Side-effects of extracorporeal shock wave therapy (ESWT) in the treatment of tennis elbow

• DOI: 10.1007/s00402-001-0362-7
• Publication Date: 2002-10-06T09:38:39Z
• Authors: Haake M.; Böddeker I.; Decker T.; Buch M.; Vogel M.; Labek G.; Maier M.; Loew M.; Maier-Boerries O.; Fischer J.; Betthäuse...; Rehack H.; Kanovsky W.; Müller I.; Gerdesmeyer L.; Rompe J.
• Keywords: Adult; Male; Migraine Disorders; Tennis Elbow; Middle Aged; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Lithotripsy; Syncope, Vasovagal; Humans; Female; Single-Blind Method

Apart from a few observational reports, there are no studies on the side-effects of extracorporeal shock wave therapy (ESWT) in the treatment of insertion tendopathies. Within the framework of a randomised, placebo-controlled, single-blind, multicentre study to test the effectiveness of ESWT in the case of lateral epicondylitis (LE), side-effects were systematically recorded. A total of 272 patients from 15 centres was allocated at random to active ESWT (3 x 2000 pulses, energy flux density ED(+) 0.04 to 0.22 mJ/mm(2) under local anaesthesia) or placebo ESWT. In all, 399 ESWT and 402 placebo treatments were analysed. More side-effects were documented in the ESWT group (OR = 4.3, CI = [2.9; 6.3]) than in the placebo group. Most frequently, transitory reddening of the skin (21.1%), pain (4.8%) and small haematomas (3.0%) were found. Migraine was registered in four and syncopes in three instances after ESWT. ESWT for LE with an energy flux density of ED(+) 0.04 to 0.22 mJ/mm(2) is a treatment method which has very few side-effects. The possibility of migraine being triggered by ESWT and the risk of a syncope should be taken into account in the future. No physical shock wave parameters could be definitely identified as the cause of the side-effects observed.