Clinical and Sonographic Evaluation of the Effectiveness of Extracorporeal Shock Wave Therapy in Patients with Lateral Epicondylitis

Abstract

Objective: This study assessed and compare the clinical and sonographic outcomes of extracorporeal shock wave therapy (ESWT) in patients with lateral epicondylitis (LE). Methods: Forty-two LE patients were randomly divided into two groups: the ESWT group (n=21) and the sham-ESWT control group (n=21). Both groups underwent wrist resting splinting, stretching, strengthening exercises for wrist extensors, and ice application. Grip strength, pain, and functionality were assessed by various tests, and common extensor tendon (CET) thickness was measured sonographically before, after, and 1 month after treatment by a blind examiner. Results: At baseline, there was no significant difference between the groups. Significant differences were observed in pain pressure threshold, grip strength, visual analog scale, and Patient-Rated Tennis Elbow Evaluation (PRTEE) scores between baseline, post-treatment, and 1 month after treatment in both groups (p<0.05). However, the Short Form12 (SF-12) physical scores showed a significant difference only 1 month after treatment (p<0.01). In the SF-12 mental score tests, no significant difference was found. CET thickness in the ESWT group significantly decreased after treatment and 1 month after treatment (p<0.05), whereas no significant difference was observed in the control group. Conclusions: Both the ESWT and control groups showed a reduction in pain and improvement in function. However, the ESWT group showed statistically superior results in terms of pain reduction and functional improvement compared with the control group. In addition, sonographic evaluation revealed a significant reduction in CET thickness in the ESWT group, whereas no significant change was noted in the control group.