Shockwave Therapy for Pain Associated with Upper Extremity Orthopedic Disorders: A Review of the Clinical and Cost-Effectiveness


( Last Updated : September 1, 2016)
Project Line:
Health Technology Review
Project Sub Line:
Summary with Critical Appraisal
Project Number:
RC0808-000

Details


Question


  1. What is the clinical effectiveness of shockwave therapy for chronic pain associated with upper extremity orthopedic disorders?

  2. What is the cost-effectiveness of shockwave therapy for chronic pain associated with upper extremity orthopedic disorders?


Key Message

Evidence from four systematic reviews suggests that, in comparison with placebo, shockwave therapy (SWT) using high energy is effective in reducing pain in calcific tendinitis of the shoulder. Evidence suggests that that there is no significant benefit with SWT compared to placebo or other treatments in case of non-calcific tendinitis of the shoulder. It should be noted however, that there is considerable overlap in the studies included in the four systematic reviews, hence findings are not mutually exclusive.Findings on the effectiveness of shockwave therapy compared with placebo or control for treating lateral epicondylitis were inconsistent, hence definitive conclusions are not possible. Evidence from single studies suggests there is no significant difference between SWT and physical therapy or percutaneous tenotomy for treating lateral epicondylitis. Findings on the effectiveness of SWT compared with corticosteroid injection for treating lateral epicondylitis were inconsistent, hence definitive conclusions are not possible.Adverse events commonly reported with SWT include pain, small bruises and hematomas, petechial bleeding, and erythema.No studies on cost-effectiveness of SWT were identified