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Sports Medicine
Published in: Sports Medicine 13/2002

01-11-2002 | Review Article

Extracorporeal Shockwave Therapy

A Review

Authors: Bryan Chung, J. Preston Wiley

Published in: Sports Medicine | Issue 13/2002

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Abstract

Extracorporeal shockwave therapy (ESWT) has been in use for the treatment of tendinopathies since the early 1990s. The exact mechanism by which ESWT relieves tendon-associated pain is not known; however, there is an increasing body of literature that suggests that it can be an effective therapy for patients who have had repeated nonsurgical treatment failures. The highest strength of evidence is shown in randomised controlled trials, of which there are a small number. Reported results for tendinopathies of the shoulder, elbow and heel have shown consistent positive results in favour of ESWT over placebo ESWT in individuals who have failed conservative therapy. These studies provide strong evidence for ESWT as an effective therapy for the treatment of chronic treatment-resistant tendinopathies. There is still much debate over several issues surrounding ESWT that have not been adequately addressed by the literature: high- versus low-energy ESWT, shockwave dosage and number of sessions required for a therapeutic effect. Further research is needed to ascertain the most beneficial protocol for patient care.
Literature
1.
Thiel M. Application of shock waves in medicine. Clin Orthop 2001 Jun; (387): 18–21
2.
Haupt G. Use of extracorporeal shock waves in the treatment of pseudarthrosis, tendinopathy and other orthopedic diseases. J Urol 1997; 158: 4–11PubMedCrossRef
3.
Odgen JA, Tóth-Kischkat A, Schultheiss R. Principles of shock wave therapy. Clin Orthop 2001 Jun; (387): 8–17
4.
Delius M. Medical applications and bioeffects of extracorporeal shock waves. Shock Waves 1994; 4: 55–72CrossRef
5.
Rompe JD, Kirkpatrick CJ, Küllmer K, et al. Dose-related effects of shock waves on rabbit tendo Achillis. J Bone Joint Surg Br 1998 May; 80 (3): 546–52PubMedCrossRef
6.
7.
Ogden JA, Alvarez RA, Levitt R, et al. Shock wave therapy for chronic proximal plantar fasciitis. Clin Orthop 2001 Jun; (387): 47–59
8.
Loew M, Jurgowski W, Mau HC, et al. Treatment of calcifying tendinitis of rotator cuff by extracorporeal shock waves: a preliminary report. J Shoulder Elbow Surg 1995 Mar/Apr; 4 (2):101–6PubMedCrossRef
9.
Sistermann R, Katthagen BD. Complications, side-effects and contraindications in the use of medium and high-energy extracorporeal shock waves in orthopedics [in German]. Z Orthop Ihre Grenzgeb 1998; 136 (2): 175–81PubMedCrossRef
10.
European Society for Musculoskeletal Shockwave Therapy. Guideline recommendation for the standardization of ESWT as a substitution of surgery in the field of orthopaedic medicine. International Society of Musculoskeletal Shockwave Therapy [online]. Available from URL: http://​www.​ismst.​com/​quality_​standards.​htm [Accessed 2001 Aug 8]
11.
Price DD, McGrath PA, Rafil A, et al. The validation of visual analogue scale measures for chronic and experimental pain. Pain 1983; 17: 45–56PubMedCrossRef
12.
Myles PS, Troedel S, Boquest M, et al. The pain visual analog scale: is it linear or nonlinear? Anesth Analg 1999; 89: 1517–20PubMed
13.
Dexter F, Chestnut DH. Analysis of statistical tests to compare visual analog scale measurements among groups. Anesthesiology 1995; 82 (4): 896–902PubMedCrossRef
14.
Todd KH. Clinical versus statistical significance in the assessment of pain relief. Ann Emerg Med 1996; 27 (4): 439–41PubMedCrossRef
15.
Wewers ME, Lowe NK. A critical review of visual analogue scales in measurement of clinical phenomena. Res Nurs Health 1990; 13: 227–36PubMedCrossRef
16.
McCormack HM, Horne DJ, Sheather S. Clinical applications of visual analogue scales: a critical review. Psychol Med 1988; 18: 1007–19PubMedCrossRef
