Authors' objectives:

This study reviews the use of extra corporeal shockwave therapy (Sonocur) in workers with lateral epicondylitis.

Authors' recommendations: Medical-conclusions The Cochrane Library systematic review (Level 1 quality of evidence) on the use of Extracorporeal Shock Wave Therapy (ESWT) in the treatment of lateral epicondylitis suggests that: a) There are conflicting results in the literature b) Further clinical trials are necessary to clarify the value of this treatment modality. A November 2002 prospective, randomized, multi center clinical trial led the authors to conclude that ESWT should only be applied in further, high quality clinical trials until it is proved to be effective. They felt their study showed it was ineffective in treating lateral epicondylitis. The ongoing WCB of BC lateral epicondylitis ESWT study shows that 73% of workers who continue to work while receiving this treatment will remain at work 6 weeks after their last treatment. Approximately 27% of patients will stop work, because of their elbow problem. Of those workers not working who receive ESWT treatment, 20% will return to work and remain at work 6 weeks after the last treatment. The majority (67%) of non-working lateral epicondylitis patients, however, will not return to work after ESWT treatment. Recognizing that ESWT is, in fact, many different types of treatment, the literature describing this treatment is extraordinarily scattered and compares apples to oranges, making its interpretation difficult. Hence, while we have discussed ESWT in relation to epicondylitis, the WCB should extend its conclusions to all musculoskeletal conditions and not approve its use. The attached editorial outlines some further thoughts around this issue. Corporate/Other Conclusions: Based on broad assumptions and limited data ; if the Board were to broaden and expand the use of ESWT treatments there is likely a wide range of financial costs (savings) involved - from a 1.5 million dollars added cost, to a 160,000 dollar savings per year. The WCB of BC should continue with its present policy of not approving ESWT treatment requests.

Authors' methods: Review

Project Status: Completed

URL for project: http://www.worksafebc.com/health_care_providers/related_information/evid ence_based_medicine/default.asp

Year Published: 2003

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Canada

Organisation Name: WorkSafeBC

Contact Address: 6591 Westminster Highway, Richmond, BC, V7C 1C6 Canada. Tel: 604-231-8417; Fax: 604-279-7698

Contact Name: ebpg@worksafebc.com

Contact Email: ebpg@worksafebc.com

Copyright: WorkSafe BC