Comparing the Effects of Dry Needling and Radial Shock Wave Therapy on Pain, Disability and Grip Strength of Patients With Tennis Elbow

Tennis elbow involves the lateral part of the elbow that seriously impairs upper extremity function. Recently, radial shock wave therapy (RSWT) and dry needling (DN) have been proposed for the treatment of various tendinopathies. This study aims to compare the effects of DN and RSWT on the pain, disability and grip strength of patients with tennis elbow.

 In this pilot study, 12 patients with tennis elbow aged 30-50 years participated. They were randomly divided into two groups: RSWT (n= 6; three sessions per week; 1.5-Bar, 10-Hz, 2000 shock waves) and DN (n=6; five sessions). To assess the pain level, we used the visual analog scale (VAS) and pressure pain threshold (PPT). To assess functional disability, the quick disabilities of the arm, shoulder and hand (Quick DASH) questionnaire was used. We also measured the hand grip strength. All outcome measures were assessed before, immediately after and four weeks after the intervention.

In the RSWT group, the pain (VAS score) and disability (grip) in the follow-up phase showed a significant decrease compared to the pre-test phase (P<0.05), while the post-test scores showed no significant decrease compared to pre-test scores (P˃0.05). The score of quick DASH significantly decreased in the post-test and follow-up phases compared to the pre-test phase (P<0.05). In the DN group, the pain significantly decreased in the follow-up phase compared to the pre-test phase (P<0.05) and the disability significantly decreased in the post-test and follow-up phases compared to the pre-test phase (P<0.05). No significant difference in the quick DASH score was found among different time points (P>0.05). The mean PPT scores of the first and second trigger points and the PPT for the average of the first and second trigger points were not significantly different among different time points in any group (P>0.05). Moreover, none of the study variables were significantly different between the two treatment groups in the post-test and follow-up phases (P>0.05).

 Both DN and RSWT can reduce pain and improve the hand grip strength of patients with tennis elbow. Their effects on pain reduction were maintained four weeks after the intervention. The RSWT can reduce the Quick DASH score. There is no significant difference between their effects on pain, grip strength, and Quick DASH score. Therefore, both DN and RSWT have a therapeutic potential in treating tennis elbow.