Sadiye Murat, Bilinc Dogruoz Karatekin, Melisa Zengin

Purpose
The aim of this study is to assess the clinical and sonographic outcomes of radial extracorporeal shock wave therapy (rESWT) in patients with lateral epicondylitis (LE).

Methods
Forty-two patients with LE for at least 3 months were randomized into two groups:

  • rESWT group (21 patients)
  • sham-rESWT control group (21 patients).

The rESWT group received rESWT treatment on the lateral epicondyle once per week for 3 weeks, 2000 pulses, 10 Hz, 1.8 bar.

The sham-rESWT group followed the same treatment schedule. The ESWT applicator was applied to the lateral epicondyle and made sounds, but no shocks were emitted.

Both groups received a wrist resting splint, stretching and strengthening exercises, and ice application.

Assessments
Hand grip strength, pain, functionality, and common extensor tendon (CET) thickness were evaluated before, after, and one month post-treatment.

Results

Baseline: There were no significant differences between the groups.

Post-Treatment and One Month Follow-Up: Significant improvements in pain pressure threshold, grip strength, visual analog scale (VAS), and Patient-Rated Tennis Elbow Evaluation scores were observed in both groups. However, the rESWT group showed superior results in these pain reduction and functional improvement measures compared to the control group. For example, after treatment, the median VAS score decreased by 57% in the rESWT group, whereas the sham group VAS scores decreased by only 14%.

Sonographic Findings: CET thickness significantly decreased in the rESWT group post-treatment and one month after treatment. The median thickness decreased by 15%. There was no significant change in the control group.

Conclusion

  • While both groups showed improvement, the rESWT group showed statistically superior outcomes in function and pain reduction.
  • Sonographic evaluation revealed a significant reduction in CET thickness in the rESWT group, indicating that rESWT has a physical impact on treating LE.

Citation: Murat S, Dogruoz Karatekin B, Zengin M. Clinical and Sonographic Evaluation of the Effectiveness of Extracorporeal Shock Wave Therapy in Patients with Lateral Epicondylitis. Medeni Med J. 2024;39(2):109-116. doi:10.4274/MMJ.galenos.2024.60308

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