Lateral Epicondylitis, Lateral Epicondylitis (Tennis Elbow)
Conditions
Keywords
Lateral Epicondylitis, Tennis Elbow, Dextrose Prolotherapy, ESWT, Extracorporeal Shock Wave
Brief summary
Lateral epicondylitis is a common musculoskeletal disorder associated with pain and impaired upper extremity function. The aim of this study was to compare the effectiveness of extracorporeal shock wave therapy (ESWT) and single-session 5% dextrose prolotherapy (DPT) in patients with lateral epicondylitis and to evaluate the relative superiority of these treatment approaches during short- and mid-to-long-term follow-up. Ninety-six patients were allocated into three groups: conventional treatment alone, conventional treatment plus ESWT, and conventional treatment plus DPT. Pain, functional status, grip strength, and common extensor tendon thickness were evaluated during follow-up.
Detailed description
Lateral epicondylitis is a common musculoskeletal disorder associated with pain, reduced grip strength, and impaired upper extremity function. This study aimed to compare the effectiveness of extracorporeal shock wave therapy (ESWT) and single-session 5% dextrose prolotherapy (DPT) in patients with lateral epicondylitis and to evaluate their relative effectiveness during short- and mid-to-long-term follow-up. Ninety-six patients were allocated into three groups: conventional treatment alone, conventional treatment plus ESWT, and conventional treatment plus DPT. Conventional treatment consisted of home exercise and splinting. ESWT was applied in 3 sessions (2000 pulses, 0.15 mJ/mm²), while the DPT group received a single ultrasound-guided 5% dextrose injection. Primary outcomes included Visual Analog Scale pain scores for rest, night pain, resisted wrist extension, and grip pain. Secondary outcomes included QuickDASH, PRTEE, grip strength measured with a Jamar dynamometer, and ultrasonographic assessment of common extensor tendon thickness. Clinical assessments were performed at baseline, 1, 3, and 6 months.
Interventions
BEHAVIORALConventional Treatment group
Splinting and home exercise program
DEVICEExtracorporeal Shock Wave Therapy (ESWT)
3 sessions, weekly, 4Hz, 2000 pulses/session, 0.15 mJ/mm².
PROCEDUREDextrose prolotherapy (DPT)
Single-session ultrasound-guided 1 mL 5% dextrose injection.
Sponsors
Gaziler Physical Medicine and Rehabilitation Education and Research Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
Participants were allocated into three parallel groups: conventional treatment alone, conventional treatment plus extracorporeal shock wave therapy (ESWT), and conventional treatment plus single-session 5% dextrose prolotherapy.
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* Adults aged 18-75 years * Clinical and ultrasonographic diagnosis of lateral epicondylitis * Symptoms persisting for at least 3 months * Visual Analog Scale (VAS) score ≥4 * Resistance to previous medical treatment * Ability to comply with study procedures and complete questionnaires
Exclusion criteria
* Injection treatment for lateral epicondylitis within the previous 3 months * History of trauma within the previous 3 months * Cervical disc herniation * Median or ulnar tunnel neuropathy * Medial epicondylitis * Anticoagulant therapy use * Pregnancy or breastfeeding * Psychiatric disorders or cognitive impairment interfering with questionnaire -completion * Allergy to the treatment solution * History of upper extremity surgery or fracture * Rheumatoid arthritis * Connective tissue diseases such as dermatomyositis
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| VAS Resisted Wrist Extension Pain | Baseline, 1 month, 3 months, and 6 months after treatment | Pain during resisted wrist extension assessed using the Visual Analog Scale (VAS). |
| VAS Gripping Pain | Baseline, 1 month, 3 months, and 6 months after treatment | Pain intensity during gripping assessed using the Visual Analog Scale (VAS). |
| VAS Resting Pain | Baseline, 1 month, 3 months, and 6 months after treatment | Resting pain assessed using the Visual Analog Scale (VAS). |
| VAS Night Pain | Baseline, 1 month, 3 months, and 6 months after treatment | Night pain assessed using the Visual Analog Scale (VAS). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Quick-DASH Score | Baseline, 1 month, 3 months, and 6 months after treatment | Functional disability assessed using the Quick Disabilities of the Arm, Shoulder and Hand questionnaire. The QuickDASH score ranges from 0 to 100, where 0 indicates no symptoms and normal upper extremity function, while 100 indicates the highest symptom severity and the poorest functional status. |
| PRTEE Score | Baseline, 1 month, 3 months, and 6 months after treatment | Functional outcome assessed using the Patient-Rated Tennis Elbow Evaluation questionnaire. The PRTEE consists of 15 items divided into two subscales: pain (5 items) and function (10 items). The total score ranges from 0 to 100, with 0 indicating no pain and normal function, and 100 indicating the highest pain severity and the poorest functional status. Higher scores reflect greater pain intensity and functional impairment. |
| Grip Strength | Baseline and 6 months | Grip strength measured using a Jamar dynamometer. |
| Common Extensor Tendon Thickness | Baseline and 6 months | Ultrasonographic measurement of common extensor tendon thickness. |
Countries
Turkey (Türkiye)
Outcome results
None listed