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

27 maj 2026 uppdaterad 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.

Studieöversikt

Status

Avslutad

Betingelser

Intervention / Behandling

Detaljerad beskrivning

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.

Studietyp

Interventionell

Inskrivning (Faktisk)

96

Fas

  • Inte tillämpbar

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studieorter

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

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

  • Vuxen
  • Äldre vuxen

Tar emot friska volontärer

Nej

Beskrivning

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

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Behandling
  • Tilldelning: Randomiserad
  • Interventionsmodell: Parallellt uppdrag
  • Maskning: Ingen (Open Label)

Vapen och interventioner

Deltagargrupp / 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.
Beteende: 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.
Beteende: Conventional Treatment group
Splinting and home exercise program
Procedur: Dextrose prolotherapy (DPT)
Single-session ultrasound-guided 1 mL 5% dextrose injection.
Aktiv komparator: Conventional Treatment
Splinting and home exercise program.
Beteende: Conventional Treatment group
Splinting and home exercise program

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
VAS Resisted Wrist Extension Pain
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Quick-DASH Score
Tidsram: 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
Tidsram: 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
Tidsram: Baseline and 6 months
Grip strength measured using a Jamar dynamometer.
Baseline and 6 months
Common Extensor Tendon Thickness
Tidsram: Baseline and 6 months
Ultrasonographic measurement of common extensor tendon thickness.
Baseline and 6 months

Samarbetspartners och utredare

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Sponsor

Gaziler Physical Medicine and Rehabilitation Education and Research Hospital

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Faktisk)

1 oktober 2023

Primärt slutförande (Faktisk)

29 augusti 2025

Avslutad studie (Faktisk)

29 augusti 2025

Studieregistreringsdatum

Först inskickad

27 maj 2026

Först inskickad som uppfyllde QC-kriterierna

27 maj 2026

Första postat (Faktisk)

2 juni 2026

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

2 juni 2026

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

27 maj 2026

Senast verifierad

1 maj 2026

Mer information

Termer relaterade till denna studie

Nyckelord

Ytterligare relevanta MeSH-villkor

Andra studie-ID-nummer

  • E1-23-4037

Plan för individuella deltagardata (IPD)

Planerar du att dela individuella deltagardata (IPD)?

NEJ

IPD-planbeskrivning

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

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