17.
Constant CR, Murley AH. A clinical method of functional assessment of the shoulder. Clin Orthop 1987; 214: 160–4PubMed
18.
Kay SP, Amstutz HC. Shoulder hemiarthroplasty at UCLA. Clin Orthop 1988; 228: 42–8PubMed
19.
Rompe J, Zollner J, Eysel P. Surgical treatment versus high-energy extracorporeal shock wave therapy (HESWT) for calcifying tendinitis of the shoulder: a prospective controlled study [abstract]. In: Selected Abstracts from the 2nd Congress of the International Society for Musculoskeletal Shockwave Therapy; 1999 May 27–29; London
8.
Loew M, Jurgowski W, Mau HC, et al. Treatment of calcifying tendinitis of rotator cuff by extracorporeal shock waves: a preliminary report. J Shoulder Elbow Surg 1995 Mar/Apr; 4 (2):101–6PubMedCrossRef
21.
Spindler A, Berman A, Lucero E, et al. Extracorporeal shock wave treatment for chronic calcific tendinitis of the shoulder. J Rheumatol 1998; 25 (6): 1161–3PubMed
22.
Rompe JD, Zollner J, Nafe B, et al. Significance of calcium deposit elimination in tendinosis calcarea of the shoulder [in German]. Z Orthop Ihre Grenzgeb 2000; 138 (4): 335–9PubMedCrossRef
23.
Roles NC, Maudsley RH. Radial tunnel syndrome. J Bone Joint Surg Br 1972; 54 (3): 499–508PubMed
24.
Krischek O, Hopf C, Nafe B, et al. Shock-wave therapy for tennis and golfer’s elbow: 1 year follow-up. Arch Orthop Trauma Surg 1999; 119: 62–6PubMedCrossRef
25.
Melikyan EY, Shahlin E, Wundram K, et al. Prospective randomized double blinded study of extracorporeal shock wave therapy versus placebo for intractable tennis elbow[abstract]. In: Selected Abstracts from the 4th Congress of the International Society for Musculoskeletal Shockwave Therapy; 2001 May 24–26; Berlin
26.
Hudak PL, Amadio PC, Bombardier C, on behalf of the Upper Extremity Collaborative Group. Development of an upper extremity outcome measure: the DASH (Disabilities of the Arm, Shoulder and Hand). Am J Ind Med 1996; 29: 602–8PubMedCrossRef
27.
Navsarikar A, Gladman DD, Husted JA, et al. Validity assessment of the disabilities of arm, shoulder and hand questionnaire (DASH) for patients with psoriatic arthritis. J Rheumatol 1999 Oct; 26 (10): 2191–4PubMed
28.
Verhaar J, Walenkamp G, Kester A, et al. Lateral extensor release for tennis elbow: a prospective long-term follow-up study. J Bone Joint Surg Am 1993; 75: 1034–43PubMed
29.
Haake M, Rautmann M, Wirth T. Extracorporeal shock wave therapy vs surgical treatment in calcifying tendinitis and noncalcifying tendinitis of the supraspinatus muscle. Eur J Orthop Surg Traumatol 2001; 11: 21–4CrossRef
30.
Haake M, Rautmann M, Wirth T. Assessment of the treatment costs of extracorporeal shock wave therapy versus surgical treatment for shoulder diseases. Int J Technol Assess Health Care 2001; 17 (4): 612–7PubMed
31.
Riedel C, Betz U, Rompe JD, et al. Treatment of chronic tennis elbow with low-energy shockwave therapy and cervical spine manual therapy [abstract]. In: Selected Abstracts from the 2nd Congress of the International Society for Musculoskeletal Shockwave Therapy; 1999 May 27–29; London
32.
Wang CJ, Chen HS, ChenWS, et al. Treatment of painful heels using extracorporeal shock wave. J Formos Med Assoc 2000; 99 (7): 580–3PubMed
33.
Hearnden A, Flannery MC. A prospective, blinded randomized control trial assessing the use of different energy extracorporeal shock wave therapy for calcifying tendinitis [abstract]. In: Selected Abstracts from the 3rd Congress of the International Society for Musculoskeletal Shockwave Therapy; 2000 Jun 1–3; Naples
34.
Crowther MAA. A prospective randomized study comparing shockwave therapy and steroid injection in the treatment of tennis elbow [abstract]. In: Selected Abstracts from the 3rd Congress of the International Society for Musculoskeletal Shockwave Therapy; 2000 Jun 1–3; Naples
35.
