Shock wave therapy ineffective for tennis elbow

By Will Boggs, MD

NEW YORK (Reuters Health) - Shock wave therapy is not effective for treating tennis elbow, researchers warn. "There is currently no place for shock wave therapy in the management of (tennis elbow)," Dr. Rachelle Buchbinder from Monash University, Melbourne, Australia, told Reuters Health.

Tennis elbow is an overuse injury to tendons around the outer side of the elbow. As the name implies, it often arises in racquet-sport enthusiasts, but can also result from other repetitive arm motions, such as using a screwdriver, hammering or painting.

While tennis elbow generally improves on its own, it may persist in a small percentage of people. So-called extracorporeal shock wave therapy (ESWT) has been tried for tennis elbow, in which shock waves are focused on the problem area. ESWT is believed to work by causing microscopic injuries to the affected tissue that stimulate the healing process.

However, "high-quality" evidence for the benefits of ESWT for tennis elbow is lacking.

Buchbinder and colleagues investigated whether three ultrasound-guided ESWT sessions given at weekly intervals reduced pain and improved function in 68 patients with tennis elbow.

Patients treated with ESWT and "control" patients who were given a "sub therapeutic" dose of shock wave therapy experienced similar improvements in pain and function at 6 months, the investigators found.

In fact, there were no differences between the groups in any outcome measure at the 6-week and 6-month follow-up visits.

""Our study found little evidence to support the use of ESWT for the treatment of (tennis elbow), Buchbinder and colleagues conclude in a report of the study published in the Journal of Rheumatology this month.

"The evidence from high quality trials with low risk of bias and high quality systematic reviews have yet to find that shock wave therapy is of value," Buchbinder added in comments to Reuters Health.

SOURCE: Journal of Rheumatology, October 2008.