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Clinical and Sonographic Evaluation of the Effectiveness of ESWT

April 8, 2025

2 min read

Roy Nissim

Clinical and Sonographic Evaluation of the Effectiveness of ESWT

Clinical and Sonographic Evaluation of the Effectiveness of Extracorporeal Shock Wave Therapy in Patients with Lateral Epicondylitis

Sadiye Murat, Bilinc Dogruoz Karatekin, Melisa Zengin

Purpose

The aim of this study is to assess the clinical and sonographic outcomes of radial extracorporeal shock wave therapy (rESWT) in patients with lateral epicondylitis (LE).

Methods

Ultrasonographic measurement of common

Forty-two patients with LE for at least 3 months were randomized into two groups:

  • rESWT group: 21 patients received rESWT treatment once per week for 3 weeks (2000 pulses, 10 Hz, 1.8 bar).
  • Sham-rESWT group: 21 patients followed the same schedule, but the device emitted no shocks.

Assessments

Evaluations were conducted before treatment, after treatment, and at one-month follow-up. Metrics included:

  • Hand grip strength
  • Pain pressure threshold
  • Functionality (Patient-Rated Tennis Elbow Evaluation)
  • Common Extensor Tendon (CET) thickness via ultrasound

Results

Baseline: No significant differences between groups.

Post-Treatment & Follow-Up: Both groups improved, but the rESWT group had significantly better outcomes in pain, strength, and CET thickness.

Sonographic Findings: Median CET thickness in the rESWT group decreased by 15%, with no significant change in the control group.

Conclusion

rESWT demonstrates statistically superior results in pain relief and tendon healing in lateral epicondylitis patients when compared to placebo treatment.

Study Snapshot

Condition Studied: Lateral Epicondylitis (Tennis Elbow)

Participants

42 total, all diagnosed with LE for over 3 months.

  • 21 in rESWT group
  • 21 in sham control group

Treatment Protocol

rESWT: 3 sessions (weekly), 2000 pulses, 10 Hz, 1.8 bar

Evaluation Metrics

  • Pain (VAS)
  • Grip strength
  • Functionality (PRTEE)
  • CET thickness (Ultrasound)

Key Result

15% reduction in CET thickness in rESWT group.

Takeaway

rESWT is a promising non-invasive therapy for improving pain and tendon healing in LE patients.

Flow diagram of the study

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Roy Nissim

Roy Nissim

Dr. Roy Nissim earned his Bachelor of Science in General Biology from The University of Arizona, with minors in Chemistry and Athletic Coaching. He further distinguished himself by earning a Master of Science in Entrepreneurship, graduating Summa Cum Laude. His chiropractic education was completed at Cleveland Chiropractic College in Los Angeles, California, where he was an active member of the Sports Council and graduated Cum Laude. As a board-certified chiropractor and certified practitioner in Active Release Techniques® (ART®) and other advanced soft tissue therapies, Dr. Roy is committed to helping individuals achieve optimal health and peak performance. His personalized treatment plans are tailored to each patient’s activity level, lifestyle, and specific needs. By integrating manual therapy, cutting-edge technology, traditional chiropractic techniques, and exercise rehabilitation, Dr. Roy has successfully treated chronic, acute, and repetitive strain injuries in half the time of conventional therapies. His approach accelerates recovery, enabling patients to return to their daily activities after just a few treatments.

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