Comparative Effects of Focused and Radial Extracorporeal Shock Wave Therapies on Lateral Epicondylitis: A Randomised Sham-controlled Trial.

OBJECTIVE

To evaluate and compare the effects of radial and focused types of extracorporeal shock wave therapy (ESWT) on lateral epicondylitis.

STUDY DESIGN

A randomised sham-controlled trial. Place and Duration of the Study: Department of Sports Medicine, Yuzuncu Yil University Hospital, Van, Turkiye, from August 2019 to April 2020.

METHODOLOGY

Patients with acute lateral epicondylitis were randomised into focused, radial, and sham ESWT groups. The ESWT was applied for three sessions at 2-4 days intervals. All the subjects were evaluated at baseline (week 0), week 5, and 13. Patient-rated tennis elbow evaluation (PRTEE) scores were used as outcome measures.

RESULTS

At weeks 5 and 13, all PRTEE scores (pain, function, and total) were remarkably improved in the focused and radial groups (p<0.001), but not in the sham group (p>0.05). Focused ESWT was superior to radial ESWT for the change of pain scores from baseline to week 5 (18.8±13.9 vs. 11.8±9.1; p=0.026) and week 13 (17.8±13.1 vs. 11.7±10.5, p=0.084). Focused ESWT was more effective than radial ESWT for the change of function scores from baseline to weak 5 (17.9±12.5 vs. 11.2±9.5; p=0.025) and week 13 (16.9±11.6 vs. 10.7±10.1; p=0.032). Focused ESWT was superior to radial ESWT for the change of total scores from baseline to week 5 (36.7±25.9 vs. 23.0±17.2; p=0.021) and week 13 (34.7±24.3 vs. 22.4±18.5; p=0.044).

CONCLUSION

Focused and radial ESWT are effective in lateral epicondylitis. The focused ESWT is superior to the radial ESWT. Thus, focused ESWT should be preferred in lateral epicondylitis.

KEY WORDS

Lateral epicondylitis, Shock wave, Randomised sham-controlled trial.