Summary

Extracorporeal shock wave therapy (ESWT) represents an innovative form of treatment for the pain therapy of punctiform (near-the-bone) soft tissue pain of the skeletal and locomotor system. After its use for stone fragmentation in the kidneys, gallbladder, pancreas and salivary glands, as well as since 1989 for the treatment of pseudarthrosis, a completely new area of indications has followed with pain therapy.

ESWT was employed in 4892 sessions in the course of a controlled prospective study from September 1 1992 to December 31 1994 at the Orthopedic University Clinic in Hamburg in 512 patients who had presented for surgery. The most frequent indication in the case of shoulder pain was the impingement syndrome, calcifying tendinitis, chronic bicipital bursitis, acute and chronic subdeltoideal subacromial bursitis, chronic insertion tendinitis of the deltoid muscle, partial or total shoulder stiffness, commencing and with restrictions advanced osteoarthritis of the shoulder and acromioclavicular arthrosis. In the region of the elbow, humerolateral and humero-ulnar epicondylitis as well as with limitations the supinator fissure syndrome were treated. In the hand polyarthrosis, styloidalgia as well as chronic pain conditions after distal fracture of the radius were treated. In the hip incipient arthrosis and insertion tendinitis of the rectus femoris muscle and of the adductors as well as trochanter insertion tendinitis were treated. Incipient arthrosis and capsular insertion pains ventrally and dorsally could be treated. Achillodynia, plantar heel spur pains and pains in oestochondrosis dissecans tali were treated in the lower leg and foot. Therapy on the trunk of the body has been rather problematic so far except for coccygodynia. After an average of 10 sessions (from 1 to more than 30 sessions), 362 patients (70.7%) stated clear to complete pain reduction, which shows according to provisional calculations a half-life of more than one year. In total 16 patients (3.1%) were still treated by surgery. Side effects were not observed.