Haake M, Böddeker R, Decker T, et al. Extracorporeal shock wave therapy (ESWT) in the treatment of tennis elbow: a prospective randomized placebo-controlled multicentre trial [abstract]. In: Selected Abstracts from the 4th Congress of the International Society for Musculoskeletal Shockwave Therapy; 2001 May 24–26; Berlin
36.
Vara FJ, Garzon N, Ortega E, et al. Treatment of the patellar tendinitis with local aplication of extracorporeal shock wave [abstract]. In: Selected Abstracts from the 3rd Congress of the International Society for Musculoskeletal Shockwave Therapy; 2000 Jun 1–3; Naples
37.
Abt T, Leier TU, Mellerowicz H. Shockwave therapy for painful heel spur: results of a prospective randomized double blind study measuring plantar heel pressure with a Novel Emed AT-4 pedograph system. [abstract]. In: Selected Abstracts from the 4th Congress of the International Society for Musculoskeletal Shockwave Therapy; 2001 May 24–26; Berlin
38.
Buch M, Fleming L, Theodore G, et al. Prospective randomized placebo controlled double blind multicenter study to evaluate safety and efficacy of extracorporeal shockwave therapy (ESWT) in chronic plantar fasciitis [abstract]. In: Selected Abstracts from the 4th Congress of the International Society for Musculoskeletal Shockwave Therapy; 2001 May 24–26; Berlin
39.
Loew M, Jurgowski W. Initial experiences with extracorporeal shockwave lithotripsy (ESWL) in treatment of tendinosis calcarea of the shoulder [in German]. Z Orthop Ihre Grenzgeb 1993; 131 (5): 470–3PubMedCrossRef
40.
Loew M, Jurgowski W, Thomsen M. Effect of extracorporeal shockwave therapy on tendinosis calcarea of the shoulder: a preliminary report [in German]. Urologe A 1995 Jan; 34 (1): 49–53PubMed
41.
Krischek O, Rompe JD, Herbsthofer B, et al. Symptomatic low energy shockwave therapy in heel pain and radiologically detected plantar heel spur [in German]. Z Orthop Ihre Grenzgeb 1998; 136 (2): 169–74PubMedCrossRef
42.
Maier M, Stäbler A, Lienemann A, et al. Shockwave application in calcifying tendinitis of the shoulder: prediction of outcome by imaging. Arch Orthop Trauma Surg 2000; 120: 493–8PubMedCrossRef
43.
Loew M, Daecke W, Kusnierczak D, et al. Shock-wave therapy is effective for chronic calcifying tendinitis of the shoulder. J Bone Joint Surg Br 1999; 81 (5): 863–7PubMedCrossRef
44.
Wang CJ, Ko JY, Chen HS. Treatment of calcifying tendinitis of the shoulder with shock wave therapy. Clin Orthop 2001; 387: 83–9PubMedCrossRef
45.
Rompe JD, Zollner J, Nafe B. Shock wave therapy versus conventional surgery in the treatment of calcifying tendinitis of the shoulder. Clin Orthop 2001; 387: 72–82PubMedCrossRef
46.
Jakobeit C, Winiarski B, Jakobeit S, et al. Ultrasound-guided, high-energy extracorporeal shock-wave treatment of symptomatic calcareous tendinopathy of the shoulder. ANZ J Surg 2002; 72 (7): 496–500PubMedCrossRef
47.
Richter D, Ekkernkamp A, Muhr G. Extracorporeal shock wave therapy: an alternative concept for the treatment of epicondylitis of the humerus and radius? [in German]. Orthopade 1995 Jun; 24 (3): 303–6PubMed
48.
Rompe JD, Hopf C, Küllmer K, et al. Extracorporeal shockwave therapy of radiohumeral epicondylopathy: an alternative treatment concept [in German]. Z Orthop Ihre Grenzgeb 1996 Jan; 134 (1): 63–6PubMedCrossRef
49.
Krischek O, Rompe JD, Hopf C, et al. Extracorporeal shockwave therapy in epicondylitis humeri ulnaris or radialis: a prospective, controlled, comparative study [in German]. Z Orthop Ihre Grenzgeb 1998 Jan/Feb; 136 (1): 3–7PubMedCrossRef
50.
Hammer DS, Rupp S, Ensslin S, et al. Extracorporeal shock wave therapy in patients with tennis elbow and painful heel. Arch Orthop Trauma Surg 2000; 120: 304–7PubMedCrossRef
51.
Ko JY, Chen HS, Chen LM. Treatment of lateral epicondylitis of the elbow with shock waves. Clin Orthop 2001; 387: 60–7PubMedCrossRef
52.
Rompe JD, Riedel C, Beta U, et al. Chronic lateral epicondylitis of the elbow: a prospective study of low-energy shockwave therapy and low-energy shockwave therapy plus manual therapy. Arch Phys Med Rehabil 2001; 82: 578–82PubMedCrossRef
