Introduction: Lateral epicondylitis, or “tennis elbow”, is a relatively common disorder.Various therapeutic modalities have been tried in an attempt to manage the disorder butneither the conservative methods nor the surgical options have proved to be benefi cial sofar. During the past decade in the USA and European countries and the past several yearsin Bulgaria, the shock wave therapy (focused and radial) has been introduced as a methodof choice in the treatment of chronic tendynopathies.
The AIM of the present study was to make quantitative assessment of the effect of radialshockwave therapy in patients with lateral epicondylitis.
PATIENTS AND METHODS: The study included 16 patients with lateral epicondylitis (9 males,7 females, mean age 47.2 ± 2.3 yrs) of mean duration of 15.06 ± 4.06 months. We usedthe BTL-5000 radial shockwave therapy equipment and performed 5 procedures (one perweek). The total number of shocks was 2500, the pressure was 2 Bars: 1500 shocks of 5 Hzfrequency followed by 500 shocks of 10 Hz frequency were applied locally on the lateralepicondyle and 500 shocks of 2 Bar pressure and 5 Hz frequency were applied along themuscles near the insertion. The patients were evaluated 5 times: before treatment, immediatelyafter the end of treatment and at 3, 6 and 12 months of follow-up. Pain was assessedat rest, on palpation and by the Thomsen test using a visual analogue scale (VAS).The patient-rated tennis elbow evaluation (PRTEE) questionnaire was used to assess thepatients‘ pain, functional condition and limitations in performing specifi c activities, as wellas for the overall self evaluation.
RESULTS: We found signifi cant difference (p < 0.05) between the mean pain scores (at rest,on palpation and by Thomsen test) before treatment and these scores obtained immediatelyafter treatment, the decrease sustained at 3, 6 and 12 months. VAS showed decrease from3.75 ± 0.49 before therapy to 2.44 ± 0.39 after treatment, to 1.94 ± 0.46 at 3 months and to0.69 ± 0.38 at one year at rest, from 7.44 ± 0.38 before therapy to 4.69 ± 0.51 after treatment,to 3.56 ± 0.40 at 3 months and 1.46 ± 0.56 at one year at palpation, and from 5.87 ±0.46 before therapy to 3.5 ± 0.29 after it, to 2.5 ± 0.40 at 3 months and 1 ± 0.38 at one yearin the Thomsen test.
The pain, function and the total score as assessed on the patient-rated scale (PRTEE) alsoshowed statistically signifi cant improvement (p < 0.05) after completion of therapy andover the whole follow-up. Total score decreased from 56.75 ± 2.34 before therapy to 39.38 ±3.96 after treatment, to 27.53 ± 3.7 at 3 months and to 13.69 ± 4.48 at one year.
CONCLUSION: Based on the results of this preliminary study we could recommend the radialshock wave therapy in the treatment of lateral epicondylitis of more than 6 months‘ durationif the condition is recalcitrant to other conservative methods of treatment.
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