Extracorporeal shock wave therapy (ESWT) versus local corticosteroid injection in treatment of lateral epicondylitis (tennis elbow) in athletes: clinical and ultrasonographic evaluation

Abstract Background 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. The purpose of this work was to compare the efficiency of extracorporeal shock wave therapy and local corticoi...

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Autores principales:	Noha Hosni Ibrahim, Refaat Mostafa El Tanawy, Amal Fathy Soliman Mostafa, Mayada Fawzy Mahmoud
Formato:	article
Lenguaje:	EN
Publicado:	SpringerOpen 2021
Materias:	Lateral epicondylitis Corticosteroids injection Shock wave therapy Diseases of the musculoskeletal system RC925-935
Acceso en línea:	https://doaj.org/article/c0ca3bacfd3647b3907dbf7efab7b6b1
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spelling	oai:doaj.org-article:c0ca3bacfd3647b3907dbf7efab7b6b12021-11-07T12:18:03ZExtracorporeal shock wave therapy (ESWT) versus local corticosteroid injection in treatment of lateral epicondylitis (tennis elbow) in athletes: clinical and ultrasonographic evaluation10.1186/s43166-021-00081-21110-161X2090-3235https://doaj.org/article/c0ca3bacfd3647b3907dbf7efab7b6b12021-11-01T00:00:00Zhttps://doi.org/10.1186/s43166-021-00081-2https://doaj.org/toc/1110-161Xhttps://doaj.org/toc/2090-3235Abstract Background 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. 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. Results Both 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. Conclusions Both 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.Noha Hosni IbrahimRefaat Mostafa El TanawyAmal Fathy Soliman MostafaMayada Fawzy MahmoudSpringerOpenarticleLateral epicondylitisCorticosteroids injectionShock wave therapyDiseases of the musculoskeletal systemRC925-935ENEgyptian Rheumatology and Rehabilitation, Vol 48, Iss 1, Pp 1-14 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Lateral epicondylitis Corticosteroids injection Shock wave therapy Diseases of the musculoskeletal system RC925-935
spellingShingle	Lateral epicondylitis Corticosteroids injection Shock wave therapy Diseases of the musculoskeletal system RC925-935 Noha Hosni Ibrahim Refaat Mostafa El Tanawy Amal Fathy Soliman Mostafa Mayada Fawzy Mahmoud Extracorporeal shock wave therapy (ESWT) versus local corticosteroid injection in treatment of lateral epicondylitis (tennis elbow) in athletes: clinical and ultrasonographic evaluation
description	Abstract Background 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. 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. Results Both 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. Conclusions Both 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.
format	article
author	Noha Hosni Ibrahim Refaat Mostafa El Tanawy Amal Fathy Soliman Mostafa Mayada Fawzy Mahmoud
author_facet	Noha Hosni Ibrahim Refaat Mostafa El Tanawy Amal Fathy Soliman Mostafa Mayada Fawzy Mahmoud
author_sort	Noha Hosni Ibrahim
title	Extracorporeal shock wave therapy (ESWT) versus local corticosteroid injection in treatment of lateral epicondylitis (tennis elbow) in athletes: clinical and ultrasonographic evaluation
title_short	Extracorporeal shock wave therapy (ESWT) versus local corticosteroid injection in treatment of lateral epicondylitis (tennis elbow) in athletes: clinical and ultrasonographic evaluation
title_full	Extracorporeal shock wave therapy (ESWT) versus local corticosteroid injection in treatment of lateral epicondylitis (tennis elbow) in athletes: clinical and ultrasonographic evaluation
title_fullStr	Extracorporeal shock wave therapy (ESWT) versus local corticosteroid injection in treatment of lateral epicondylitis (tennis elbow) in athletes: clinical and ultrasonographic evaluation
title_full_unstemmed	Extracorporeal shock wave therapy (ESWT) versus local corticosteroid injection in treatment of lateral epicondylitis (tennis elbow) in athletes: clinical and ultrasonographic evaluation
title_sort	extracorporeal shock wave therapy (eswt) versus local corticosteroid injection in treatment of lateral epicondylitis (tennis elbow) in athletes: clinical and ultrasonographic evaluation
publisher	SpringerOpen
publishDate	2021
url	https://doaj.org/article/c0ca3bacfd3647b3907dbf7efab7b6b1
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Extracorporeal shock wave therapy (ESWT) versus local corticosteroid injection in treatment of lateral epicondylitis (tennis elbow) in athletes: clinical and ultrasonographic evaluation

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