Ann Rehabil Med.  2012 Oct;36(5):681-687.

Effectiveness of Initial Extracorporeal Shock Wave Therapy on the Newly Diagnosed Lateral or Medial Epicondylitis

• Lee SS
• Kang S
• Park NK
• Lee CW
• Song HS
• Sohn MK
• Cho KH
• Kim JH

Abstract

OBJECTIVE
To evaluate the effectiveness of initial extracorporeal shock wave therapy (ESWT) for patients newly diagnosed with lateral or medial epicondylitis, compared to local steroid injection. METHOD: An analysis was conducted of twenty-two patients who were newly confirmed as lateral or medial epicondylitis through medical history and physical examination. The ESWT group (n=12) was treated once a week for 3 weeks using low energy (0.06-0.12 mJ/mm2, 2,000 shocks), while the local steroid injection group (n=10) was treated once with triamcinolone 10 mg mixed with 1% lidocaine solution. Nirschl score and 100 point score were assessed before and after the treatments of 1st, 2nd, 4th and 8th week. And Roles and Maudsley score was assessed one and eight weeks after the treatments.
RESULTS
Both groups showed significant improvement in Nirschl score and 100 point score during the entire period. The local steroid injection group improved more in Nirschl score at the first week and in 100 point score at the first 2 weeks, compared to those of the ESWT group. But the proportion of excellent and good grades of Roles and Maudsley score in the ESWT group increased more than that of local steroid injection group by the final 8th week.
CONCLUSION
The ESWT group improved as much as the local steroid injection group as treatment for medial and lateral epicondylitis. Therefore, ESWT can be a useful treatment option in patients for whom local steroid injection is difficult.

Keyword

Extracorporeal shock wave therapy (ESWT); Local steroid injection; Lateral epicondylitis; Medial epicondylitis

MeSH Terms

Humans
Lidocaine
Physical Examination
Shock
Triamcinolone
Lidocaine
Triamcinolone

Figure

• 

  Fig. 1 Nirschl score compared to before treatment and 1-, 2-, 4- and 8-week follow-up. This figure shows significant improvement of both ESWT and local steroid injection group in Nirschlscore during the entire period. Only, local steroid injection group was more effective at the first week. The two way repeated measures ANOVA showed a significant group×time interaction (*p<0.05) and a significant effect of two groups at the first week (†p<0.05). ESWT: Extracorporeal shock wave therapy.

• 

  Fig. 2 100 point score compared to before treatment and 1-, 2-, 4- and 8-week follow-up. This figure shows significant improvement of both ESWT and local steroid injection group in 100 point score during the entire period. The local steroid injection group was more effective at the first 2 weeks. The two way repeated measures ANOVA showed a significant group×time interaction (*p<0.05) and a significant effect of two groups at the first 2 weeks (†p<0.05). ESWT: Extracorporeal shock wave therapy.

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