Short-term effects of extracorporeal shockwave therapy and low-level laser therapy on clinical outcomes and ultrasonographic tendon thickness in lateral elbow tendinopathy

Background This study aimed to compare the short-term effects of extracorporeal shock wave therapy (ESWT) and low-level laser therapy (LLLT) on pain, elbow function, health-related quality of life, hand grip strength, and ultrasonographic extensor tendon thickness in patients with LET. Objective In this prospective, randomized, controlled, single-blind trial, patients with LET were randomly assigned to either ESWT or LLLT. Both groups received the same standardized home exercise program and lateral epicondylitis brace. Visual Analog Scale (VAS), the Patient-Rated Tennis Elbow Evaluation (PRTEE), Short Form-36 (SF-36), hand grip strength, and ultrasonographic evaluation were assessed before and after three weeks of randomisation. Results At three weeks, the ESWT group demonstrated significantly lower post-treatment pain intensity (VAS) than the LLLT group (p = 0.004). ESWT was also associated with significantly better outcomes in PRTEE pain scores (p = 0.030), ultrasonographic tendon thickness (p = 0.021), and the Role Physical (p = 0.029) and General Health (p = 0.005) domains of the SF-36. No significant between-group differences were observed in hand grip strength, PRTEE function, PRTEE total score, or the remaining SF-36 domains. Conclusion When used as adjuncts to a standardized exercise program and LET brace, ESWT was associated with greater short-term pain reduction and more favorable outcomes in the PRTEE pain subscale, ultrasonographic tendon thickness, and selected domains of health-related quality of life compared with LLLT. These findings suggest that ESWT may offer greater short-term pain-related benefits than LLLT when both are added to exercise and bracing.