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

27. mai 2026 oppdatert av: 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.

Studieoversikt

Status

Fullført

Forhold

Intervensjon / Behandling

Detaljert 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.

Studietype

Intervensjonell

Registrering (Faktiske)

96

Fase

  • Ikke aktuelt

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiesteder

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

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

  • Voksen
  • Eldre voksen

Tar imot friske frivillige

Nei

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

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Ingen (Open Label)

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / 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.
Atferdsmessig: Conventional Treatment group
Splinting and home exercise program
Enhet: 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.
Atferdsmessig: Conventional Treatment group
Splinting and home exercise program
Fremgangsmåte: Dextrose prolotherapy (DPT)
Single-session ultrasound-guided 1 mL 5% dextrose injection.
Aktiv komparator: Conventional Treatment
Splinting and home exercise program.
Atferdsmessig: Conventional Treatment group
Splinting and home exercise program

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
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
Tiltaksbeskrivelse
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

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

Gaziler Physical Medicine and Rehabilitation Education and Research Hospital

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Faktiske)

1. oktober 2023

Primær fullføring (Faktiske)

29. august 2025

Studiet fullført (Faktiske)

29. august 2025

Datoer for studieregistrering

Først innsendt

27. mai 2026

Først innsendt som oppfylte QC-kriteriene

27. mai 2026

Først lagt ut (Faktiske)

2. juni 2026

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

2. juni 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

27. mai 2026

Sist bekreftet

1. mai 2026

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • E1-23-4037

Plan for individuelle deltakerdata (IPD)

Planlegger du å dele individuelle deltakerdata (IPD)?

NEI

IPD-planbeskrivelse

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

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Nei

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

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