الفهرس 
Anatomy of Elbow JointOnly 14 pages are availabe for public view
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Abstract
Background: Lateral epicondylitis (LE), is a common overuse syndrome affecting the extensor tendons of the forearm. Corticosteroid (CS) injection is the most common intervention for treatment of LE. Extracorporeal shockwave therapy (ESWT) is a noninvasive modality stimulating the neovascularization process, tendon healing and pain relief.
Objectives: to compare the effectiveness of ESWT versus local corticosteroid injection versus conventional physiotherapy (PT) in the treatment of chronic LE.
Methods: Forty-five elbows of 45 patients with LE for at least 3 months were randomly divided into three groups: group I received corticosteroid injection, group II received ESWT sessions, and group III received conventional physiotherapy sessions. Visual Analogue Scale (VAS) was used to asses pain intensity, patient-rated tennis elbow evaluation (PRTEE) questionnaire for pain and functional assessment, and a hand dynamometer for hand grip strength (HGS). All patients were evaluated before treatment, at 4 and 12 weeks after treatment.
Results: Our results revealed that the three groups showed a highly significant VAS score reduction, PRTEE score reduction and increasing grip strength compared to baseline (P <0.01) at 4 weeks and 12 weeks after treatment. However, there was a highly significant VAS score reduction in ESWT and CS groups more than PT group at 4 weeks after treatment (P <0.01) while ESWT group showed a highly significant improvement regarding functional score (PRTEE score reduction) more than CS and PT groups at 4 and 12 weeks of follow up (P <0.01), with no significant difference in HGS among the three groups.
Conclusion: ESWT, local corticosteroid injection and conventional physiotherapy were effective in treatment of chronic LE during 12 weeks of follow-up but ESWT had a better effect on pain intensity and functional disability in daily life activity at short and loge term follow up