A comparison of effectivenesses of rswt with two different energy densities in the treatment of chronic lateral epicondylitis

Objective:The aim of this study was to compare effectivenesses of RSWT with two different energy densities in the treatment of chronic lateral epicondylitis. Material and method:The study included 48 patients with lateral epicondylitis non-responsive to conservative treatment and persisting for at least 6 months. Patients were randomly divided into three groups which consist of 16 persons. Three sessions of treatment was applied at weekly intervals with BTL 6000 SWT topline equipment. RSWT with two different energy levels was applied group 1 and 2, while grup 3 received plasebo therapy. 0.11 mJ/mm2 RSWT (2000 shock waves at 2 bars of air pressure and frequency of 5-10 Hz) was applied group1 and 0.21 mJ/mm2 RSWT (2000 shock waves at 4 bars of air pressure and frequency of 5-10 Hz) was applied grup 2. The patients were evaluated before the treatment and 3, 6 and 12 weeks after the treatment using Visual Analog Scale (VAS) for subjective pain intensity, algometer for pain threshold, dynamometer for grip strength (pain free and maximum grip strength), DASH and PRTEE questionnaires for functionality. Results: There was no statistically significant difference in demographic evaluations between groups before treatment. While significant clinical improvement based on all parameters was observed 3, 6 and 12 weeks after the treatment in group 1 and 2, no statistically significant improvement was observed in group 3. Although the improvement in VAS, PRTEE and maximum grip strength was greater in the group 2 compared to the group 1, statistical analyses showed no significant difference between the groups after 3, 6 and 12 weeks follow-up. In evaluation of pain threshold, pain free grip strength and DASH statistically significant more improvement was found in group 2 comparing to group 1. Conclusion: According to these study results we concluded that, RSWT with energy level of 0.21 mJ/mm² appears to be more effective than RSWT with energy level of 0.11 mJ/mm² in pain relief, increasing grip strength and functional improvement in chronic lateral epicondylitis.