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.