ESWT vs HILT in Chronic Lateral Epicondylitis (ESWT vs HILT)

Effectiveness of Shockwave Therapy Versus High-Power Laser Therapy in the Management of Chronic Lateral Epicondylitis: A Double-Blind Randomized Controlled Trial

This randomized controlled trial aims to compare the effectiveness of Extracorporeal Shock Wave Therapy (ESWT) and High-Intensity Laser Therapy (HILT) in patients with chronic lateral epicondylitis.

Study Overview

• Status: Not yet recruiting
• Conditions: Chronic Lateral Epicondylitis
• Intervention / Treatment: Other: Conventional Physical Therapy; Device: Extracorporeal shock wave therapy; Device: High-power intinsty laser

Detailed Description

Participants will be randomly assigned into three groups receiving either conventional physiotherapy alone, ESWT plus conventional physiotherapy, or HILT plus conventional physiotherapy. Clinical assessments will be performed before and after treatment

• Study Type: Interventional
• Enrollment (Estimated): 72
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: mohammed ALI alghamdi; Phone Number: =966538500550; Email: pt.mohammedhajar@gmail.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• • Age 40-50 years.

  • Clinically diagnosed chronic lateral epicondylitis.
  • Symptoms lasting more than 3 months.
  • Positive clinical provocation tests.
  • Localized tenderness over the lateral epicondyle.

Exclusion Criteria:

• • Previous elbow surgery.

  • Corticosteroid injection within the last 6 months.
  • Cervical radiculopathy.
  • Peripheral nerve entrapment.
  • Rheumatologic or systemic inflammatory disorders.
  • Elbow fracture.
  • Severe elbow instability

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Group A; Conventional Physical Therapy	Other: Conventional Physical Therapy; The conventional program will include TENS for twenty minutes in elbow region; the use of pulse ultrasound with duty cycle 80% on the lateral epicondyle for five minutes with an intensity of 0.8 W per every cm'; the use of ice for ten minutes; training for correcting the daily activities to minimize pressure on the elbow (preferentially, holding, lifting and pressing the objects will be asked to be carried out in supination); and, stretch and strain wrist muscle strengthening exercises (Fekri et al., 2019). The exercise therapy method involved six elbow joint exercises. They are a total of six exercises (Fig. 2) for patients with tennis elbow. Each exercise will be performed three times a day, with each session involving five repetitions of the movement, over four weeks, gradually increasing weight until the movement is effective but below the pain threshold. Painful movements will be avoided, and exercises causing pain or discomfort will be discontinued following consultation from a p
Active Comparator: Group B; ESWT + Conventional Physical Therapy	Other: Conventional Physical Therapy; The conventional program will include TENS for twenty minutes in elbow region; the use of pulse ultrasound with duty cycle 80% on the lateral epicondyle for five minutes with an intensity of 0.8 W per every cm'; the use of ice for ten minutes; training for correcting the daily activities to minimize pressure on the elbow (preferentially, holding, lifting and pressing the objects will be asked to be carried out in supination); and, stretch and strain wrist muscle strengthening exercises (Fekri et al., 2019). The exercise therapy method involved six elbow joint exercises. They are a total of six exercises (Fig. 2) for patients with tennis elbow. Each exercise will be performed three times a day, with each session involving five repetitions of the movement, over four weeks, gradually increasing weight until the movement is effective but below the pain threshold. Painful movements will be avoided, and exercises causing pain or discomfort will be discontinued following consultation from a p; Device: Extracorporeal shock wave therapy; The Group will receive ESWT plus conventional physiotherapy treatment program. Regarding ESWT protocol, the group will receive 1,000, 1,500, and 2,000 pulses during the first, second, and third through fifth treatments, respectively (pressure, 2.5 bar; frequency, 8 Hz; energy density, 0.4 mJ/mm2). The patients received 5 ESWT treatments once per week. The treatments were performed using a Rosetta ESWT (CR Technology, Korea). Ultrasound gel was applied between the apparatus head and skin. The procedure was performed in the area with the most intense pain. Treatment was administered at the anterior aspect of the LE and three points around it at a radius of 1.5-2 cm. The treatment time did not exceed 10 minutes. During the treatments, the patients did not receive any drugs (Lizis, 2015).
Active Comparator: Group C: HILT + Conventional Physical Therapy	Other: Conventional Physical Therapy; The conventional program will include TENS for twenty minutes in elbow region; the use of pulse ultrasound with duty cycle 80% on the lateral epicondyle for five minutes with an intensity of 0.8 W per every cm'; the use of ice for ten minutes; training for correcting the daily activities to minimize pressure on the elbow (preferentially, holding, lifting and pressing the objects will be asked to be carried out in supination); and, stretch and strain wrist muscle strengthening exercises (Fekri et al., 2019). The exercise therapy method involved six elbow joint exercises. They are a total of six exercises (Fig. 2) for patients with tennis elbow. Each exercise will be performed three times a day, with each session involving five repetitions of the movement, over four weeks, gradually increasing weight until the movement is effective but below the pain threshold. Painful movements will be avoided, and exercises causing pain or discomfort will be discontinued following consultation from a p; Device: High-power intinsty laser; The Group will receive HILT plus conventional physiotherapy treatment program. High-power laser used in the present research paper was MLS Laser, Model M6 (ASA), that will be included in class four lasers device, with maximum 25-Watt power, average power of 3.3 Watts, wavelength of 808 nm in a continuous state. The target region diameter in this device will be 5 cm and the energy used for treating the patients will be 272.4 Jules, and the energy density will be 13.89 Jules per cm' with a 700-hertz frequency for a period of three minutes on the lateral epicondyle and the origin of the wrist's extensor muscles (Fekri et al., 2019).

