Comparative effectiveness of extracorporeal shock wave therapy, local corticosteroid injection, and conventional physiotherapy in treatment of chronic lateral epicondylitis

Ismael, Mona Mohamed Mohamed; Arafa, Mostafa A.; Zohiery, Abeer K. El; Ibrahim, Saad M.

doi:10.1186/s43166-020-00024-3

Cited by 3 publications

(1 citation statement)

References 25 publications

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“…In a review of the more contemporary literature, outcomes of ESWT seem to have improved. Ismael et al performed a RCT evaluating the efficacy of ESWT (pressure 1.6 bar, frequency 16 Hz, 2,000 shocks) for 3 sessions (1-week interval between sessions), CSI (single injection), and PT where all 3 modalities provided improvement in clinical symptoms at 12 weeks of follow-up 70 . However, ESWT demonstrated greater effects on improving functional disability (decrease in PRTEE) when compared with CSI and conventional PT (−38.6 vs. −32.5 vs. −30.0; p = 0.030).…”

Section: Extracorporeal Shockwave Therapymentioning

confidence: 99%

Lateral Epicondylitis

et al. 2023

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Section: Extracorporeal Shockwave Therapymentioning

confidence: 99%

Lateral Epicondylitis

et al. 2023

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Focused shock wave and ultrasound therapies in the treatment of lateral epicondylitis - a randomized control trial

Król,

Łojewski,

Król

et al. 2024

Sci Rep

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Persistent symptoms of lateral epicondylitis prompt patients to seek effective conservative treatment. The study aimed to determine the effects of focused shock wave (FSWT) and ultrasound therapies for lateral epicondylitis. Sixty patients with tennis elbow were randomly divided into three equal groups: A, B, and C. Group A received a total of 3 FSWT sessions, with 7 days between treatments; Group B received ultrasound therapy in 10 sessions over 2 weeks, while patients in Group C were treated with placebo ultrasound. All patients were also given deep friction massage. Before the start of therapy, and at 1, 3, 6, and 12 weeks after its completion, pain intensity and function of the affected upper limb were assessed in all patients. Wrist extensor and flexor strength and grip strength were measured in the affected and unaffected limb. Significant reductions in pain and significant improvements in the function of the affected limb compared to baseline values were observed in all study groups at 6 and 12 weeks after the completion of therapy. Analysis of percentage changes in these variables showed significant differences between Groups A and B in favor of Group A. The strength of wrist extensors and grip strength of the affected limb at 6 and 12 weeks after treatment completion was significantly higher in Groups A and B compared to pre-therapy values. However, there were no statistically significant differences between the groups regarding percentage changes in muscle strength in the affected limb. Pain reduction and function improvement in patients with lateral epicondylitis were significantly greater after FSWT (0.2 mJ/mm 2 / 4 Hz / 2000 shocks) than after sonotherapy (3 MHz / 0.5 W/cm 2 / 20%). Increases in wrist extensor strength and grip strength of the affected limb were comparable after both therapies. Given the greater therapeutic effect in the subjective evaluation, we recommend a combination therapy of FSWT with deep friction massage. Trial registration The trial was prospectively registered in the ISRCTN registry (no. ISRCTN11907358 registration date 30.07.2020).

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Extracorporeal shock wave therapy (ESWT) versus local corticosteroid injection in treatment of lateral epicondylitis (tennis elbow) in athletes: clinical and ultrasonographic evaluation

Ibrahim

Tanawy

Mostafa

et al. 2021

Egypt Rheumatol Rehabil

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Background Lateral epicondylitis is one of the commonly noticed disorders of the arm described by agony focused over lateral epicondyle which is the site of wrist extensors origin. The purpose of this work was to compare the efficiency of extracorporeal shock wave therapy and local corticoid injection in management of lateral epicondylitis both clinically and ultrasonographically as well as to assess the role of ultrasound in diagnosis and follow-up of lateral epicondylitis. This study was performed on 30 athletes diagnosed as lateral epicondylitis. Results Both corticosteroid injection and shock wave treatment showed a highly significant effectiveness on pain by visual analog scale (VAS). A highly significant difference between before treatment and after 2 as well as 4 weeks of treatment regarding the functional disability parameters as patient-rated tennis elbow evaluation (PRTEE) and quick disabilities of the arm, shoulder, and hand (DASH) was found. Likewise, a statistically significant improvement in favor of shock wave therapy group after 2 weeks was found, inversely insignificant difference after 8 and 12 weeks regarding to VAS occurred. Both PRTEE and Quick DASH test showed a statistically significant difference among groups through all follow-up period. There was a statistically insignificant difference among the studied groups according to ultrasound (US) changes in the form of focal areas of hypo-echogenicity through follow-up periods. A significant improvement in favor of ESWT group is detected among the studied groups regarding tendon thickening in ultrasonography before treatment and after 2 and 4 weeks. However, the difference was insignificant after 8 and 12 weeks. Conclusions Both corticosteroid local injection and shock wave therapy are helpful and effective for lateral epicondylitis treatment. However, a shock wave therapy revealed better improvement on long-term clinical and ultrasonogrphic follow-up than corticosteroid injection. Musculoskeletal ultrasound represents a helpful diagnostic and follow-up tool for lateral epicondylitis.

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Comparative effectiveness of extracorporeal shock wave therapy, local corticosteroid injection, and conventional physiotherapy in treatment of chronic lateral epicondylitis

Cited by 3 publications

References 25 publications

Lateral Epicondylitis

Lateral Epicondylitis

Focused shock wave and ultrasound therapies in the treatment of lateral epicondylitis - a randomized control trial

Extracorporeal shock wave therapy (ESWT) versus local corticosteroid injection in treatment of lateral epicondylitis (tennis elbow) in athletes: clinical and ultrasonographic evaluation

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