CellSonic VIPP, Owner'S Manual

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The complications of ESWT in proximal plantar fasciitis are low and negligible. Local
reddening, ecchymosis, or mild hematoma, and migraine are among the list of
complications. The complications can be successfully managed conservatively and
spontaneous recovery is anticipated.
In summary, the literature review unveiled discrepancy and controversy on the effect of
ESWT on proximal plantar fasciitis. Many factors can influence the effects of ESWT in
the treatment of proximal plantar fasciitis. The vast majority of the published papers are in
favor of ESWT. Additional studies are needed to validate the effectiveness of ESWT in
the treatment of proximal plantar fasciitis.
Lateral epicondylitis of the elbow
Several studies investigated the effect of shockwave therapy in patients with lateral
epicondylitis of the elbow, and the success rate ranged from 68% to 91% [
69 , 70 , 71 , 72 ,
73 , 74 , 75 ]. Rompe et al reported good or excellent outcome in 48% and an acceptable
results in 42% at the final review at 24 weeks in 50 patients with chronic tennis elbow
treated with 3,000 impulses of shockwave therapy compared with 6% and 24%,
respectively, in the control patients treated with 30 impulses [
76 ]. Wang et al compared
the results of shockwave therapy in 57 patients (58 elbows) with lateral epicondylitis of
the elbow with a control group of 6 patients (6 elbows) with a follow
- up of 12 to 26
months. The overall results of the treatment group were complaints free in 27 (61.4)%,
significantly better in 13 (29.5)%, slightly better in 3 (6.8%) and unchanged in 1 (2.3%).
Recurrent pain of lesser intensity was noted in 3 patients (6.8%). In the control group,
however, the results were unchanged in all 6 patients [
77 ]. Few studies reported no effect
of ESWT or less effect comparable to the placebo [ 78 , 79 , 80 , 81 , 82 , 83 ]. In a review of 9
placebo - controlled trials, Buchbinder et al concluded that there is "platinum" level that
ESWT provides little or no benefit in term of pain and function in lateral elbow pain.
There is "silver" level evidence that steroid injection may be more effective than
ESWT
[ 7 , 78 ]. Haake et al in a review of 20 studies concluded that no clinically relevant efficacy
has been proven for the use of ESWT for lateral elbow pain [ 79 , 80 ]. Speed et al in a
double blind randomized trial concluded that there appears to be a significant placebo
effect of moderate dose of ESWT in subjects with lateral epicondylitis, but there is no
evidence of added benefit of treatment when compared to sham therapy [
82 ]. The
differences were attributed to the patient selection, the techniques, the manufacture
devices, the use of local anesthesia and the method of outcome measurements.
Calcifying tendinitis of the shoulder
The success rate of shockwave therapy in patients with calcific tendinitis of the shoulder
was reported ranging from 78% to 91% [
84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 , 93 ]. Spindler et
al reported complete pain relief and full shoulder joint movement in three patients two
years after shockwave therapy, and a fragmentation of calcification was achieved after 24
h [
12 ]. Wang et al compared the results of shockwave therapy in 37 patients (39
shoulders) with calcific tendonitis of the shoulder with a control group of 6 patients (6
shoulders). At 2
- to 3 - year follow - up, the overall results of the shockwave group were
complaints free in 60.6%, significantly better in 30.3%, slightly better in 3.0% and
unchanged in 6.1%. Only two patients (6%) showed recurrent pain of lesser intensity, and
none showed worse symptoms. The results of the control group were slightly better in 1
(16.7%) and unchanged in 5 (83.3%). Radiographs showed complete elimination of