The comparison of corticosteroid injection with laser, PRP, splinting and ESWT in patients with lateral epicondylitis

One of the most important reason of elbow pain is the lateral epicondylitis but still there is no consensus for the effective treatment method from many treatment modailities. In this study we try to make comparison between Laser, Platelet Rich Plasma (PRP), Splinting, Extracorporeal Shock Wave Therapy (ESWT) and Corticosteroid (CS) injection. In this study 70 female (%71,4) and 28 male (%28,6) patient with lateral epicondylitis are accepted. Patients are divided groups by computer program randomly. Laser was applied to 20 patient by 850 nm wavelength, for 40 second, 3,6 joule intensity and once in a day during 10 days. PRP injection was applied to 17 patients on lateral epicondylitis side 3 times by 15 days periods. Splinting was applied to 19 patients with lateral epicondylitis bandage for 3 months everyday during day. ESWT treatment was applied to 22 patients by 1,9 bar, 10 Hz, 2000 beats on lateral epicondyle 3 times by 7 days period. CS injection applied to 20 patients by 22G injector 1 ml betamethasone on lateral epicondyle side of pain in once. Participant's Handgrip Strength Test (HGS), Visual Analogue Scale (VAS), Patient Rated Tennis Elbow Evaluation (PRTEE) and The Disabilities of the Arm, Shoulder and Hand (DASH) scales questionnaire was done 3 times first right before the begining of the treatment, second after 1 month of treatment and third on the third month of the treatmet. In the study groups there was no demograpic differences. In all group's 1st and 3rd month treatment VAS, PRTEE and DASH scales was improved but there was not significant differences. When we evaluate HGS while in PRP groups on 1st and 3rd months there was not improvement but in Laser, Splinting, ESWT and CS groups there was significant improvement. But in the healing groups there was not significant difference. As conclusion all of these treatment modalities are effetive in the treatment of lateral epicondylitis. Together with that, our suggestion is instead of choosing such an invasive method PRP and CS injection, should be chosen Splinting, Laser and ESWT as a noninvasive method prior to invasive methods.