Abstract
BackgroundLateral epicondylitis is one of the commonly noticed disorders of the arm described by agony focused over lateral epicondyle which is the site of wrist extensors origin. The purpose of this work was to compare the efficiency of extracorporeal shock wave therapy and local corticoid injection in management of lateral epicondylitis both clinically and ultrasonographically as well as to assess the role of ultrasound in diagnosis and follow-up of lateral epicondylitis. This study was performed on 30 athletes diagnosed as lateral epicondylitis.ResultsBoth corticosteroid injection and shock wave treatment showed a highly significant effectiveness on pain by visual analog scale (VAS). A highly significant difference between before treatment and after 2 as well as 4 weeks of treatment regarding the functional disability parameters as patient-rated tennis elbow evaluation (PRTEE) and quick disabilities of the arm, shoulder, and hand (DASH) was found. Likewise, a statistically significant improvement in favor of shock wave therapy group after 2 weeks was found, inversely insignificant difference after 8 and 12 weeks regarding to VAS occurred. Both PRTEE and Quick DASH test showed a statistically significant difference among groups through all follow-up period.There was a statistically insignificant difference among the studied groups according to ultrasound (US) changes in the form of focal areas of hypo-echogenicity through follow-up periods. A significant improvement in favor of ESWT group is detected among the studied groups regarding tendon thickening in ultrasonography before treatment and after 2 and 4 weeks. However, the difference was insignificant after 8 and 12 weeks.ConclusionsBoth corticosteroid local injection and shock wave therapy are helpful and effective for lateral epicondylitis treatment. However, a shock wave therapy revealed better improvement on long-term clinical and ultrasonogrphic follow-up than corticosteroid injection. Musculoskeletal ultrasound represents a helpful diagnostic and follow-up tool for lateral epicondylitis.
Highlights
Lateral epicondylitis is one of the commonly noticed disorders of the arm described by agony focused over lateral epicondyle which is the site of wrist extensors origin
In the 1990s, Extracorporeal shock wave therapy (ESWT) developed a prevalent in Germany for soft-tissue ailments, involving petrifying rotator cuff tendonitis, humeral epicondylitis, and plantar fasciitis
There was a statistically insignificant variation between CS injection and ESWT groups concerning to age, gender, weight, height, BMI, dominant hand, laterality of painful hand, and duration of disease (Table 1)
Summary
Lateral epicondylitis is one of the commonly noticed disorders of the arm described by agony focused over lateral epicondyle which is the site of wrist extensors origin. Lateral epicondylitis (LE), known as tennis elbow, is a familiar musculoskeletal disorder that affects 1–3% of the adult populace and 2 and 23% of the operating populace [1] It is presented by tenderness over the lateral epicondyle of the humerus, associated with pain on resisted wrist dorsiflexion [2]. It grows because of tedious motions of the prime and elbow, such as the working, forehand, and backhand changes in tennis and other noise sports. In the 1990s, ESWT developed a prevalent in Germany for soft-tissue ailments, involving petrifying rotator cuff tendonitis, humeral epicondylitis, and plantar fasciitis It is utilized worldwide for musculoskeletal complaints treatment [11]. Corticosteroid suppresses the immune system by controlling the proinflammatory proteins [12]
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