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Elbow News

Shocking But True: Shockwave Therapy Alone May Be as Good as It Gets

Tennis elbow (also called lateral epicondylitis) can be tough to treat. This is true partly because no one knows exactly what causes the pain. And some cases of tennis elbow don't get much better with the common treatments of rest, ice, bracing, and anti-inflammatory medication.

In the past 10 years, there has been much research to find better treatments for tennis elbow. Two treatments that seem to be somewhat successful are low-energy shockwave therapy and manual therapy of the cervical spine (the neck). Shockwave therapy involves sending electromagnetic impulses into the elbow. No one knows exactly why it works, but it has been shown to have success rates of about 50% in relieving the pain of tennis elbow. Manual therapy is a specialized form of hands-on treatment used to mobilize one or more joints. Research has shown that up to 80% of people with tennis elbow also have problems in the cervical spine or where the neck and thoracic vertebrae join.

These researchers treated 30 patients with tennis elbow using shockwave therapy followed with manual therapy of the cervical spine. Patients had three shockwave treatments and then 10 manual treatments. The control group was made up of 30 patients who got shockwave therapy only. All patients had tennis elbow that had lasted for at least six months, had gotten at least three steroid injections, and had tried at least six months of conservative treatments. All patients had follow-up physical exams 12 weeks and one year after shockwave treatment began. They also answered questions about their elbow pain and function.

There were no real differences between the groups at the beginning of the study--or after a year. Yet both groups improved significantly over that time. Roughly 60% of the patients in each group reported excellent or good outcomes, which means that they felt--at most--occasional pain in their elbows. These results support the idea that shockwave therapy can be an effective treatment for tennis elbow. However, it appears that manual therapy of the cervical spine may not be of much extra help--shocking, but true.


Jan D. Rompe, MD, et al. Chronic Lateral Epicondylitis of the Elbow: A Prospective Study of Low-Energy Shockwave Therapy and Low-Energy Shockwave Therapy Plus Manual Therapy of the Cervical Spine. In Archives of Physical Medicine and Rehabilitation. May 2001. Vol. 82. No. 5. Pp. 578-582.

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