Comparison of the effectiveness of local corticosteroid injection and extracorporeal shock wave therapy in patients with lateral epicondylitis

Background: Extracorporeal shock wave therapy (ESWT) is a nonsurgical treatment for plantar fasciitis (PF) that has had satisfactory clinical outcomes. However, local corticosteroid injection (LCI) is often regarded as first-line treatment of PF, but there have been few studies comparing the 2 methods. Therefore, we compared the effect of ESWT and LCI on patients with PF. Methods: This was a block randomized controlled study comparing 49 patients treated with ESWT and 47 patients treated with LCI from January 2017 to December 2018 who were followed for 6 months. We evaluated the clinical outcomes in the 2 groups, including average pain, first-step pain, plantar fascia thickness, and Foot Function Index, Chinese version of the PF patients. Results: All patients had pain relief and function improvement after treatment, whereas the LCI group did not maintain significant clinical improvement at the 3-month follow-up. The patients in the ESWT group had a significantly better clinical outcome with better duration of improvement than the LCI group. Conclusion: For PF patients, both ESWT and LCI resulted in clinical improvement but EWST provided longer relief than LCI. Level of Evidence: Level II, prospective comparative study.

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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

Egyptian Rheumatology and Rehabilitation ◽

10.1186/s43166-021-00081-2 ◽

2021 ◽

Vol 48 (1) ◽

Author(s):

Noha Hosni Ibrahim ◽

Refaat Mostafa El Tanawy ◽

Amal Fathy Soliman Mostafa ◽

Mayada Fawzy Mahmoud

Keyword(s):

Shock Wave ◽

Tennis Elbow ◽

Corticosteroid Injection ◽

Lateral Epicondylitis ◽

Extracorporeal Shock Wave Therapy ◽

Shock Wave Therapy ◽

Extracorporeal Shock Wave ◽

Significant Difference ◽

Insignificant Difference

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.

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Letter to the editor regarding “A randomized controlled trial: comparing extracorporeal shock wave therapy versus local corticosteroid injection for the treatment of carpal tunnel syndrome”

Medical Oncology ◽

10.1007/s12032-020-01418-1 ◽

2020 ◽

Vol 37 (10) ◽

Author(s):

Cong-Xian Chen ◽

Zeng Zeng

Keyword(s):

Shock Wave ◽

Randomized Controlled Trial ◽

Corticosteroid Injection ◽

Controlled Trial ◽

Extracorporeal Shock Wave Therapy ◽

Shock Wave Therapy ◽

Randomized Controlled ◽

Extracorporeal Shock Wave ◽

Tunnel Syndrome ◽

Local Corticosteroid Injection

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Extracorporale shockwavetherapie bij een calcificatie van het mediale collaterale knieligament: een casus met literatuurnazicht

Tijdschrift voor Geneeskunde ◽

10.47671/tvg.77.21.177 ◽

2021 ◽

Author(s):

L. Cuigniez ◽

P. Pauwels ◽

E. Lorré ◽

C. Roman ◽

L. Vanden Bossche

Keyword(s):

Shock Wave ◽

Medial Collateral Ligament ◽

Conservative Therapy ◽

Corticosteroid Injection ◽

Extracorporeal Shock Wave Therapy ◽

Shock Wave Therapy ◽

Collateral Ligament ◽

Case Presentation ◽

Extracorporeal Shock Wave ◽

Local Corticosteroid Injection

Extracorporeal shock wave therapy as a treatment for medial collateral knee ligament calcification: case presentation and overview of the literature Background Calcification of the medial collateral ligament is an uncommon cause of medial knee pain. In the few case reports that have been written, in multiple cases various conservative treatments have been assessed, often with an unsatisfactory result, leading to the excision of the toothpaste-like calcification. The conservative treatment consists of a short period of ice, analgesics or anti-inflammatory drugs, physiotherapy, a local corticosteroid injection or ultrasound-guided lavage. Case presentation A 40-year-old man with recurring medial knee pain since 2 years was diagnosed with medial collateral ligament calcification of the right knee. The pain was located near the medial epicondyle of the femur. The range of motion was maximal with painful knee flexion and moderate tenderness at the proximal medial collateral ligament. The pain started after a bicycle crash and the diagnosis was made by means of an MRI. Initially, the pain briefly improved after a local corticosteroid injection and physiotherapy, but reoccurred during running. The subsequent physical examination and ultrasound confirmed the diagnosis. The treatment consisted of a combination of physiotherapy and extracorporeal shock wave therapy, performed twice with an interval of 71 days. The follow-up after 5 months revealed that the patient had regained optimal knee function and was pain free at rest and during running. Conclusion Symptomatic medial collateral ligament calcification is a rarely diagnosed condition, mostly treated surgically without adequate conservative therapy. This case report suggests that conservative therapy consisting of physiotherapy and extracorporeal shock wave therapy can be successful in treating medial collateral ligament calcification.

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