Efficacy of extracorporeal shockwave therapy in patients with lateral epicondylitis: A randomized, placebo-controlled, double-blind clinical trial

Abstract

Objective: Lateral epicondylitis is a common elbow problem. Although extracorporeal shockwave therapy (ESWT) is widely used in the treatment of lateral epicondylitis, its efficacy is still controversial. Moreover, the number of prospective, randomized, controlled studies in the literature is not sufficient. Here, we intend to investigate the efficacy of ESWT.

Methods: The study was randomized, placebo-controlled, double-blind, and prospectively planned. Forty patients who met the inclusion criteria were divided into two groups, real ESWT (Group 1, n=20) and placebo ESWT (Group 2, n=20), in a 1: 1 randomized closed envelope manner. Patients were evaluated for Patient-Rated Tennis Elbow Evaluation-Turkish Version (PRTEE-T), visual analog scale (VAS) pain scores, and grip and pinching strengths. The evaluation were performed thrice before, at the end of treatment and 1 month after treatment. Both groups were treated with wrist splinting, ice treatment, and rest.

Results: There was no statistical difference between sex and dominant hand in both groups. There was no significant difference in the grasp and pinching strength between the measurements of the groups themselves (p>0.05). When examined in terms of VAS scores, only significant changes were found in the actual ESWT group (p<0.05). According to the PRTEE-T scores, both groups showed significant changes (p<0.05). No significant difference was found between post-treatment and control measures in the grip and pinching power between groups, VAS and PRTEE-T scores before treatment (p>0.05).

Conclusion: Although pain and functional improvement were more prominent in our patients treated with ESWT than placebo, no statistically significant results were found.

Keywords: Epicondylitis; high-energy shock waves; lateral humeral.