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
1. Pain intensity measured using Visual Analogue Scale (VAS).	at baseline 4 weeks and 8 weeks
2. Grip strength measured using Hand Dynamometer.	at baseline 4 weeks and 8 weeks
3. Upper limb disability measured using QuickDASH Questionnaire.	at baseline 4 weeks and 8 weeks

Secondary Outcome Measures

Outcome Measure	Time Frame
1. Pressure Pain Threshold using Algometer.	at baseline 4 weeks and 8 weeks
2. Pinch Strength Measurement.	at baseline 4 weeks and 8 weeks
3. Elbow Range of Motion (ROM).	at baseline 4 weeks and 8 weeks
4. Oxford Elbow Score (OES).	at baseline 4 weeks and 8 weeks

Collaborators and Investigators

• Sponsor: Kafrelsheikh University
• Investigators: Study Chair: MAHMOUD MOHAMMED EWIDA, PHD, Professor of Basic Sciences for Physical Therapy Department of Basic Sciences for Physical Therapy Faculty of Physical Therapy Kafrelsheikh University; Study Director: MOHAMMED FATHY ABDEL-GALIL, Lecturer of Basic Sciences for Physical Therapy Department of Basic Sciences for Physical Therapy Faculty of Physical Therapy Kafrelsheikh University; Study Director: HOSSAM MOHAMMED GAD, PHD, Professor of Orthopaedic Surgery Department of Orthopaedic Surgery Faculty of medicine Kafrelsheikh University

Study record dates

Study Major Dates

• Study Start (Estimated): August 1, 2026
• Primary Completion (Estimated): October 30, 2026
• Study Completion (Estimated): April 1, 2027

Study Registration Dates

• First Submitted: June 12, 2026
• First Submitted That Met QC Criteria: June 12, 2026
• First Posted (Actual): June 17, 2026

Study Record Updates

• Last Update Posted (Actual): June 17, 2026
• Last Update Submitted That Met QC Criteria: June 12, 2026
• Last Verified: June 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Therapeutics; Physical Therapy Modalities; Rehabilitation; Ultrasonic Therapy; Diathermy; Hyperthermia, Induced; Extracorporeal Shockwave Therapy
• Other Study ID Numbers: KFSIRB200-1048

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No