Case Report: Application of extracorporeal shockwave therapy in medial epicondylitis with concomitant ulnar nerve instability: a case series with long-term follow-up.

The study included only three patients, making it impossible to generalize findings or determine which patient characteristics predict success. The design was retrospective with no control group, so improvements cannot be attributed solely to ESWT rather than natural history or other factors. One patient dropped out early due to lack of benefit, which complicates the interpretation of overall efficacy.

The research was funded by the University of Pisa. No commercial conflicts of interest were declared.

Do not assume ESWT will work for all patients with this condition. One patient had no response at all, and the small sample size means we cannot identify who will benefit. Treat this as preliminary evidence requiring careful patient selection and monitoring.