Extra-Corporeal Shock Wave Treatment (ESWT) for Tennis Elbow

EFFECTIVENESS: 2/5

Studies are conflicting, and many guidelines list it as “not recommended.” Some recent studies show it is helpful for up to 80 % of patients treated. Overall, there appears to be a trend favoring this treatment but studies are still conflicting.

Sources:

Speed C. A systematic review of shockwave therapies in soft tissue conditions: focusing on the evidence. Br J Sports Med. 2014 Nov; 48(21):1538-42.

Schmitz C, Császár NBM, Milz S, et al. Efficacy and safety of extracorporeal shock wave therapy for orthopedic conditions: a systematic review on studies listed in the PEDro database. British Medical Bulletin. 2015;116(1):115-138. doi:10.1093/bmb/ldv047.

Sims SE, Miller K, Elfar JC, Hammert WC. Non-surgical treatment of lateral epicondylitis: a systematic review of randomized controlled trials. Hand (N Y). 2014 Dec; 9(4):419-46.

SELF CARE: 0/5  

You can’t do this on your own.

COST: 2/5

Online costs quotes range from $1000-2000 for one treatment. Pretty expensive, but less expensive than surgery.

Sources:

Stasinopoulos D, Johnson MI. The effectiveness of extracorporeal shock wave therapy for tennis elbow (lateral epicondylitis). British Journal of Sports Medicine 2005;39:132-136.

http://www.cochrane.org/CD003524/MUSKEL_shock-wave-therapy-for-elbow-pain

USEFULNESS (overall rating): 2/5

This treatment uses pulses of energy (shock waves) to produce a mechanical force at the area of injury which would hopefully stimulate healing in damaged tissues. Many clinicians have held out ESWT as a safe alternative to more invasive procedures such as surgery.

It is generally considered “safe and effective” but it does have negative side effects, and its overall effectiveness has not been established. ESWT side effects typically are mild, usually including soreness at the application site, redness or bruising, though some patients describe the procedure as quite painful. Studies on the effectiveness of ESWT have been conflicting. Some has shown some benefit, while others have shown it is no better than placebo. Given its relatively low risk, it may be worth a try if all other methods fail.