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

Published on: September 16, 2016
Project Number: RC0811-000
Product Line: Rapid Response
Research Type: Devices and Systems
Report Type: Summary with Critical Appraisal
Result type: Report

Question

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

Key Message

For plantar fasciitis, overall there is some suggestion that, in comparison with placebo, shockwave therapy (SWT) is an effective treatment option. Limited evidence suggests that for plantar fasciitis, the effectiveness of SWT is comparable with platelet rich plasma injection, corticosteroid injection or surgery. Adverse events were sparsely reported. Adverse effects reported with SWT included skin reddening, bruising at the site of application, and local swelling and pain.For greater trochanteric pain syndrome, a case control study showed that SWT was statistically significantly more effective than conservative treatment, and findings from a quasi-randomized controlled trial (RCT) comparing SWT with corticosteroid injection or home training were inconsistent. For patellar tendinopathy, a case control study and a quasi-RCT showed that SWT was statistically significantly more effective than conservative treatment. One retrospective study showed that effectiveness of SWT and surgery was comparable. Findings from studies comparing SWT with placebo or corticosteroid injection were inconsistent. For medial tibial stress syndrome, addition of SWT to either conservative treatment or to a running program had added benefit. No studies on the cost-effectiveness of SWT for chronic pain associated with lower extremity orthopedic disorders were identified.

Tags

rehabilitation, high-energy shock waves, pain, musculoskeletal, other miscellaneous topics, electrocorporeal, Therapies, Therapy, ESWT, leg, orthopaedic, orthopaedics, heel, Knee, Hips