amacı akut (3 aydan az süren) ve kronik kalıcı (6 aydan fazla süren) LE gruplarına uygulanan EŞDT’nin sonuçlarını değerlendirmek ve karşılaştırmaktı.

Çalışma Planı: Çalışmaya LE tanısı alan ve BTL-5000 tipi şok ekstrakorporeal şok dalga tedavisi uygulanan 54 hasta katıldı. Semptomları 3 aydan az bir süredir devam eden 24 hasta akut LE grubu (Grup A), 6 aydan daha fazla süren 30 hasta ise kronik LE grubu (Grup B) olarak sınıflandırıldı. Tüm olguların tedavi öncesi ve 2., 12. ve 24. haftalarda muayeneleri yapılarak sandalye kaldırırken, çalışma sırasında ve LE bölgesine bası uygulandığında hissettikleri ağrı değerlendirildi.

Bulgular: Grup A ve Grup B’nin 2.,  12. ve 24. haftalardaki değerlerinin neredeyse tamamının başlangıç değerlerine göre geliştiği gözlendi.

Çıkarımlar: Ekstrakorporeal şok dalga tedavisinin kronik LE’de olduğu kadar akut lateral LE’nin tedavisinde de etkili olduğunu gördük. Buna ek olarak, mevcut verilere göre, akut evrede bulunan LE hastalarının kronik evreye geçişinin uygulanacak EŞDT ile önlenebileceği düşüncesindeyiz.

Anahtar Kelimeler: Epikondilit, Ekstrakorporeal şok dalga tedavisi, tenisçi dirseği

 

 

Anahtar Kelimeler

• -

Kaynakça

1. Allander E. Prevalence, incidence, and remission rates of some common rheumatic diseases or syndromes. Scand J Rheumatol 1974;3:145–53.
2. Behrens SB, Deren ME, Matson AP, Bruce B, Green A. A review of modern management of lateral epicondylitis. Phys Sportsmed 2012;40:34–40.
3. Böddeker I, Haake M. Extracorporeal shockwave therapy in treatment of epicondylitis humeri radialis. A current overview. [Article in German] Orthopade 2000;29:463– 9. [Abstract]
4. Buchbinder R, Green SE, Youd JM, Assendelft WJ, Barn- sley L, Smidt N. Shock wave therapy for lateral elbow pain. Cochrane Database Syst Rev 2005;4:CD003524.
5. Bisset L, Paungmali A, Vicenzino B, Beller E. A system- atic review and meta-analysis of clinical trials on physical interventions for lateral epicondylalgia. Br J Sports Med 2005;39:411–22.
6. McCallum SD, Paoloni JA, Murrell GA. Five-year pro- spective comparison study of topical glyceryl trinitrate treatment of chronic lateral epicondylosis at the elbow. Br J Sports Med 2011;45:416–20.
7. Paoloni JA, Appleyard RC, Murrell GA. The Orthopaedic Research Institute-Tennis Elbow Testing System: A mod- ified chair pick-up test-interrater and intrarater reliability testing and validity for monitoring lateral epicondylosis. J Shoulder Elbow Surg 2004;13:72–7.
8. Smidt N, van der Windt DA, Assendelft WJ, Devillé WL, Korthals-de Bos IB, Bouter LM. Corticosteroid injections, physiotherapy, or a wait-and-see policy for lat- eral epicondylitis: a randomised controlled trial. Lancet 2002;359:657–62.

9. Struijs PA, Smidt N, Arola H, Dijk CN, Buchbinder R, Assendelft WJ. Orthotic devices for the treatment of tennis elbow. Cochrane Database Syst Rev 2002;1:CD001821.
10. Crowther MA, Bannister GC, Huma H, Rooker GD. A prospective, randomised study to compare extracorporeal shock-wave therapy and injection of steroid for the treat- ment of tennis elbow. J Bone Joint Surg Br 2002;84:678– 9.
11. Green S, Buchbinder R, Barnsley L, Hall S, White M, Smidt N, et al. Non-steroidal anti-inflammatory drugs (NSAIDs) for treating lateral elbow pain in adults. Co- chrane Database Syst Rev 2002;2:CD003686.
12. Ko JY, Chen HS, Chen LM. Treatment of lateral epicon- dylitis of the elbow with shock waves. Clin Orthop Relat Res 2001;387:60–7.
13. Rasmussen S, Christensen M, Mathiesen I, Simonson O. Shockwave therapy for chronic Achilles tendinopathy: a double-blind, randomized clinical trial of efficacy. Acta Orthop 2008;79:249–56.
14. Furia JP. High-energy extracorporeal shock wave therapy as a treatment for insertional Achilles tendinopathy. Am J Sports Med 2006;34:733–40.
15. Chung B, Wiley JP. Effectiveness of extracorporeal shock wave therapy in the treatment of previously untreated lateral epicondylitis: a randomized controlled trial. Am J Sports Med 2004;32:1660–7.
16. Chung B, Wiley JP, Rose MS. Long-term effectiveness of extracorporeal shockwave therapy in the treatment of pre- viously untreated lateral epicondylitis. Clin J Sport Med 2005;15:305–12.
17. Haake M, König IR, Decker T, Riedel C, Buch M, Müller HH; Extracorporeal Shock Wave Therapy Clinical Trial Group. Extracorporeal shock wave therapy in the treat- ment of lateral epicondylitis : a randomized multicenter trial. J Bone Joint Surg Am 2002;84–A:1982–91.
18. Rompe JD, Hope C, Küllmer K, Heine J, Bürger R. Anal- gesic effect of extracorporeal shock-wave therapy on chron- ic tennis elbow. J Bone Joint Surg Br 1996;78:233–7.
19. Ozturan KE, Yucel I, Cakici H, Guven M, Sungur I. Au- tologous blood and corticosteroid injection and extracopo- real shock wave therapy in the treatment of lateral epicon- dylitis. Orthopedics 2010;33:84–91.