Summary

Extracorporeal shock wave application (ESWA) has been used so far successfully only for the therapy of renal calculi, gallstones, pancreatic duct stones and salivary calculi. In the last two years, apart from calcifying tendinitis, humero-ulnar and humeroradial epicondylitis and all more or less punctiform limited peripheral soft tissue pains and pains in the vicinity of bones have become indicated in the accident surgical orthopedic case material. The exact action mechanism is currently not yet clarified. On one hand selective tissue damage ("denervation") with subsequent local hyperemia and on the other hand afferent inhibition of pain conduction by hyperstimulation are assumed. The extracorporeal shock wave treatment of soft tissue symptoms in the region of the shoulder, elbow and foot is described and the results gained are compared with existing studies. Complete freedom from symptoms could be achieved in 47 out of 84 cases. 24 patients showed a clear improvement. No effect due to the therapy was shown solely in 13 out of 84 patients. The results have been lasting at least in the medium term. Side effects occurred in the form of small subcutaneous hematomas and erosion of the skin when using energies of more than 20 mJ.