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Original Article · Open access

Comparison of local massage, steroid injection, and extracorporeal shock wave therapy efficacy in the treatment of lateral epicondylitis

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Baki Volkan Çetin

Department of Orthopedics and Traumatology, Harran University Faculty of Medicine, Şanlıurfa, Türkiye

ORCID: 0000-0003-3231-404X

Ömercan Sepetçi

Department of Orthopedics and Traumatology, Harran University Faculty of Medicine, Şanlıurfa, Türkiye

ORCID: 0000-0003-0501-4332

İzzettin Yazar

Department of Orthopedics and Traumatology, Göksun State Hospital, Kahramanmaraş, Türkiye

ORCID: 0000-0002-9099-3477

Ahmet Yiğit Kaptan

Department of Orthopedics and Traumatology, Harran University Faculty of Medicine, Şanlıurfa, Türkiye

ORCID: 0000-0002-2369-8056

Özlem Orhan

Department of Orthopedics and Traumatology, Harran University Faculty of Medicine, Şanlıurfa, Türkiye

ORCID: 0000-0001-7508-135X

Mehmet Demir

Department of Orthopedics and Traumatology, Şanlıurfa Trainig and Research Hospital, Şanlıurfa, Türkiye

ORCID: 0000-0003-4697-6634

Mehmet Akif Altay

Department of Orthopedics and Traumatology, Harran University Faculty of Medicine, Şanlıurfa, Türkiye

ORCID: 0000-0001-9164-6090

Abstract

Objectives: This study aimed to compare the clinical outcomes of patients with lateral epicondylitis (LE) treated with local massage, corticosteroid (CS) injection, and extracorporeal shock wave therapy (ESWT).

Patients and methods: This randomized prospective study included 52 patients. Patients treated with local massage in Group 1 (n=17; 9 males, 8 females; mean age: 46.1±10.9 years; range, 27 to 64 years), CS injection in Group 2 (n=17; 7 males, 10 females; mean age: 46.0±8.8 years; range, 28 to 63 years), and ESWT in Group 3 (n=18; 12 males, 6 females; mean age: 46.7±11.3 years; range, 28 to 68 years) for LE were evaluated between March 2021 and June 2022. Clinical outcomes were assessed using the Visual Analog Scale (VAS), Disabilities of the Arm, Shoulder, and Hand (DASH), and DASH-Work Model (DASH-WM) scoring systems at the initial examination at the beginning of the study and at two-week, three-month, and six-month follow-up controls.

Results: Similar results were observed between VAS, DASH, and DASH-WM scores measured during LE diagnosis. In the first two weeks of follow-up, statistically significant decreases were observed in VAS, DASH, and DASH-WM scores in all three groups. Compared to baseline values, Group 1 and 2 had significant difference in VAS and DASH scores at three months. Group 3 had a significant difference in all clinical evaluation scores. At six months, no significant difference was observed in Groups 1 and 2 in any of the scoring systems, while Group 3 showed significant improvements in all scoring systems.

Conclusion: Treatment with ESWT was superior to other treatments throughout the study and at the final follow-up. In patients receiving CS injections, the clinical outcomes worsened with time, evidenced by the six-month follow-up. Further studies on combined treatment modalities are needed on this subject.

Declarations

Ethics Committee Approval

The study protocol was approved by the Harran University Clinical Research Ethics Committee (date: 15.03.2021, no: 21.06.01-23074). The study was conducted in accordance with the principles of the Declaration of Helsinki.

Informed Consent

A written informed consent was obtained from each patient.

Author Contributions

Design, data collection and processing, analysis and interpretation, literature review, writing, critical review, references and fundings: B.V.Ç.; Data collection and processing, materials: Ö.S., M.D.; Analysis and interpretation, literature review, writing: İ.Y.; Analysis and interpretation: A.Y.K., Ö.O.; Conception, design, control/ supervision: M.A.A.

Conflict of Interest

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Financial Disclosure

The authors received no financial support for the research and/or authorship of this article.

Data Sharing Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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