Comparing the efficacy of extracorporeal shock wave therapy, ultrasound and phonophoresis treatments in lateral epicondylitis: A randomized controlled trial

Objective: The aim of this study; to determine the effectiveness of ESWT, ultrasound and phonophoresis treatments on pain, grip strength, functionality and quality of life in patients with lateral epicondylitis and to determine the superiority of the treatments to each other. Materials and Methods: A total of 68 patients (40 women and 28 men) who had elbow pain for at least 4 weeks and were diagnosed with lateral epicondylitis were included in the study. The patients were randomized into 4 groups of 17 each. Stretching and eccentric strengthening exercises were given to all groups as a home program. In addition to the home exercises, ESWT was applied to the 1st group, phonophoresis to the 2nd group, and ultrasound therapy to the 3rd group. The 4th group was determined as the control group. Evaluations were made at before treatment, after treatment and at 1st month after treatment in ESWT, ultrasound and phonophoresis groups, and before treatment and 1st month in the control group. In all groups, pain severity were measured by VAS (Visual Analog Scale), limitations in activities by Roles and Maudsley Score, functionality by Patient-Rated Tennıs Elbow Evaluatıon (PRTEE), disability by Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH), quality of life by Healt Assessment Questionnaire (HAQ) and maximum grip strength by hand dynamometer. Results: Significant improvement in pain severity, functionality, disability, grip strength and quality of life was observed in the 1st month in the groups treated with ESWT, ultrasound and phonophoresis. When the efficacy of these treatments after treatment and at the 1st month were compared, no significant difference was found. Compared with the control group, the improvement in pain and functional status was significant in all three groups. It was observed that the improvement in maximum grip strength in the ESWT group, and the improvement in disability and quality of life in the ultrasound group were significant compared to the control group. Keywords: Lateral epicondylitis, extracorporeal shock wave therapy, ultrasound, phonophoresis