53.
Maier M, Steinborn M, Schmitz C, et al. Extracorporeal shockwave therapy for chronic lateral tennis elbow: prediction of outcome by imaging. Arch Orthop Trauma Surg 2001; 121: 379–84PubMedCrossRef
54.
Perlick L, Boxberg W, Giebel G. High energy shock wave treatment of the painful heel spur [in German]. Unfallchirurg 1998; 101 (12): 914–8PubMedCrossRef
55.
Maier M, Steinborn M, Schmitz C, et al. Extracorporeal shock wave application for chronic plantar fasciitis associated with heel spurs: prediction of outcome by magnetic resonance imaging. J Rheumatol 2000 Oct; 27 (10): 2455–62PubMed
56.
Maier M, Durr HR, Kohler S, et al. Analgesic effect of low energy extracorporeal shock waves in tendinosis calcarea, epicondylitis humeri radialis and plantar fasciitis [in German]. Z Orthop Ihre Grenzgeb 2000 Mar-Apr; 138 (1): 34–8PubMedCrossRef
57.
Chen HS, Chen LM, Huang TW. Treatment of painful heel syndrome with shock waves. Clin Orthop 2001; 387: 41–6PubMedCrossRef
58.
Weil Jr LS, Roukis TS, Wel Sr LS, et al. Extracorporeal shock wave therapy for the treatment of chronic plantar fasciitis: indications, protocol, intermediated results and a comparison of results to fasciotomy. J Foot Ankle Surg 2002; 41(3): 166–72PubMedCrossRef
59.
Rompe JD, Bürger R, Hopf C, et al. Shoulder function after extracorporeal shock wave therapy for calcific tendinitis. J Shoulder Elbow Surg 1998 Sept/Oct; 7 (5): 505–9PubMedCrossRef
60.
Seil R, Rupp S, Hammer DS, et al. Extracorporeal shockwave therapy in tendinosis calcarea of the rotator cuff: comparison of different treatment protocols [in German]. Z Orthop Ihre Grenzgeb 1999; 137 (4): 310–5PubMedCrossRef
61.
Schmitt J, Haake M, Tosch A, et al. Low-energy extracorporeal shock-wave treatment (ESWT) for tendinitis of the supraspinatus. J Bone Joint Surg Br 2001; 83 (6): 873–6PubMedCrossRef
62.
Haake M, Sattler A, Gross MW, et al. Comparison of extracorporeal shock wave therapy with radiotherapy for supraspinatus tendinitis: randomised prospective single-blind trial with two-sample parallel group design [in German]. Z Orthop 2001; 139: 397–402 PubMedCrossRef
63.
Haake M, Deike B, Thon A, et al. Exact focusing of extracorporeal shock wave therapy for calcifying tendinopathy. Clin Orthop 2002; 397: 323–31PubMedCrossRef
64.
Rompe JD, Hopf C, Küllmer K, et al. Analgesic effect of extracorporeal shock-wave therapy on chronic tennis elbow. J Bone Joint Surg Br 1996; 78 (2): 233–7PubMed
65.
Rompe JD, Küllmer K, Riehle HM, et al. Effectiveness of low energy extracorporeal shock waves for chronic plantar fasciitis. Foot Ankle Int 1996; 2: 215–21CrossRef
66.
Rompe JD, Hopf C, Nafe B, et al. Low-energy extracorporeal shock wave therapy for painful heel: a prospective controlled single-blind study. Arch Orthop Trauma Surg 1996; 115: 75–9PubMedCrossRef
67.
Rompe JD, Schoellner C, Nafe B. Evaluation of low-energy extracorporeal shock-wave application for treatment of chronic plantar fasciitis. J Bone Joint Surg Am 2002; 84 (3): 335–41PubMedCrossRef
68.
Buchbinder R, Ptasznik R, Gordon J, et al. Ultrasound-guided extracorporeal shock wave therapy for plantar fasciitis. JAMA 2002; 288 (11): 1364–72PubMedCrossRef
69.
Gerdesmeyer L, Garve R, Gradinger R. The relationship of clinical outcome of lateral epicondylitis after ESWT and number of treatments [abstract]. In: Selected Abstracts from the 4th Congress of the International Society for Musculoskeletal Shockwave Therapy; 2001 May 24–26; Berlin
Metadata
Title
Extracorporeal Shockwave Therapy
A Review
Authors
Bryan Chung
J. Preston Wiley
Publication date
01-11-2002
Publisher
Springer International Publishing
Published in
Sports Medicine / Issue 13/2002
Print ISSN: 0112-1642
Electronic ISSN: 1179-2035
DOI
https://doi.org/10.2165/00007256-200232130-00004

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