Comparison of local massage, steroid injection, and extracorporeal shock wave therapy efficacy in the treatment of lateral epicondylitis
Baki Volkan Çetin1
, Ömercan Sepetçi1, İzzettin Yazar2, Ahmet Yiğit Kaptan1, Özlem Orhan1, Mehmet Demir3, Mehmet Akif Altay1
1Department of Orthopedics and Traumatology, Harran University Faculty of Medicine, Şanlıurfa, Türkiye
2Department of Orthopedics and Traumatology, Göksun State Hospital, Kahramanmaraş, Türkiye
3Department of Orthopedics and Traumatology, Şanlıurfa Trainig and Research Hospital, Şanlıurfa, Türkiye
Keywords: Extracorporeal shock wave therapy, lateral epicondylitis, local massage, corticosteroids.
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.
Citation: Çetin BV, Sepetçi Ö, Yazar İ, Kaptan AY, Orhan Ö, Demir M, et al. Comparison of local massage, steroid injection, and extracorporeal shock wave therapy efficacy in the treatment of lateral epicondylitis. Jt Dis Relat Surg 2024;35(2):386-395. Doi: 10.52312/jdrs.2024.1648.
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.
A written informed consent was obtained from each patient.
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.
The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.
The authors received no financial support for the research and/or authorship of this article.
The data that support the findings of this study are available from the corresponding author upon reasonable request.