Shock wave therapy for lateral elbow pain.

Area of Science:

• Orthopedics
• Physical Medicine and Rehabilitation
• Pain Management

Background:

• Lateral elbow pain, commonly known as tennis elbow, affects numerous individuals.
• Interventions for lateral elbow pain are continually being reviewed for efficacy.

Purpose of the Study:

• To evaluate the effectiveness and safety of extracorporeal shock wave therapy (ESWT) for treating lateral elbow pain.
• To compare ESWT with placebo and steroid injections.

Main Methods:

• Systematic review of nine randomized controlled trials (RCTs) involving 1006 participants comparing ESWT to placebo.
• Inclusion of one RCT (93 participants) comparing ESWT to steroid injection.
• Assessment of methodological quality and data extraction by two independent reviewers.
• Pooled analyses performed where appropriate; individual trial results described otherwise.

Main Results:

• Eleven of thirteen pooled analyses showed no significant benefit of ESWT over placebo for pain or function.
• Two pooled analyses favored ESWT, but these findings were not consistently supported by other trials.
• Steroid injection demonstrated greater effectiveness than ESWT at three months post-treatment (84% vs. 60% pain reduction).
• ESWT reported minimal adverse effects, primarily transient pain, skin redness, and nausea.

Conclusions:

• "Platinum" level evidence suggests ESWT provides little to no benefit for pain and function in lateral elbow pain.
• "Silver" level evidence indicates steroid injection may be more effective than ESWT for this condition.