Extracorporeal shockwave therapy versus steroid injection in treatment of tennis elbow

BackgroundTennis elbow is a tendinosis with angiofibroblastic degeneration of the wrist extensors' origin with extensor carpi radialis brevis; the tendinous origin is the main part to be affected 2 cm distal to lateral epicondyle.ObjectivesTo compare the short-term effects of extracorporeal shockwave therapy (ESWT) versus corticosteroid injection (CI) in patients with chronic tennis elbow who failed previous conservative treatment using the patient-related tennis elbow evaluation system.Patients and methodsThis prospective study was performed at the Orthopedic Surgery Department and Rheumatology and Rehabilitation Department of Menoufia University Hospitals and Talkha Central Hospital. The study included patients diagnosed with tennis elbow who failed conservative treatment. The patients showed positive clinical history and positive clinical examination, demonstrating tennis elbow.ResultsThe success rate in the ESWT group at 3-month follow-up was 89.7% and at 6-month follow-up was 93.1%. The ESWT group had a 0% recurrence rate, where the patient experienced improvement during the 3-month follow-up followed by reappearance of the symptoms. The success rate in the CI group at 3-month follow-up was 89.3% and at 6-month follow-up was 75.0%. The CI group had a 25% recurrence rate, where the patients experienced improvement during the 3-month follow-up followed by reappearance of the symptoms.ConclusionOur results propose that although ESWT and CI were effective in the treatment of chronic lateral epicondylitis at 12 weeks of follow-up, ESWT was superior to CI owing to its effect on pain and improving function at short-term and long-term follow-up.