Comparison of extracorporeal shock-wave therapy and wrist-extensor splint application in the treatment of lateral epicondylitis: a prospective randomized controlled study

Abstract

BackgroundExtracorporeal shock-wave therapy (ESWT) and wrist-extensor splints (WESs) are two commonly used methods in the treatment of lateral epicondylitis. In this study, the efficacy of these two methods was compared.MethodsThe study was planned as a prospective randomized controlled study. A total of 67 patients were enrolled. The patients were divided into two groups: group 1 received ESWT (32 patients) and group 2 received WES (35 patients). Patients in group 1 underwent four sessions of ESWT once every week. In each session, an ESWT device at 10–12 Hz, 2,000 pulses, and 1.6–1.8 bar pressure was used. Patients in group 2 used a wrist splint, holding the wrist at 30°–45° extension for 4 weeks. Patients were assessed for handgrip strength, pain at rest, pain while working, and quality of life. Data were collected before and after treatment (at weeks 4, 12, and 24). A visual analog scale was used to evaluate pain at rest and while working, a hand dynamometer for handgrip strength, subscales of the SF36 Health Survey to evaluate quality of life, and the Turkish version of the patient-rated tennis-elbow evaluation was used to evaluate functioning of the affected arm during various daily life activities.ResultsIn both ESWT and WES groups, although there were considerably significant improvements (P<0.001) in the parameters evaluated (pain at rest and while working, handgrip strength, Patient-Rated Tennis Elbow Evaluation, Nirschl score, and SF36 subscales) were observed at 4, 12, and 24 weeks compared to pretreatment values, there was no statistically significant difference between the two groups in terms of our evaluation parameters at the three time points (P>0.05).ConclusionBoth ESWT and WES applications were found to yield significantly superior results when compared to pretreatment values. In comparison of the two groups, on the other hand, there was no statistically significant difference.

Comparison and Short Term Effect of Extracorporeal Shock Wave Therapy and Kinesiotaping in Treatment of Lateral Epicondylitis

“…In line with the previous reports, the affected elbow region was in the dominant arm. We found that the VAS score, a scale we used to assess pain intensity at rest, night, and activity, was significantly reduced at fourth postoperative week in both the ESWT and kinesiotaping groups at a similar level, which was in accordance with the literature reports (32,33). Our study employed DASH score for functional evaluation, which showed significant reduction in both groups, again to a statistically similar degree.…”

“…To date, many studies have utilized the sub-dimensions of SF 36 to rate quality of life (32,(34)(35)(36). In the present study, where the sub-dimensions of SF36 were used, we detected a significant improvement in both the ESWT and KT groups.…”

“…Another study indicated that, thanks to its ease of use and low side effect profile, ESWT may be used as an alternative to surgical methods (39). Another study comparing ESWT and splint use reported no difference between the conservative methods, with both ESWT and splint use being effective treatments (32).…”

Efficacy of Extracorporeal Shock Wave Therapy for Lateral Epicondylitis: A Systematic Review and Meta-Analysis

“…Evaluations using VAS and grip strength revealed superior outcomes in the corticosteroid group at 4 weeks, while at 52 weeks, the success rate of corticosteroid injection (50%) was substantially lower than autologous blood injection (83%) and ESWT (89%). Eraslan et al [30] and Aydin and Atic [1] drew similar conclusions. Thus, ESWT appears to demonstrate greater long-term efficacy than corticosteroid injection.…”

“…Lateral epicondylitis (LE) is a common musculoskeletal pathology arising secondary to recurrent microtrauma of the upper extremity, particularly impacting the lateral epicondyle of the elbow [1,2]. Major symptoms include decreased grip and upper-extremity strength along with pain and inflammation originating from the lateral elbow.…”