Prolotherapy vs Radial Extracorporeal Shock Wave Therapy in the Short-term Treatment of Lateral Epicondylosis: A Randomized Clinical Trial

Pain Med. 2019 Sep 1;20(9):1745-1749. doi: 10.1093/pm/pny303.


Objective: The aim of this study was to compare the efficacy of prolotherapy with hypertonic dextrose and radial shock wave therapy in chronic lateral epicondilosis.

Design: Prospective single-blind randomized clinical trial.

Setting: Physical medicine and rehabilitation clinic.

Subjects: Thirty-three patients with at least three months of signs and symptoms of lateral epicondilosis, as well as failure of at least one of the conservative treatments, randomly allocated into two groups.

Methods: Sixteen patients received three sessions of shock wave therapy, and 17 received one session prolotherapy. Severity of pain via visual analog scale (VAS), grip strength via Baseline Pneumatic Dynamometer, pressure pain threshold (PPT) by algometer and Disabilities of Arm, Shoulder, and Hand quick questionnaire (Quick DASH) were assessed at baseline, four weeks, and eight weeks after the intervention.

Results: Within-group analysis showed that in both groups, differences between all of the outcome measures were significant after four and also eight weeks. Between-group analysis after four and eight weeks showed that the VAS and Quick DASH had significantly more improvement in the shock wave group. However, the two groups were similar regarding grip strength and PPT. No complication was observed in the two groups.

Conclusions: Based on the results of this study, a regiment of three sessions (weekly) of radial extracorporeal shock wave therapy is significantly more effective than one session of prolotherapy with 20% dextrose regarding pain and function in the management of chronic lateral epicondylosis in short-term follow-up.

Keywords: Extracorporeal Shock Wave Therapy; Lateral Epicondilosis; Prolotherapy; Tennis Elbow.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Extracorporeal Shockwave Therapy / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prolotherapy / methods*
  • Prospective Studies
  • Single-Blind Method
  • Tennis Elbow / therapy*
  • Treatment Outcome
  • Young Adult