Extracorporeal Shock Wave versus Ultrasound Guided Local Corticosteroid Injection in Treatment of Lateral Epicondylitis

doi:10.21608/ejhm.2025.407384

Extracorporeal Shock Wave versus Ultrasound Guided Local Corticosteroid Injection in Treatment of Lateral Epicondylitis

Document Type : Original Article

10.21608/ejhm.2025.407384

Abstract

Background: Shock waves are high energy sound waves that showed high efficacy in diminishing the high levels of the inflammatory mediators. An ultrasound-guided corticosteroid injection is a highly effective method that significantly reduces pain and inflammation and has been demonstrated to offer superior temporary results in regaining grip strength.
Aim: This study aimed to evaluate the efficacy of extracorporeal shock wave therapy in relation to ultrasound-guided corticosteroid (CS) injections for managing lateral epicondylitis (LE).
Patients and methods: The investigation consisted of 60 cases encompassing both male and female participants with LE who were divided into two equal. Group I received a single US-guided corticosteroid injection and group B underwent extracorporeal shock wave therapy (ESWT) treatment.
Results: At both follow-ups, the visual analogue scale, Likert scale, patient-rated tennis elbow evaluation, and tendon thickness were notably higher in groups I and II compared to their pre-treatment levels, with an even greater increase observed at the 2^ndfollow-up compared to the 1^st (P < 0.05). Furthermore, the Maudsley, Cosens, and Mills tests yielded significantly higher scores in groups I and II at both follow-ups than pre-treatment (P < 0.05). At the second follow-up, group I had substantially greater Power Doppler readings than before treatment, reflecting a statistically significant change (p < 0.05). Conclusions: Results showed that corticosteroid injections and ESWT were effective in treating LE, but ESWT demonstrated superior improvement in clinical and ultrasonographic follow-ups after 12 weeks compared to corticosteroid injections.

Keywords