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Comparison of ESWT and Single-Session 5% Dextrose Prolotherapy in Lateral Epicondylitis

27. maj 2026 opdateret af: Merve Örücü Atar, Gaziler Physical Medicine and Rehabilitation Education and Research Hospital

Comparison of the Effectiveness of Extracorporeal Shock Wave Therapy and 5% Dextrose Prolotherapy in Patients With Lateral Epicondylitis: A Prospective Randomized Controlled Trial

Lateral epicondylitis is a common musculoskeletal disorder associated with pain and impaired upper extremity function. The aim of this study was to compare the effectiveness of extracorporeal shock wave therapy (ESWT) and single-session 5% dextrose prolotherapy (DPT) in patients with lateral epicondylitis and to evaluate the relative superiority of these treatment approaches during short- and mid-to-long-term follow-up. Ninety-six patients were allocated into three groups: conventional treatment alone, conventional treatment plus ESWT, and conventional treatment plus DPT. Pain, functional status, grip strength, and common extensor tendon thickness were evaluated during follow-up.

Studieoversigt

Status

Afsluttet

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

Lateral epicondylitis is a common musculoskeletal disorder associated with pain, reduced grip strength, and impaired upper extremity function. This study aimed to compare the effectiveness of extracorporeal shock wave therapy (ESWT) and single-session 5% dextrose prolotherapy (DPT) in patients with lateral epicondylitis and to evaluate their relative effectiveness during short- and mid-to-long-term follow-up.

Ninety-six patients were allocated into three groups: conventional treatment alone, conventional treatment plus ESWT, and conventional treatment plus DPT. Conventional treatment consisted of home exercise and splinting. ESWT was applied in 3 sessions (2000 pulses, 0.15 mJ/mm²), while the DPT group received a single ultrasound-guided 5% dextrose injection.

Primary outcomes included Visual Analog Scale pain scores for rest, night pain, resisted wrist extension, and grip pain. Secondary outcomes included QuickDASH, PRTEE, grip strength measured with a Jamar dynamometer, and ultrasonographic assessment of common extensor tendon thickness. Clinical assessments were performed at baseline, 1, 3, and 6 months.

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

96

Fase

  • Ikke anvendelig

Kontakter og lokationer

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Studiesteder

  • Tyrkiet (Türkiye)
    • Cankaya
      • Ankara, Cankaya, Tyrkiet (Türkiye)
        • SBU Ankara Physical Medicine and Rehabilitation Training and Research Hospital Ankara, Turkey

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ingen

Beskrivelse

Inclusion Criteria:

  • Adults aged 18-75 years
  • Clinical and ultrasonographic diagnosis of lateral epicondylitis
  • Symptoms persisting for at least 3 months
  • Visual Analog Scale (VAS) score ≥4
  • Resistance to previous medical treatment
  • Ability to comply with study procedures and complete questionnaires

Exclusion Criteria:

  • Injection treatment for lateral epicondylitis within the previous 3 months
  • History of trauma within the previous 3 months
  • Cervical disc herniation
  • Median or ulnar tunnel neuropathy
  • Medial epicondylitis
  • Anticoagulant therapy use
  • Pregnancy or breastfeeding
  • Psychiatric disorders or cognitive impairment interfering with questionnaire -completion
  • Allergy to the treatment solution
  • History of upper extremity surgery or fracture
  • Rheumatoid arthritis
  • Connective tissue diseases such as dermatomyositis

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Aktiv komparator: Conventional Treatment + ESWT
Three treatment sessions administered at weekly intervals using 2000 pulses per session at an energy flux density of 0.15 mJ/mm².
Adfærdsmæssigt: Conventional Treatment group
Splinting and home exercise program
Enhed: Extracorporeal Shock Wave Therapy (ESWT)
3 sessions, weekly, 4Hz, 2000 pulses/session, 0.15 mJ/mm².
Aktiv komparator: Conventional Treatment + Dextrose Prolotherapy
Single-session ultrasound-guided injection of 1 mL 5% dextrose.
Adfærdsmæssigt: Conventional Treatment group
Splinting and home exercise program
Procedure: Dextrose prolotherapy (DPT)
Single-session ultrasound-guided 1 mL 5% dextrose injection.
Aktiv komparator: Conventional Treatment
Splinting and home exercise program.
Adfærdsmæssigt: Conventional Treatment group
Splinting and home exercise program

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
VAS Resisted Wrist Extension Pain
Tidsramme: Baseline, 1 month, 3 months, and 6 months after treatment
Pain during resisted wrist extension assessed using the Visual Analog Scale (VAS).
Baseline, 1 month, 3 months, and 6 months after treatment
VAS Gripping Pain
Tidsramme: Baseline, 1 month, 3 months, and 6 months after treatment
Pain intensity during gripping assessed using the Visual Analog Scale (VAS).
Baseline, 1 month, 3 months, and 6 months after treatment
VAS Resting Pain
Tidsramme: Baseline, 1 month, 3 months, and 6 months after treatment
Resting pain assessed using the Visual Analog Scale (VAS).
Baseline, 1 month, 3 months, and 6 months after treatment
VAS Night Pain
Tidsramme: Baseline, 1 month, 3 months, and 6 months after treatment
Night pain assessed using the Visual Analog Scale (VAS).
Baseline, 1 month, 3 months, and 6 months after treatment

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Quick-DASH Score
Tidsramme: Baseline, 1 month, 3 months, and 6 months after treatment
Functional disability assessed using the Quick Disabilities of the Arm, Shoulder and Hand questionnaire. The QuickDASH score ranges from 0 to 100, where 0 indicates no symptoms and normal upper extremity function, while 100 indicates the highest symptom severity and the poorest functional status.
Baseline, 1 month, 3 months, and 6 months after treatment
PRTEE Score
Tidsramme: Baseline, 1 month, 3 months, and 6 months after treatment
Functional outcome assessed using the Patient-Rated Tennis Elbow Evaluation questionnaire. The PRTEE consists of 15 items divided into two subscales: pain (5 items) and function (10 items). The total score ranges from 0 to 100, with 0 indicating no pain and normal function, and 100 indicating the highest pain severity and the poorest functional status. Higher scores reflect greater pain intensity and functional impairment.
Baseline, 1 month, 3 months, and 6 months after treatment
Grip Strength
Tidsramme: Baseline and 6 months
Grip strength measured using a Jamar dynamometer.
Baseline and 6 months
Common Extensor Tendon Thickness
Tidsramme: Baseline and 6 months
Ultrasonographic measurement of common extensor tendon thickness.
Baseline and 6 months

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Gaziler Physical Medicine and Rehabilitation Education and Research Hospital

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

1. oktober 2023

Primær færdiggørelse (Faktiske)

29. august 2025

Studieafslutning (Faktiske)

29. august 2025

Datoer for studieregistrering

Først indsendt

27. maj 2026

Først indsendt, der opfyldte QC-kriterier

27. maj 2026

Først opslået (Faktiske)

2. juni 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

2. juni 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

27. maj 2026

Sidst verificeret

1. maj 2026

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • E1-23-4037

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

INGEN

IPD-planbeskrivelse

Individual participant data will not be publicly shared due to institutional and ethical restrictions regarding patient confidentiality.

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