Bayram Korhan, Yesil Hilal, Dogan Erdal
Department of Physical Medicine and Rehabilitation, Izmir Katip Celebi University Faculty of Medicine, Izmir, Turkey.
Department of Physical Medicine and Rehabilitation, Usak State Hospital, Usak, Turkey.
North Clin Istanb. 2014 Aug 3;1(1):33-38. doi: 10.14744/nci.2014.77487. eCollection 2014.
Lateral epicondylitis is one of the widely seen lesions of the arm characterized by pain localized over lateral epicondyle which is the insertion site of the wrist extensors, and extensor muscles of the forearm. It is easy to diagnose lateral epicondylitis but treatment involves some inherent drawbacks. Conservative management includes non-steroidal anti-inflammatory drugs, ultrasound therapy, steroid injections, functional bracing, laser therapy and extracorporeal shock wave therapy, however none of these modalities have been shown to be really effective based on evidence-based data. Our study is aimed to determine the efficacy of extracorporeal shock wave therapy (ESWT) therapy in the treatment of lateral epicondylitis.
A total of 12 patients with the diagnosis of lateral epicondylitis were included in the study and 3 sessions of ESWT were applied (1 session per week). Maximum grip strength and pain scores were assessed before and at 1. month after the treatment. Spesific tests for lateral epicondylitis were utilized and Turkish version of the Patient Rated Tennis Elbow Evaluation (PRTEE-T) questionnaire was administered and data obtained were analyzed.
Visual analog scale (VAS) scores were significantly lower (p<0.05) and grip strength significantly increased (p<0.05) one month after ESWT treatment. Overall PRTEE-T survey scores decreased significantly at first month (p<0.001) after treatment. Patient's and physician's global self-assessment scores were significantly lower after treatment (p<0.05).
To conclude, ESWT utilization in conservative treatment of lateral epicondyilitis was found to be effective on reducing pain, and improving functional activities and quality of life.
肱骨外上髁炎是上肢常见病变之一,其特征为疼痛局限于肱骨外上髁,此处是腕伸肌及前臂伸肌的附着点。肱骨外上髁炎易于诊断,但治疗存在一些固有缺陷。保守治疗包括使用非甾体类抗炎药、超声治疗、类固醇注射、功能性支具、激光治疗及体外冲击波治疗,然而基于循证医学数据,这些方法均未显示出真正的有效性。我们的研究旨在确定体外冲击波治疗(ESWT)对肱骨外上髁炎的疗效。
本研究共纳入12例诊断为肱骨外上髁炎的患者,进行3次ESWT治疗(每周1次)。在治疗前及治疗后1个月评估最大握力和疼痛评分。采用肱骨外上髁炎的特异性检查,并使用患者自评网球肘评估(PRTEE-T)问卷的土耳其语版本进行调查,对获得的数据进行分析。
ESWT治疗1个月后,视觉模拟量表(VAS)评分显著降低(p<0.05),握力显著增加(p<0.05)。治疗后第1个月,PRTEE-T总体调查评分显著降低(p<0.001)。治疗后患者和医生的总体自我评估评分显著降低(p<0.05)。
总之,发现ESWT用于肱骨外上髁炎的保守治疗在减轻疼痛、改善功能活动和生活质量方面是有效的。